Child With Ear Infection, Elevated WBC Count, Stomach Irritation. Reason Of Chest Sinking?

Posted on Wed, 9 Jan 2013

Question: My baby is 3 months old. I just noticed while she was hiccupping and fussing that her chest sinks in at the sternal notch. Is this normal? She does not have any abnormal breath sounds or labored breathing. At one month she began having unexplained fevers and was diagnosed with an ear infection. Blood cultures and urine culture came back negative. Her WBC count was elevated. She recieved 3 injections of Rocephin followed by 10 days of Amoxil. With in 2 days of completion of meds, her fever returned this time not her ears. Another urine done that was negative and another elevated CBC. She recieved one Rocephin injection and returned for f/u CBC in 24 hours. It was improved and there was not a significant shift. She recieved a 2nd Rocephin injection and then started 10 days of Suprex on yesterday. She is extremely irritable and has stomach irritation from the meds and is also on prescription probiotics although they don't appear to be helping with the diarrhea and irritation. She has had fever on 12 different occasions (mostly unexplained). She has an appointment with an immunologist next week. I have not noticed her chest sinking in until tonight. The area is large enough to sit a quarter in (she only weighs 12 lbs). I was wondering if this is normal for a baby or if this could somehow relate to her other problems?

Answered by Dr. Rajiv K Khandelwal (53 minutes later)

Hi,

Thank you for your query.

I can understand your dilemma at your child having repeated infection. Your concern is about the sinking of the chest when your daughter cries or hiccups. An infant's chest wall is very pliable and one can observe the indrawing of the chest during crying or hiccups.

As your duaghter is having repeated infection with raised blood counts I hope an X-ray chest must have been done. If it has not been done then kindly request the treating doctor to get it done. Though unlikely as she does not have any abnormal breathing but an underlying lung pathology may be giving rise to repeated infection. The indrawing of the chest wall can be explained too.

I hope I have answered your query to your satisfaction. Please feel free to revert back in case you need any clarifications or would like to share more facts of the case.

Wishing your daughter an early recovery.

Regards,

RKK

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar