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History of bronchitis. Gets wheeze, often get cold and cough. Had an allergic episode. Treated with cetrizine. Decrease in AEC count. Advice?

DOCTOR OF THE MONTH - Feb 2013
Feb 2013
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hi,
My son is 10 years old, he has history of bronchitis. He gets wheeze which is often preceeded by cold and fever (indicating an infection). He recently had an allergic episode which lasted for 15 days. Initially he was treated with cetrizine for about a week . I got an AEC test done since he got 1 or 2 rashes despite treatment, this revealed a value of 1200. I continued treatment with CPM. After a week, i got him retested for AEC which revealed a value of 900 indicating decrease in AEC count. Please advise me
Posted Sat, 9 Nov 2013 in Child Health
 
 
Answered by Dr. E Venkata Ramana 50 minutes later
Brief Answer:
Frequent wheezing needs evaluation for asthma.

Detailed Answer:
Hi,

Thank you for your query on Healthcare Magic.

Raised absolute eosinophil count is suggestive of an allergic cause.

Wheezing preceded by cold and fever is seen in conditions such as allergic bronchitis, asthma, and uncommon conditions such as tropical eosinophilia.

Wheezing episodes usually requires treatment with bronchodilator such as salbutamol or terbutaline in the form of inhalation or oral syrup.

And allergic manifestations such as skin rash is treated with oral antihistamines such as cetirizine or chlorpheniramine maleate(CPM).

It seems the child is responding to CPM as there is decrease in absolute eosinophil count from 1200 to 900.

But recurrent wheezing requires clinical assessment and investigations for asthma as this requires treatment with inhalers.

And child should be protected from exposure to allergens such as dust, pet animals, pollution, pollen, plants, perfumes and sprays, paints, smoke, crowds, and people with cold and cough.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
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