Toddler Coughing / Ill for 6 Months; Possible Atelectasis?

[bugmq]

My daughter is 3 1/2 years old and has todate been suffering from a respiratory disorder since August. From August to November her condition was dismissed by her GP as a viral, thus untreatable. Towards November's end, a chest xray yeilded a double pneumonia result. Asthma has been ruled out.

She has been on Amoxicillan ever since, and was on erythromycin and amoxicilian on and off since August 2004.

She is now being seen by a pediatric specialist, who claims that if the current course of amox. does not recitfy the problem, a bronchoscopy will be ordered, to see if there may be a blockage. Apparently, this is common among young children, who sometime inhale small objects (eg peanuts, crayons, etc) with the result of ongoing strenuous coughing.

She no longer has a fever and her appetite has returned, but her cough has worsened. She has coughing fits lasting 20-30 seconds and usually vomits as a result.

Here are my questions (and thank you in advance for considering them!):

1. Could you point me in the direction of a source with detailed information on such a condition in children, as I could not locate anything in detail on the internet?
2. What are the implications of ongoing treatment of antibiotics in small children? (eg, dental, immune system weakness, etc?)
3. What questions should I be asking her practioners at present and after a bronchocopy?
4. How can I keep my daughter comfortable when she has her coughing spasms, and how can I help to minimize them?

Thank you and regards

[Yawni2009]

A related discussion, My Son same situation 15 mos. old was started.

[bugmq]

My daughter has had a sweat test - negative

Her bronchoscopy showed no blockage and no abnormalities
save for a pocket of mucus from which a swab was taken.
I'm told that TB was not grown but that a full analysis
would take 8 weeks to confirm. Also, the doctor said
the lab identified a pnuemonia bug and an influenza bug.

As my daughter has been chronically ill since June '04,
and is now still suffering another respiratory infection
(strenuous cough, fever 104+), she has been given another
supply of Amoxicillan.

To recap, since the onset, in June 2004, she has been
treated w/ amox, I would say a total of about 4 months,
maybe more, in the past 9 months.

Erythromyicin was prescribed, but she would not tolerate
it.

I dont know what else to do. I've lost all confidence in the
medical profession, and the quality of my daughter's life
has been compromised by her illness and, in my estimation,
the negligence of her doctors.

Remember, we are in the UK. She does have a pediatrician
in the US and I am wondering if it is worth while flying
her over there, to Childrens' Hospital in Philadelphia
for an intense evaluation.

Could you recommend any course of action? Another type of
antibiotic? Alternative medicine? Etc,??


Disclaimer: I am not embelishing any of this. My daughter
is well and truly ill. She is less than 2% on the UK
national average for height and weight compared to those of
her age. She does not deserve any of this.

Thank you

[bugmq]

Hi there and thank you for your reply.

My daughter has had her bronchoscopy. There were
no lung obstructions found and bronchia formation
is normal.

There was a pocket of mucus found in the right lung
and a culture was taken for testing. This resulted
in another chest infection, which precipitated a
5 day course of antibiotics.

She still has her strenuous cough (by the way, I've
noticed that her stomach muscles are very firm and
pronounced - evidence of the exertions during coughing
spasms).

We await results of a sweat test undertaken to rule out
cystic fibrosis.

Should the sweat test prove negative, what other course of
care do you recommend?

Allergy testing?

The coughing is so troubling, especially for a girl of
3.5 years. She has hellish bouts 5-7 times per day.

Or perhaps we should resign ourselves to hoping that she
will "outgrow" this malady and try to keep her as
comfortable as possible?

[National Jewish]

It is important to be aware of the side effects of the specific antibiotic that is being used for ongoing treatment in small children.  Your pharmacist is the best source of this information.  When the same antibiotic is used for ongoing treatment, it is possible for the germ to become resistant to that particular antibiotic.  Then that antibiotic will not clear up the infection and a different antibiotic needs to be used.

After the bronchoscopy you want to know what your daughter

[bugmq]

I havent noticed that she's breathing fast. I am and American living in the UK. We are subject to the constraints of the UK's National Health Service, so I'm afraid that that we are pretty much stuck with the appointments we have.

Believe me, it's a complete and absolute nightmare.

[bugmq]

Thanks for your comments.

She's on a Steroid inhaler that is really not doing much good.
I felt her chest last night while she was sleeping: left side
moves up and down, right side does not.

Pediattric Surgeon cant fit her in until March for Bronchoscopy. If part of her right lung is collapsed, will there be any danger of waiting until March if this is the case??

[ozark]

yes there is   If i were you i'd either take her to her pediatrician today or the er....i would not wait esp. if her right chest isnt moving that means her lung is not expanding well...is she breathing fast at rest or sleep

[ozark]

she could possibly have aspirated something....have they tried her on prednisone?  sometimes with such inflammation, from whatever that is causing such strenuous cough with vomiting, a steroid may be  indicated.......has she had a repeat chest xray?  good luck

[bugmq]

yep, and whooping cough is ruled out.

[ozark]

has she ever been tested for whooping cough? i think amox would cover that if she has it.......