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Non stop coughing with wheezing during night.

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Hi, my niece is 8 months old. She has been on antibiotics for the past 5 days for cold. Today she started to have non-stop coughing that lasted about half an hour and she was wheezing too. She didn't have this before. Her older brother has asthma and uses ventolin inhaler. We went back indoors and she has been ok now. I think it was due to the cold air and temperature change. Should I be really worried about this? What if it happens again during the night?

Category: Pediatrician

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Category: ICU/ Critical Care Specialist
 27 Doctors Online

Dear friend,
Thank you for your query at DoctorSpring.com

I can understand your concerns. That must have been a really difficult situation, seeing your niece cough almost continuously.
There are a few issues, however:
1. Based on your description, the illness appears to be a viral upper respiratory tract infection ( cold). Then why is she on antibiotics? Prescribing antibiotics unnecessarily or self medication leads to a lot of problems both for the child and the community. So you need to meet a good paediatrician right away, get her examined thoroughly and decide of she actually needs those antibiotics.
2. The cough that you are describing is PERTUSOID in nature, occurring in bouts with associated noisy breathing. Did she have a 'whooping sound' at the end of every prolonged bout of cough? I hope she has received her vaccinations for pertussis at ages 1.5, 2.5 and 3.5 months respectively.
As you rightly describe, such a bout can be induced by bronchospasm or pertussis. It is important to differentiate the two. If it indeed pertussis, it is dangerous and the child would need appropriate therapy with macrolide antibiotics. If not treated, pertussis is a disease with many complications.
If indeed the bout of cough was due to bronchospasm, there is no reason to worry. With a sibling diagnosed as asthma, there is a family predisposition for viral infection induced wheezing. Such a child is labeled as a MULTI-TRIGGER WHEEZER. She needs bronchodilators (Syrup Asthalin) for about a week. But, she is at a high risk for such episodes of wheezing and the family needs to be aware. She would not be labeled as asthma now. If she continues to have these wheezing episodes till beyond 3 years old patientof age, she may need to be treated as asthma.
I would be happy to help with any other queries that that you may have. Hoping that the above explanation is useful .
Regards
Dr. Saptharishi L G


Patient replied :

Thanks for the answer. Yea I think it would be probably a bronchospasm from the cold dry air and the temperature change. I just wondered if she had it again during the night, is there a need to take her into the emergency department to get her medication to calm it down or is it ok to wait till tomorrow?


Dear friend,
You can wait and watch as of now.
If the symptoms recur during night, start her on 2.5 ml of Syrup Asthalin (5 ml contains 2 mg). You can visit the paediatric emergency tomorrow, if she does not have recurrence of such a bout. In case she has one more, start her on Asthalin and take her to the nearest paediatric emergency.
I hope that answers your question.
Regards
Dr. Saptharishi L G


Dr. Saptharishi L G
Category: ICU/ Critical Care Specialist
Experience: 
Senior Residency: DM,  Pediatric Critical Care, PGIMER

Residency: MD, Pediatrics, Postgraduate Medical Education & Research (PGIMER), Chandigarh, 2013

Internship: JIPMER, 2009

Medical School: MBBS, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry, 2008
Dr. Saptharishi L G and 4 other Medical Specialists are ready to help you

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