Recurrent Pneumonia in 13 mos. old

[Aidens_Mom]

My son had been diagnosed with pneumonia 4 times in the past four months, as well as bronchiolitis in between. He has been treated with Rocephin, Azithromycin, and Amoxil. He has breathing treatments 4 times a day (pulmicort & xopenex) has had 2 episodes of cyanosis, and been hospitalized for low oxygen satuation, wheezing etc. His pediatrician tells me I shouldn't panic and that he has asthma. He is only 13 mos old! Despite all of the above therapies he continues to wheeze, have high fevers of 103 and higher. She told me I don't need to see a pediatric pulmonologist as they will simply tell me the same thing she has! I am @ my wits end and have a really sick little boy. Is a specialist what I should be pushing for??

[Corvin]

I might have worded that funny about "asthma can lead to pneumonia but not the other way around". Pneumonia can also antagonize asthma if the person already has asthma,but pneumonia doesn't actually cause asthma.

[Corvin]

I just looked up pulmicort and it is a corticosteroid and isn't usually used if the patient has an infection,it will actually prolong or worsen the infection,unless they're simultaneously givien antibiotics. But don't stop this medication without the direction of a doctor either. The xopenex on the other hand shouldn't cause any contradictions.

[Corvin]

Hi Aidens_Mom,

Ya it's new to me also that asthma causes a 103 degree fever! Asthma can lead to pneumonia but not the other way around. When steroids are inhaled into the lungs to treat asthma it creates an immune suppression and can make the person more susceptible to infection.  

This is a scary thing for a mother not to mention your son and should be investigated further. I would recommend they refer you to a Immunologist,and have the level of antibodies your son has evaluated. Some infants are more immunoglobulin deficient then normal and may need immunoglobulin therapy,temporarily at least. He probably will be IgG deficient because around 6 months of age the IgG he got from you in utero gets used up and infants don't produce their own IgG until around age 2. Infants have weaker immune systems because of this and other antibodies are in lower supply also,compared to adults anyway. Chronic recurring upper respiratory infections are extremely common in anyone with immune deficiency.

Beyond this I don't know what to add except it's very important that they identify the specific pathogen(s) that is making him sick,because there can be atypical infections from bacteria,viruses,fungi,and parasites. Pneumonia is not always caused by just good old streptococcal or influenza,but if he improved temporarily at least from the antibiotics then it is bacterial.

Unfortunately sometimes you have to tell doctors what they should do,and a second opinion is never bad either, Take care