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Forum Name: Pediatric Topics

Question: one yr old boy, chronic pneumonia


 bpangel3 - Sun Nov 13, 2005 10:32 pm

My son will be one yr old on Tuesday. In two months he has had pneumonia three times. Once requiring two antibitoics. He has had numerous double ear infection and been found to have fluid behind his ear drums likely requiring tubes. He has had abdominal problems since birth, and bowel problems as well. He was diagnosed with bronchiolitis at 2 months of age and intermittedly wheezes and coughs even when not sick. He was admitted to hospital for losing over 2 1/2 pounds in 3 weeks and dehydration. He has neurofibromatosis type 1, clear mri. Is his chronic abdominal, bowel and respiratory problems just spontaneous, a result of his neurofibromatosis or is it related to something else? I am afraid for him as the bouts of pneumonia seem to get worse everytime. I am scared that one of these days it is going to get so bad he will not make it. Please help!!!
 Dr. Heba Ismail - Fri Nov 18, 2005 2:23 pm

I believe this could be the result of one of several causes:
1- Your child could have some form of immune deficiency which should require further investigation.
2- This picture could result from reflux and repeated aspiration, causing both the repeated pneumonia and ear infection.
3- Or this can occur with a defect in the mucociliary system which normally clears secretions in our body.
Discuss these possibilities with your doctor and see what he/she thinks.
 bpangel3 - Sun Nov 20, 2005 12:31 pm

Thanks for your reply. Reflux was ruled out a few months ago as his abdominal symptoms do not fit the bill for it.

The paediatrician is talking about testing for cystic fibrosis and asthma. However, there is no known family history of cf and limited of asthma. I have asthma due to environmental factors and one of my cousins had asthma as a child which he outgrew. Could one of those be the immune defiencies you talked about?

Could asthma or cf have anything to do with a build up of fluid in his ears causing chronic ear infections that requires tubes or sleep apnea which may require his adnoids out? Sorry for all the questions, it has been a long year of dr and hospital visits and I am anxious to get to the cause of my sons problems so it can be treated and he does not have to be sick anymore. He has been on antibiotics for over 20 days straight, is this safe for a baby his age?

Thanks again,
Angel
 Dr. Heba Ismail - Tue Nov 22, 2005 9:22 am

Dear Angel,
Cystic fibrosis is a possibile explanation, and it also causes immune-deficiency. But other immune-deficiency states should be ruled out.
An abnormality of the mucociliary system as 'Primary ciliary dyskinesia' should also be ruled out.
As for the antibiotics, it depends on the nature of those antibiotics he's taking, some can be taken safely for up to 4-6 weeks.
 bpangel3 - Tue Nov 22, 2005 11:28 am

Thank you again. I will have my paediatrician look into your suggestions, I just hope answers can be found soon as each infection seems worse then the last.

As for antibiotics he was on Biaxin first, and now double dose Amoxicillin 3x daily. He has been on so many antibiotics in the last couple months that I worry about the long lasting effects of those as well.

Thanks Again.

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