In a 1-year-old child with a gradual onset of symptoms, which condition should the neonatal/pediatric specialist suspect?

In a 1-year-old child presenting with a gradual onset of symptoms, respiratory syncytial virus (RSV) is a common consideration. RSV infection typically manifests with mild upper respiratory symptoms initially and then progresses over days to include lower respiratory tract symptoms, such as wheezing and difficulty breathing. This gradual escalation aligns well with the typical clinical course of RSV.

Other conditions have different presentations. For instance, foreign body aspiration usually occurs suddenly, with a child presenting acutely after inhaling an object, often accompanied by specific sounds such as wheezing or stridor. Asthma can mimic this gradual onset but is less common in infants and typically presents with a history of recurrent wheezing. Epiglottitis, while a serious condition leading to airway obstruction, often develops rapidly and presents with severe, acute symptoms such as high fever, drooling, difficulty swallowing, and stridor.

Therefore, when interpreting the gradual onset of symptoms in a young child, RSV stands out as the most likely diagnosis.