1 Teething generally occurs between 6 to 24 months of age.  Symptoms of teething include irritability, tender and swollen gums, and the infant wanting to place objects or fingers into the mouth in an attempt to reduce discomfort. Fever, cough, diarrhea, and cold symptoms are not found when a child is teething.
Nocardia infection, also known as nocardiosis, is a rare condition caused by the bacterium Nocardia asteroides. According to the Centers for Disease Control and Prevention, several different types of this condition can occur.
It is at this point that the authors would suspect an early nocardia infection based on the history of poor performance, training in the late summer and early fall, the vague symptoms seen on exam and radiographs, and lack of other causes (obviously there are other clinical causes of poor performance).