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Q. How to confirm pneumonia?

Answered by
Dr. Amolkumar W Diwan
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 22, 2016 and last reviewed on: May 12, 2020

Hello doctor,

My daughter is suffering from cough for the past four weeks. She started it out very gently and it is getting worse. Last weekend she was coughing almost non-stop. I took her to a Walk-in clinic and they gave her a cough syrup and an antibiotic. I was told to start the antibiotic four days later if she does not get better. I have started the antibiotics after six days. But, she was getting weaker and coughing with choking. I took her back to the doctor. They told me that she might have whooping cough. I was not entirely surprised as she had hypoxia at birth and she did not get that one vaccine: the pertussis. She only got DT. From chest x-ray, we came to know that she had pneumonia too. But, not on both lungs and the x-ray was not entirely white, so it was a smaller pneumonia. By that time we were on day three of the antibiotics. They made a sample test from the nose for whooping cough. I was told that even if she has it the results might come back negative as she took Azithromycin. We were told to wait and see after the antibiotic. The result came back negative.

The same night her cough got so bad that she was not getting any air. She was coughing without being able to breathe. She was vomiting and a tone of white long, phlegm or mucus came out with the vomiting. It was white, sticky and lots of it. In the emergency room they turned out that she had bronchospasm. They treated her with Albuterol and steroids. She was put on Albuterol for two hours there, then we came home with an inhaler. She has been using that three to four times a day ever since then. She has been very weak. They checked her again for whooping cough and that too came back negative. She took the second dose of Prednisone three pills. She felt better and was so happy. But, the next day she did not feel that good. Today, she had more coughs and it is a second sound behind the usual cough sound. This second one is like the laryngitis cough, but not barking sound. It is just a deeper cough.

I am totally lost. I do not what to do anymore. She had a different kind of cough sounds throughout for almost a period of four weeks. Intense, barking, whooping cough like, silent, more loud and now this strange one. She is allergic on Amoxicillin, Ceftin, Bactrim and Cefalosporins. I gave her Mucinex to loosen the mucus. I would like to know what to do. Should I go and see a pulmonologist in person?

#

Hi,

Welcome to icliniq.com.

I have read your daughter's story in detail. I also heard the quality of cough you provided in the sound clip (attachment removed to protect patient identity).

  • From the above description, I feel that your daughter is suffering from bronchial asthma. I suggest you to see a pulmonologist and start her on the regular steroid inhaler.
  • Albuterol Inhaler is only for emergency. Use it as required and not for regular.
  • Also, Prednisolone tablets are given only to control acute episode. But, as asthma is a chronic disease, she must continue steroid inhaler regularly.
  • Your pulmonologist will help you prescribe the appropriate steroid inhaler.
  • As you said, all other tests like whooping cough and even x-ray is normal except pneumonia. But, this acute episode may be precipitated by the underlying pneumonia itself.
  • Antibiotics will take care of pneumonia, but for asthma, she must take regular steroid inhalers.
  • I also suggest you to do a spirometry test (pulmonary function test) to confirm asthma. It will rule out other diagnosis also.
  • Spirometry test is done by the pulmonologist and after that he will prescribe the inhaler treatment for your daughter.

The Probable causes:

Allergy.

Investigations to be done:

Spirometry (PFT).

Differential diagnosis:

Pneumonia.

Treatment plan:

Regular steroid inhalers and Albuterol inhaler (SOS).

Preventive measures:

Avoid dusts and cold drinks

Regarding follow up:

For further information consult a pulmonologist online.---> https://www.icliniq.com/ask-a-doctor-online/pulmonologist


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