Ten month old infant with wheezing for six months
| Autor: | Patrick Gordon, Bettina C. Hilman, Alaa Hegab, Maureen Heldmann |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Pediatrics medicine.medical_specialty Cystic Fibrosis Exacerbation Respiratory System Immunology Aorta Thoracic Nasal congestion Azithromycin Diagnosis Differential medicine Humans Immunology and Allergy Bronchiolitis Obliterans Respiratory Sounds Central Nervous System Vascular Malformations Respiratory distress business.industry Respiratory disease Infant Foreign Bodies medicine.disease Asthma respiratory tract diseases Surgery Pneumonia Gastroesophageal Reflux Ceftriaxone Radiography Thoracic medicine.symptom business Complication Tracheoesophageal Fistula medicine.drug |
| Zdroj: | Annals of Allergy, Asthma & Immunology. 85:179-187 |
| ISSN: | 1081-1206 |
| DOI: | 10.1016/s1081-1206(10)62464-7 |
| Popis: | HISTORY OF PRESENT ILLNESS DB, a 10-month-old white male infant, was referred by his primary care physician for recurrent wheezing over the past 6 months and two recent episodes of pneumonia that required hospital admission. At 4 months of age the mother noted noisy breathing described as “rattling” in his chest that was associated with nasal congestion. He was taken to his pediatrician who documented wheezing and prescribed nebulized albuterol. He continued to have recurrent episodes of wheezing over the next 6 months that were often associated with upper respiratory infections. He received several courses of oral antibiotics along with nebulized beta agonists. At 7 1/2 months of age he was hospitalized for 3 days for an exacerbation of asthma symptoms and bronchopneumonia. He received oxygen, IV antibiotics (ceftriaxone), IV steroids, and nebulized albuterol. He was discharged on amoxicillin/clavulanate potassium and oral steroids. An RSV ELISA during this admission was negative. Following his first admission, he was referred to an allergist who recommended 20 mg of nebulized cromolyn sodium qid along with nebulized albuterol, and environmental control measures. Serum immunoglobulins were ordered and IgG was 584 mg/dL, IgA was 28 mg/dL, and IgM was 66 mg/dL. Environmental history was reviewed with possible trigger of maternal smoking, as well as exposure to “stuffed toys” in the sibling’s bedroom. His second admission to the hospital was at 8 1/2 months of age for increasing respiratory rate, wheezing, and respiratory distress. He had been seen the day prior to admission by his pediatrician who made the diagnosis of an asthma exacerbation and recommended oral steroids, in addition to frequent nebulized albuterol. X ray of his chest revealed bronchopneumonia. He received IV ceftriaxone, IV steroids, and nebulized albuterol. He was discharged after 2 days on nebulized albuterol, cromolyn sodium, oral azithromycin, and oral steroids. After the oral steroid burst was completed, he was placed on inhaled steroids (beclomethasone dipropionate). Following this admission the patient was referred to our medical center and seen by a pediatric pulmonologist. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|