2 year old, chronic coughing, mom with questions

[Amy1129]

Long story, hopefully this is the very short version.My 23 month old son has been coughing since 6 months old.He has good days with many OK days, and lots of very bad days, very few of the he's finally healthy days.Seems to be constantly on antibiotics for every kind of chest infection, on pulmicort, albuterol 2x's a day, constant ear infections (tubes, adnoids, and tonsils are scheduled), chronic loose stools.Seen an allergist, he has lots of environmental allergies, did all the mattres covers, rugs are gone, air purifier in.All this to no avail.Chest xray showed streaking in the main bronch tubes (?) perihilar stuff hazy areas, left lobe is alot grayer than the right. SHowed other issues, but cant remember it all.Went to pedi pulmonologist in Boston, scheduled for sweat test on Friday, he doesnt think he has it, but wants to rule out CF.He wants to do CT and bronchoscope next week.Mentioned something about poss. deformed broch tubes, or weak lung walls, or even a cyst compressing his lungs causing this cough.  Does this make any sense to anyone?  Is there a name for this?  Also what are the possibilities he has a verison of pulmonary micobacterial infection?  I would like to ask his pulmonologist but dont wanna look stupid if there is no way he can have this.  
THank you for any info anyone might have
-Amy

[National Jewish]

There are other reasons for children to have recurrent respiratory infections and chronic cough.  One of the most common for a child this age is a chronic sinus infection or inflammation.  A CT scan of the sinuses may help.  This is not an easy test in a 2 year old, because the child has to lie quietly during the test, not because the test hurts.  Other not so common reasons are an immune problem leading to many infections or a chronic infection, such as you have suggested.  I would see the pediatric pulmonologist, but absolutely consider the diagnosis of chronic sinusitis as being the cause of these problems.

[poolnoni]

First...NO QUESTION IS STUPID and even more so when it comes to your own health or your loved ones health. If the doctor appears to think it is a stupid question, change doctors...you don't need him/her. Mycobacterial infection is around more then people know and lots of times misdiagnosed for a long time. Some doctors do not know that much about it so they are incline to dismiss it. Ask the question.If the doctors does cultures from the bronch this should tell if he has myco infection. Good luck

[Amy1129]

Thanks for reassuring me not to feel stupid.  My only concern is that I cannot find any info or symptoms on MAI in children.  Is there any info out there for MAI in children not having HIV?
thanks again

[poolnoni]

Check out at WWW.NTMinfo.com and read some of the posting. You will have to register-it's free. It stands for Non-Tuberculosis Mycobacteria. You will see that children do get it. Anyone can get it if they have a weakened immune system. Hope this helps

[Maral]

You poor thing.  It is very difficult to have a child with chronic illnesses.  My daughters both have chronic sinusitus which brings with it ear infections, bronchitis, and acid reflux.(Among other various ailments)  They have both had pneumonia as well.  The acid reflux can cause chronic cough.  Has anyone suggested sending you to a gastrointestinal doctor?  It may be worth looking into as I have been told that acid reflux can also trigger sinus infections which can lead to some of the problems that you're son is having.  The loose stools may be related to the antibiotics your son is taking.  Try feeding him yogurt or acidopholous milk.  My youngest daughter takes antibiotics as a daily therapy and I know from experience that this can help.  It is so difficult to identify sinus infections in a young child.  They may need to do a sinus CT if they haven't already.  Good luck to you!!!
Leslie

[poolnoni]

Amy-did you ever find out what was wrong with your 2 yr. old. Hope it wasn't anything too serious. Please let us know.

[Amy1129]

Rather than type this again, I copied this from another board I post to looking for advice.

Well we had my sons sweat test today at childrens hosp in boston and it was negative. The dr didnt seem to think he had CF but still wanted to rule it out. Anyways, last week when we first met with him, he reviewed all his sinus and chest xrays, blood tests, and his nose swab test results. All of which concerned him. He listened to his chest, he said it was crackling and popping. He looked inside his nose said it was all white and he said his tonsils and adnoids were unbelieveablely huge. He said last week that judging from everything he had in front him, he said it wasnt asthma, wasnt purely allergies. He said he thought something was "anatomically" wrong with his bronchial tubes. Either they arent stong enough and basically collapse when he gets sick or there is something, like a cyst, pushing against his lung causing the streaks he saw on the xrays. There was alot of haze in one lung and some opacification in the other. The streaks are what concerned him. After the initial appointment last week, he said lets schedule the sweat test for this week and then depending on those results we will go ahead and schedule the bronchoscopy and a CT. He gave me a 2 week script of biaxin and said he needed michaels lungs to be clear of all infections, it will make a easier brochoscopy and said see you next week. Today, I asked when we were going to see the dr, she said, i dont have you scheduled to meet him...why she asks. I tell her its to discuss and schedule the bronchoschopy and CT she said OH? OK, I'll try and find him during the test. after the test, she says go wait in the hall and I will send him out. He comes out, looking kinda confused, trying to remember who we are and asked how our son was doing, I said he;s doing rather well, has coughed that bad all week, and that we actually got some sleep. He said "great....so why do you need to talk to me...." I said we were going to schedule the bronchoscopy and he said well if he is doing good, why dont we wait until he get sick again, and when he recovers from that sickness we'll go ahead with the procedure. I replied with he's doing cause he is on this biaxin, and that he always get better while on antibiotic then once that is out of his system, he'll be sick again. He now says....lemme give you another week of biaxin, that will bring it to a total of 3 weeks on biaxin. I was speechless and said thanks, have a good weekend and left. My husband and I argued for about 15 minutes about it. I was in tears and he was happy. He was happy saying we have a healthy kid, you should be happy. Yes we have a healthy kid cause he is on antibiotic, then what? How can a dr tell me he thinks he is anatomically wrong or have a cyst one day, and then say oh good, he's doing good today, call me if he gets sick again and give me more meds?
Should I be angree or is the dr doing the right thing? My husband thinks this is great news, no need to put our son under and have this procedure done. I think I still dont have any answers as to why he has been coughing on and off since 6 months old (he's turning 2 in june) . Please help me figure out my feelings or maybe guide me in what ot do next.

[poolnoni]

When a doctor can't to remember what he has said or remember the patient, I think that is a poor excuse. I would still get another opinion. Damn these doctors..what if it was there own child?  Maybe you should ask that question? I used to be afraid of what to say to doctors, in order not to offend them. I have changed my ways. I say it like I see it. If the doc. can proof me wrong then I am the first to apoligize. I can understand your husband's reasoning but I can better understand a mother's intuition. If nothing comes of this, that is very good but at least you will have the piece of mind knowing you did everything.
Good luck Amy. Keep me posted.