5 year old son with Asthma and several odd symptoms...

[RCPMOM]

I have a son who is 5 1/2 years old, history of Asthma since 10 months and a functional heart murmur for which his cardiologist released him after and Echo that said his heart was perfect.  

He woke last Thursday night with Croup (or something like it) and a fever of 103.  We used the nebulizer, motrin, and the cool night air.  They prescribed Prednisone for him on Friday.  Friday night he was at the ER for an asthma flair up.  His O2 was 93 on arrival and 95-96 when we left.  They said his lungs sounded good, except for a slight wheeze on the upper right side.    

Sunday night we noticed he had mottled skin and seemed "breathed" with more than very light activity and we called the nurse who told us he would be fine, but should be seen Monday.  He was seen on Monday and they said his lungs sound clear, but his O2 was still 96.  He said the mottled skin is likely from prednisone and he is probably short of breath from not being up to speed yet.  He did not do a chest xray.  He also said he did not hear my sons heart murmur, but heard a "split sound" on his heart which he assured me was no reason for concern despite my anxiety.  He said I did not need to follow up with his cardiologist, as it is considered a normal heart rhythm variation.  They have never heard this before, but he said it is perfectly fine.

Today he continues to have mottled skin at times, it comes and goes, and we are noticing some bluish color on his top lip that also seems to come and go.  He also gets "breathed" with anything more than light activity as has been the case since the "croup" sound began 5 days ago.  Hands and feet are pink, quick refill on his fingers and his bottom lip is pink.  Throughout all of this, he has kept a congested, semi-tight cough when he does cough but that is not too often.

Am I just being overly anxious Mom or do these symptoms add up to something worth worrying about?  

[National Jewish Health]

Your son’s fever and “breathed” (breathlessness?) remain unexplained and, if either persists at this time, is worrisome and worthy of further investigation.  If the fever persists, the mottled skin could be a sign of bacterial infection and, possibly also an explanation for the shortness of breath.  However a more likely explanation for persistent fever with shortness of breath, would be pneumonia.  The oxygen saturations, as noted by you, are within the normal range and splitting of the second heart sound is normal, unless the splitting is pronounced or progressively widening, in which case, further investigation would be warranted.

The information provided indicates that asthma is very unlikely to be the cause of his being “breathed”, especially with the fever and the observation of “clear lungs”.  Infection, however, commonly can be associated with to asthma symptoms.

In either case, persistence of any of the 3, fever, mottling or shortness of breath with “very light activity”, should be an indication for clinical reevaluation by his doctor and for a blood count and chest x-ray.  I suspect that his doctor would want to reevaluate him at this time.

You are not an overly anxious Mom.  There is a possibility that these symptoms, especially if present when you receive this message, could add up to something worthy of your concern.

Good luck.

[RCPMOM]

Thank you for your reply.  He is now feeling 95% better.  They diagnosed him with the flu and said it simply had to run it's course.  If this is the flu with a flu shot, I can't imagine what it would be like without a flu shot!!!

Thank you again,