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Respiratory Disorders (Expert Forum)
2 1/2 yr child chronic cough, asthma or allergies or neither?
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2 1/2 yr child chronic cough, asthma or allergies or neither?
by kimjj, Dec 16, 2005 12:00AM
My child is 2 1/2 years and has had severe coughing bouts every month for the past 3 months. She goes to ped and gets antibiotics, albuterol and pulmicort. The antibiotics help but the cough has returned 3 x's and I fear will keep returning. The cough disturbs her sleep and rack her body during days. They seem to be mainly dry but occasionally productive. No other symptoms. No fever, good appetite, no wheezing. This has happened once before, last January, so it does seem to be mainly a winter problem. The ped says it is bronchialitis, asthma, allergies, and sinusitis, in that order. The diagnosis seems to be different every time we go. She has prescribed 3 weeks of antibiotics, along with albuterol and pulmicort for a longer time. She wants to send us to an allergist if the cough comes back again. I'm no dr but there's got to be a better solution. My ped really doesn't seem to know what it is, but she said she's not surprised we came back. What is wrong with my daughter and how do I help her? Thanks for any help.
Doctor's Answer
by National Jewish, Dec 23, 2005 12:00AM
, Dec 23, 2005 12:00AM
This is a fairly common problem for children at this age. There are several possible diagnoses that can cause the repeated episodes of coughing. Here are some and ways to evaluate them.
· The most likely cause is a sinus infection. This causes coughing that goes away with antibiotics. A CT of the sinuses is the only way to make the diagnosis. While this is a very safe test, it is not so easy to do on a 2½ year old.
· Bronchiolitis is NOT the cause. It is not repetitive in the way you have described. Usually bronchiolitis causes wheezing with the coughing and really does not respond to antibiotics, as it is a viral infection.
· Asthma is a possible cause. It is usually not an allergic problem in children this age. It is more likely due to viral infections. Therefore it is fairly common in the winter. It also is made worse by sinus infections. Most of the time, but not always, the child wheezes as well as coughs. If the cough is due to asthma, it should respond very well to a short course of oral steroids.
· General allergy does not cause this type of problem in a 2½ year old.
It sounds like your pediatrician is frustrated and seeking help. A good pediatric allergist or pulmonologist should be able to sort this out for you easily.
· The most likely cause is a sinus infection. This causes coughing that goes away with antibiotics. A CT of the sinuses is the only way to make the diagnosis. While this is a very safe test, it is not so easy to do on a 2½ year old.
· Bronchiolitis is NOT the cause. It is not repetitive in the way you have described. Usually bronchiolitis causes wheezing with the coughing and really does not respond to antibiotics, as it is a viral infection.
· Asthma is a possible cause. It is usually not an allergic problem in children this age. It is more likely due to viral infections. Therefore it is fairly common in the winter. It also is made worse by sinus infections. Most of the time, but not always, the child wheezes as well as coughs. If the cough is due to asthma, it should respond very well to a short course of oral steroids.
· General allergy does not cause this type of problem in a 2½ year old.
It sounds like your pediatrician is frustrated and seeking help. A good pediatric allergist or pulmonologist should be able to sort this out for you easily.
Member Comments (2)
by littlevicko, Dec 29, 2005 12:00AM
HI,I KNOW YOU MUST BE FRUSTRATED,LAST YEAR AT THIS TIME MY THEN 9 YEAR OLD DEVELOPED A SEVERE COUGH,DOCTORS KEPT TREATING FOR SINUS INFECTION,COLD,ASTHMA,ALLERGIES YOU NAME IT,SHE WAS ON MEDS EVERY WEEK,COUGHED UP LARGE AMOUNTS OF PLEGM,THIS WENT ON FOR SEVERAL MONTHS,EVEN SENT HER TO A ASTHMA DOCTORS,PUT HER ON STEROIDS(PREDISONE,INHALERS,BREATHING TREATMENTS)NOTHING WORKED,FINALLY I GOT FED UP AND TOOK HER 3 HOURS AWAY TO LEBONHEUR CHILDRENS HOSPITAL,THEY TOOK HER RIGHT IN BECAUSE SHE WAS SO SEVERE AT THE TIME AND THE STEROIDS AND ALL THE MEDS MADE HER BLOOD PRESSURE SKY HIGH WHICH NONE OF THE LOCAL DRS HAD SEEMED TO NOTICE,PREDISONE ALSO MADE HER GAIN WEIGHT,SHE SPENT 2 WEEKS AT THIS HOSPITAL DOING EXSTENSIVE TESTING,GUESS WHAT-SHE DIDNT EVEN HAVE ASTMA,SHE HAD SEVERE SINUS DISEASE,100 PERCENT BLOCKAGE WHICH SHE HAD TO HAVE SURGERY,SHE HAS SEVERE ACID REFLUX WHICH WILL CAUSE A CONTINUOUSE COUGH,AND A INFECTED ESOPHAGUS FROM THE STOMACH ACIDS AND COUGH,PUT THAT ALL TOGETHER AND SHE WAS A VERY SICK LITTLE GIRL SO PLEASE GET A SECOND OPION,DOCTORS THESE DAYS LIKE TO GET YOU IN AND OUT AND JUST TRY TO TREAT THE SYMTOMS,AND IT ISNT GOOD FOR A CHILD TO BE ON ASTMA MEDS IF THEY DONT HAVE ASTMA-HOPE SHE GETS WELL-THANKS
