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A Child with Recurrent Pneumonia: A case study - Video

Published On 2022-08-22T09:15:17+05:30  |  Updated On 22 Aug 2022 9:15 AM IST
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Overview

In children, recurrent pneumonia is defined as the occurrence of more than one episode of pneumonia within a single year, or greater than three episodes within any duration; with radiographically documented clearing between episodes. Study in Journal of Postgraduate Medicine, Education and Research describes a study of a young girl.

An 11-year-old girl presented with history of recurrent episodes of fever, cough, and rapid breathing since the age of 5 years. Each episode had a similar pattern with moderate-grade fever, wet cough, fast breathing, and requirement of oral antibiotics for resolution. The frequency and severity of these episodes increased over time. There was no history of coughing up blood or pain in the chest. There was associated breathlessness, initially during the episodes, but later in between episodes as well. It progressed in recent years, such that at the time of presentation, the child was breathless even on minimal exertion.

These episodes were managed with antibiotics but did not correlate temporally with the episodes of respiratory symptoms. The family reported that the child's growth had faltered in recent years, and she was not gaining any weight for the past 2 years. Investigations for Allergic Bronchopulmonary Aspergillus was done. Sputum fungal smear and culture yielded yeast on three occasions. Oral prednisolone and broad-spectrum antifungal IV amphotericin were added. On day 17 of hospitalization, her sensorium deteriorated suddenly.

So the researchers concluded that a step-wise clinical approach confirmed the diagnosis of underlying chronic granulomatous disease with bronchiectasis, with disseminated tuberculosis involving the lungs and central nervous systems, complicated by Allergic Bronchopulmonary Aspergillus.

To emphasize- General physical examination is focused toward identifying dysmorphic features, growth pattern, and neurodevelopmental status of the child. so if there is presence and grade of digital clubbing pointing to an underlying chronic suppurative lung disease – that must be a keep point in directing towards further examination and investigations.

Reference:

Anvesh Reddy, Sachin Singh, Ketan Kumar; A Child with Recurrent Pneumonia: Approach to Diagnosis and Management Journal of Postgraduate Medicine, Education and Research, Volume 56 Issue 2 (April–June 2022).

Speakers

Dr. Nandita Mohan

Dr. Nandita Mohan is a practicing pediatric dentist with more than 5 years of clinical work experience. Along with this, she is equally interested in keeping herself up to date about the latest developments in the field of medicine and dentistry which is the driving force for her to be in association with Medical Dialogues. She also has her name attached with many publications; both national and international. She has pursued her BDS from Rajiv Gandhi University of Health Sciences, Bangalore and later went to enter her dream specialty (MDS) in the Department of Pedodontics and Preventive Dentistry from Pt. B.D. Sharma University of Health Sciences. Through all the years of experience, her core interest in learning something new has never stopped. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751
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