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Infant Suffering From Fever. Bronchovascular Markings In Chest, Soft Tissue Shadow In Posterosuperior Of Nasopharynx. What Is It?

Posted on Thu, 25 Apr 2013

Question: my child who is 6 years old was diagnoised in x XXXXXXX as mild prominent bronchovascular markings seen and in the second one as lobulated soft tissues dense area seen in postero superior part of nasopharynx. She is suffering from continuous fever for the past 1 and half months. pl guide us.

Answered by Dr. A.K. Srivastava (4 hours later)

Hello

Thanks for writing to H.C.M. for your query.

I have gone through your query regarding fever of your daughter for last one and half months. You have told about radiological findings of chest as prominent bronchovasicular marking, which indicates towards bronchitis, and second is in nasopharynx as soft tissue shadow in posterosuperior of nasopharynx, this indicates enlarged adenoids.

By this much we can say that your child is having adenoiditis, no doubt this may be cause of mild to moderate fever. But in cases of fever for one and half months some other important investigations are to be done they are as -

(a) Blood- CBC, ESR, Widal test, malaria parasite, SGPT, serum creatinin.

(b) Urine- Routine and microscopic, Culture and sensitivity.

(c) Culture and sensitivity of throat swab.

(d) Ultrasonography of whole abdomen.

After this much work a thorough examination and clinical co-relation of inferences of above investigation one can find out the pathology behind the fever that can be accordingly treated.

I hope this will help you .

Regards.

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

Follow up: Dr. A.K. Srivastava (6 hours later)

I forgot to write to you before that she was suffering from typhoid two months back with widal test showing 1:160 dilution (two months back) and now it has come down to 1:40 dilution (yesterday). After treatment of typhoid, she is getting only mild fever ranging from 99 to 100 for the past one and half months and first we thought that she is again infected with typhoid. Whether these reports clearly show that the fever is due to the above ent problem? Now whether I should consult pediatrician or ent for this? What is the treatment available for bronchitis and enlarged adenoids? please guide us.

Answered by Dr. A.K. Srivastava (5 hours later)

Hello

Welcome again in H.C.M. for your query

As you asked about further treatment of your child regarding fever and to which doctor you have to consult, for this my opinion is to consult ENT specialist. Because she had already been treated for typhoid and at present enlarge infected adenoid may be responsible for fever.An expert ENT doctor after examining the child may reach to conclussion for proper treatment.

Regards.

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

Follow up: Dr. A.K. Srivastava (2 days later)

thanks a lot for the advice. I have visited the ent specialist today. After seeing the X XXXXXXX report, he informed that surgery for adenoids may be necessary if she is frequently ill and there is no worry about bronchitis. However, I informed that she is getting cold and cough with fever frequently (2 times in last one month) and he suggested to use relent syrup and bricarex a syrup and consult him after 10 days. For kind information and your suggestions about surgery, if any please. Once again thank you.

Answered by Dr. A.K. Srivastava (39 minutes later)

Hello

Thanks again for considering us for your query.

After co-relating the symptoms and investigations I think your ENT doctor has suggested for adenoid surgery is a wise step. This is a minor surgery and certainly your child will get relief.

Wishing quick recovery of your child.

Regards.

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