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Child has persistent cough, constant runny nose, mild fever since starting pre-school. Cause?

Hi, my four yr old has had a persistant cough since starting pre-school 10 months ago, he also has a constant runny nose and a temp. of 39oC every week. He has lost alot of sleep over it, the cough gets worse at night due to his nose running down his thoat and he has wakened from his sleep and thrown up from the coughing a couple of times. Our doctor has given him a steroid inhalor and salbutamol inhalor and cetirizine . The inhalors are due to a wheeze he has sometimes quite badly and sometimes not at all. He is never short of breathe. He also has mild eczema and has an allergic reaction to certain food colourings i.e red colouring, foods like brown chocolate we avoid as they turn him into a monster. if this is just starting preschool and being around other kids, why is it the same symptoms, that never get better and surely he d get sick with something else once in a while.
Asked On : Fri, 8 Feb 2013
Answers:  2 Views:  51
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Pediatrician 's  Response

Kids of this age get frequent respiratory infections. Those sent to play groups and day cares are more prone as it spreads easily among kids through air and fomites- like toys etc.

If every episode of upper respiratory infection ends up in the chest- its likely that he has hyper reactive airway disease. Any viral infection can precipitate wheeze in them.
Any allergic reactions too can precipitate a wheeze.
Wheeze in the chest and breathing difficulty are not always needed to diagnose hyper reactive airway disease.
Cough associated with wheeze is usually more at night and early morning.
But wheeze should respond well to broncho-dilators like salbutamol.

If you are using MDI with a spacer, be sure the technique is right. You may use mask attached to the spacer. Nebuliser will be better to give Salbutamol to control such episodes than spacer.

How ever its better to have a look at his throat and rule out Adenoids.

If its just Allergic Rhinitis without wheeze- medications like Monteleukast will help in prevention of such episodes. Steroid nasal sprays will also help.

Kids overcome this allergy as they grow.

Keep him off allergens like pollen, dust, smoke, perfumes and other strong smells, temperature changes, animal danders and other food items he is allergic to.
Teach him hand hygiene.
Give him all the needed vaccinations after discussion with your Pediatrician.

Hope my answer helps you.
Wish your son good health.
Answered: Sun, 10 Feb 2013
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Pediatrician Dr. Vivek Gupta's  Response
thanks for your query
your child has recurrent running nose , cough . and has history of eczema and food allergy . so this is suspected as case of bronchial asthma . since night time symptom is common in your child this is a case of persistent asthma.
get an
X-ray chest PA view
eosinophil count
to find feature of asthma
steroid inhalation therapy low dose
if did not respond
add long acting beta agonist (like salmeterol )

for acute increase of breathlessness start solbutamol inhalation
and vaccinate your child by flue vaccine
try to find out pricipitating factor ( like pets, pollen , dust , mite etc ) and as for as possbile eliminate them

Answered: Sun, 10 Feb 2013
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