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Treatment for frequent BRONCHITIS and ATOPIC DERMATITIS.

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Hello,
I have a 6 year old boy with atopic dermatitis, no family predisposition. Since 2 years of age during the autumn-winter seasons he is ill with cough, seldom with fever and with nasal congestion. When he was 5 years old from Pseudomonas aeruginosa was isolated twice from throat swab. He often makes bronchitis and according to our pediatrician has data for maxillary sinusitis. Please advise what the further treatment should be?

Category: Pediatrician

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Category: ICU/ Critical Care Specialist
 23 Doctors Online

Hello. Thank you for posting your query at DoctorSpring.com
Your son's symptoms are predominantly seasonal. Presence of cough without fever can be due to allergic rhinitis or allergic sinusitis or cough-predominant asthma. Isolation of Pseudomonas aeruginosa from throat swab would not have much significance. They can be commensals. Isolation of these organisms from bronchoalveolar lavage fluid can be incriminating and can be a clue to underlying CYSTIC FIBRIOSIS.
The following questions need to be answered before I can help any further:
1. What is your child's height and weight? Is it appropriate for age?
2. How was the diagnosis of maxillary sinusitis made in your child?
3. What other allergic manifestations does he have?
4. Do you have an eosinophil count or a nasal smear for eosinophils?
5. Does he have response to anti-allergic medications like MONTELUKAST? Have they been tried? Was there a response to anti-histaminics?
regards
Dr. Saptharishi L G
Dr. Saptharishi L G
DM (Pediatric Critical Care) Senior Resident
MBBS, MD (Pediatrics), PGDCRL
Division of Pediatric Critical Care
Dept. of Pediatrics
Advanced Pediatrics Center
Post-Graduate Institute of Medical Education & Research
PGIMER, Chandigarh, India 160012


Patient replied :

Hi Dr. Saptharishi and thank you for your answer, 1. He is well developed for his age without deviations in the weight and hight. 2. The maxillary sinusitis was diagnosed radiologically. 3. There are no other allergic manifestations. 4. We have a result from blood eosinophils - 3% 5. We had some anti-histaminics treatment but without effect. We havent been prescribed MONTELUKAST.
Thank you again for your time and effort! Looking forward to your follow-up!


Hello.
Thank you for the answer.
Your child's growth being normal for age is reassuring. That in fact, would rule out conditions like cystic fibrosis who have marked growth failure. Kindly get your child evaluated for cough-variant asthma or allergic sinusitis. Eosinophil counts are within normal limits. There is no specific diagnosis that can be confirmed based on the given information. We need to continue watching him carefully and look for any new symptoms or clues.
Regards,
Dr Saptharishi


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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