I have an 11-month-old baby who weighs 10.7 kg and is 78 cm. He has never had any health issues. Today, he started coughing productively, out of the blue. A little in the morning and evening and more in the night. There is a lot of mucus breaking when he coughs, I can hear it. No fever, no other symptoms of a cold. He ate and drank normally and was reasonably active though a bit slower than usual, then I put him to bed. He now wakes up from time to time, coughing productively and crying, then goes back to sleep. I do not see any mucus but I can only hear it. He had a cold seven months ago with a runny nose and a red throat that went to his chest eventually and had a similar productive cough though less heavy than this one. My husband is currently sick with a common cold which started recently. Despite him wearing a mask when around the baby, it is not impossible that the baby was exposed to it. My question is, is this an emergency? Do I need to wake the baby up and take him to the ER? I already have an appointment with his doctor tomorrow morning. Can this be a common cold with just the chest involvement and no other symptoms like a runny nose? Or can it be pneumonia or something really bad, as long as there is no fever, just the rich, wet cough? Basically, can it wait until tomorrow, or is the baby in danger? He is now sleeping but did wake up twice crying and coughing in the last two hours.
Welcome to icliniq.com.
No, it is not an emergency as long as the child is not breathless or has difficulty in feeding, or is cyanosed. Also, a detailed investigative workup with blood tests and an X-ray of the chest is advisable to get to the diagnosis. As per your history, I do not think we will find any infectious cause in the reports. In your case, I feel the baby might have aspirated on milk or may have had reflux which is causing this problem.
Thanks for your reply.
Nine days ago when I wrote you, I did go to the ER when the baby developed a fever later in the night (not high, 101.2F rectally). His cough was very productive and very thick. They listened to his lungs, and said he was fine, he had a viral infection. The next day, he started having a very runny nose too.
Nine days later, today, he still continues to have a productive cough (though better than it used to be) and a runny, congested nose. No more fever since that very first night, the baby is active, happy, eats well, and feels well. I went again to the doctor two days ago, last Monday, said she heard pulmonary rales and proceeded to diagnose him with pneumonia (no X-ray done). Then prescribed Azithromycin, which I gave him for two days now but no improvement with his cough or runny nose.
I have a few questions.
1. Is this how pneumonia is diagnosed? Because it seems to me that pneumonia would be unlikely with his symptoms (no fever or difficulty breathing, sleeps well at night, no cough during sleep, also has a runny nose which I assume suggests a protracted cold).
2. Is it possible for a productive cough and runny nose from a viral infection to carry on for more than a week? And should I do something about it or wait it out?
3. I assume if the Azithromycin will not clear his cough, it would be more likely that his chest infection is viral, not bacterial. Should I insist on a chest X-ray even if the baby seems otherwise fine?
Welcome back to icliniq.com.
Most of the time, pneumonia is diagnosed on an X-ray chest. However, an expert doctor can diagnose pneumonia clinically. A viral infection, if co-infected with a bacterial infection, can carry on for more than a week. To clear up the doubt surrounding the case, I would still suggest an x-ray chest.
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