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Para-pneumonic effusion in children is often associated with bacterial infections; however, dual viral infections, including respiratory syncytial virus (RSV) and COVID-19, can also lead to severe respiratory complications, as demonstrated in this case. This case report presents the clinical course of a pediatric patient with both RSV and COVID-19 infections, leading to para-pneumonic effusion.  A three-year-old girl with a history of asthma and prior febrile convulsions presented to the Emergency Department with fever, cough, vomiting, and fatigue.

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