Posted by: Edie | 2012/10/01


Bronchitis etc

Dear Prof

I have two issues:

1. My 3.5 yr son has been struggling with a sinusitis and bronchitis infection for a while now. The GP put him on augmentin mid august. Early Sept we saw the pulmanologist who said he still had both infections but while he didn’ t have fever, there wasn’ t a concern. Last week he got conjunctivitis as well. Our ped is away and I took him to GP who put him on Orelox and gave tobrex for his eyes. This was Tuesday. Thursday evening he got a fever. By Friday afternoon it was 39.4. Our GP was away and I had to take him to another one, who changed the antibiotics to augmentin and also prescribed aspelone (4ml per day for 4 days) and illiadin. I gave him neither. It is just his fever, which is now more mild, but I try to keep it under control and although his eyes are not watering and red anymore the lids are really swollen. I am at the end of my tether. Our ped is back tomorrow, but fully booked until the 9th! He is now drinking the augmentin. But I don’ t know whether its helping. I’ m still giving him the eye drops, but I dont know if I should stop? Any guidance would be appreciated.
2. The other issue is that when I was pregnant, I wasn’ t sure and my gynae assumed my bloodtype was O+. I didn’ t think anything of it and he obv didn’ t verify it. My husbands is B+. I’ ve had 2 sons now, and only this year when I started donating blood I was informed my bloodtype is O-. Luckily nothing went wrong during the pregnancies, but what I want to know is, could there be any underlying issues resulting from this? I’ m not sure about their bloodgroups. The oldest struggled with low iron and we still haven t confirmed the youngest deficiencies, if any, but he is still eating everything in sight. Yesterday he ate one of those fluffy balls which we do crafts with.


Expert's Reply



Regarding your first question:It is very difficult to be sure about your son's illness without being able to see him.It is likely that he has picked up a severe viral infection particularly an infection due to an adenovirus infection.This is not responsive to an antibiotic. The question really is why is your son getting these bad infections so often? At his age he hardly has any of his sinuses formed yet, so I am not happy with assuming that he has a sino-bronchitis problem. Is he at a creche where he is picking up one infection after another? Another possibility is that he may have an immune deficiency such as a low IgA or IgG or IgG subclass deficiency.There are also other possible causes that need to be excluded such as cystic fibrosis and a condition called the immotile cilia syndrome. Your son needs to be properly investigated and these tests and also blood tests should be done.I suggest going back to the pulmonologist. Please ask about all of these tests.At the same time his iron test should also be repeated.
Your second question:It is unlikely that an Rh incompatability problem is the cause of your son's iron deficiency. There is no doubt however that your younger son also is iron deficient.He has a problem known as pica due to this deficiency. He should have the necessary tests done first and then must go onto iron treatment.

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