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My Son Has Had A Chronic Cough Since He Moved
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.
Brief Answer:
Detailed explanation provided.
Detailed Answer:
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I understand that your son has chronic cough. Cough is usually a sign of hypersensitivity of the airways or upper respiratory tract. However, pneumonitis involves alveoli or the lower respiratory tract. So, the two are distinct entities. The fibrosis involves primarily the lower airways but the cause needs to be determined. It also needs to be determined whether a false alarm is involved. CT Chest and if needed, a bronchoscopy, might need to be done. I would insist you not to worry about the radiation exposure from CT since the concern of fibrosis and infiltration would be better addressed by this. A blood allergy profile can be done to identify the possible allergic triggers.
Unless there are rales or wheeze, Flovent will not help. Rather, some antiallergic like Montair LC (monteleukast + levocetirizine, prescription medicine) or simply cetirizine (OTC) can relieve the cough to some extent. Since your child sleeps well, it is possibly not something serious. Since there are no rales, I am not worried about the lower respiratory issues that you point out. To me the concern is primarily upper respiratory and all I would suggest is some antiallergic along with steam inhalation.
Regards
Detailed explanation provided.
Detailed Answer:
Thanks once again for using the Ask a Doctor service.
I understand that your son has chronic cough. Cough is usually a sign of hypersensitivity of the airways or upper respiratory tract. However, pneumonitis involves alveoli or the lower respiratory tract. So, the two are distinct entities. The fibrosis involves primarily the lower airways but the cause needs to be determined. It also needs to be determined whether a false alarm is involved. CT Chest and if needed, a bronchoscopy, might need to be done. I would insist you not to worry about the radiation exposure from CT since the concern of fibrosis and infiltration would be better addressed by this. A blood allergy profile can be done to identify the possible allergic triggers.
Unless there are rales or wheeze, Flovent will not help. Rather, some antiallergic like Montair LC (monteleukast + levocetirizine, prescription medicine) or simply cetirizine (OTC) can relieve the cough to some extent. Since your child sleeps well, it is possibly not something serious. Since there are no rales, I am not worried about the lower respiratory issues that you point out. To me the concern is primarily upper respiratory and all I would suggest is some antiallergic along with steam inhalation.
Regards
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Above answer was peer-reviewed by :
Dr. Prasad
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