My Son Has Had A Chronic Cough Since He Moved

Posted on Sun, 11 Aug 2019

Question: My son has had a chronic cough since he moved in my moms house at 7 months old . It started at night witha. Hacking dry cough almost like gag reflux ... he has had a chronic cough ever since and is now 14 months old . I took him to hosptial after. A month of his coughing continued Becuase I was worried and demanded a x Ray and it showed pneumonitis . They think it was due to a virus . But I’m paranoid about hypersensitivity pneumonitis . We had. Chickens in a coop outside that I got rid of a couple months ago and recently also got the house checked for mold and the air sample was clean as can be . Nothing was in the air at the moment but the swan test not he floor came back aspergillus/penicillium. For months I asked his pulmonist and allergist if it could be from any of those things.. they both said they doubt its hypersensitivity pneumonitis and gave him Flovent which he has been on for months .. he has never had a CT Becuase he’s only 1 years old . The allergist also told me that he can’t be allergic to mold until he’s around 2 . It’s not enough exporsue to cause hypersensitivity , but what about the chickens or down feather sofa ? He also had a swallowing disorder where he coughs on thin liquids .. last x Ray did show superhilar opacity which the doctor thinks is just a mucus plug since he has no rales or anything like a fever to indicate infiltration. We will repeat the X-ray in 4 weeks . And if persist then will get a CT scan.

Answered by Dr. Diptanshu Das (44 minutes later)

Brief Answer:
Give steam inhalation

Detailed Answer:
Thanks for using the Ask a Doctor service.

I have gone carefully through the details and understand your concern. Most often such symptoms are due to viral infections and antibiotics are ineffective in such cases.

Such infections are frequently associated with an allergic component and the elevation in Immunoglobulin (possibly IgE) confirms this propensity. It is advisable to give some antiallergic like cetirizine once daily for next few days. The next step would be to get a blood allergy profile done to check what items the child is allergic to (irrespective of whether you detect them in your surroundings).

You need to give steam inhalation to your child. It helps in reducing the congestion. Just sit with your child on your lap and place the source of steam before you. The water vapor will be in the air and automatically the child will breathe it in. Water vapor will reach deep inside and would help in diluting the cough and thus would provide relief. Use Nasoclear Saline Nasal Drops in case of nose block.

Please be patient. It may take a few days for the recovery to occur. It should spontaneously resolve soon.

Hopefully that would help. Feel free to write back in case of further queries.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Diptanshu Das (46 minutes later)

So you think this is all due to viruses ?

Follow up: Dr. Diptanshu Das (0 minute later)

What about pneumonitis though ? Do you think he is safe from fibrosis ?

Follow up: Dr. Diptanshu Das (4 minutes later)

Could it also be from dysphasia ? A chronic cough? The word pneumonitis just makes me think it’s hypersensitivity pneumonitis . But his pulmonist made it clear to me that he doesn’t think it’s that kind of thing associated with fibrosis .

Answered by Dr. Diptanshu Das (3 minutes later)

Brief Answer:
Viral and allergic

Detailed Answer:
No, the virus is possibly secondary and the allergic propensity primary. The pneumonitis possibly has a viral origin. Can comment on the fibrosis only after checking the films.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Diptanshu Das (13 minutes later)

But you can only see fibrosis on a CT scan not a x Ray right ?

Follow up: Dr. Diptanshu Das (15 minutes later)

Viral origin as in it’s probably from a virus ? . The emergency room said it’s from a virus . But I am concerned Becuase every x Ray he has gotten ( 3 in total ) has either shown some form of peri bronchial cuffing or superhilar opacity .. or pneumonitis .... so let me ask you this then... if the emergency room took his x Ray months ago and they said he doesn’t have pneumonia but he has pneumonitis .. most likely from a virus they said .. and then later on his x Ray shows peri bronchial cuffing then does that mean the pneumonitis went away or is not as much of a concern anymore ? Becuase they would say something about pneumonitis in the report and not just peri bronchial cuffing right ?

Answered by Dr. Diptanshu Das (18 hours later)

Brief Answer:
Wait and watch

Detailed Answer:
We can observe fibrosis in an X ray as well. A lateral film might be needed along the Posteroanterior view. Since there are no rales, I could not be concerned by what seems to be pneumonitis. Rather, I would prefer to wait and watch. It is possibly just peri bronchial rather than inside the lower respiratory tract.

Regards

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Above answer was peer-reviewed by : Dr. Prasad