Get your Health question answered in 3 easy steps

189 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Child having fever, red throat and strained breathing. Strep test and culture negative. What to do?

Answered by
Dr.
Dr. Sujeet N Charugulla

General & Family Physician

Practicing since :2004

Answered : 540 Questions

default
Posted on Wed, 2 Jan 2013 in Infections
Question: My son is 4 year 8 months old. He has fever for the last 4 days. Strep test and culture were negative. He has red throat and does not eat much. Fever comes and goes with ibuprufen. He sleeps with strained breathing. Right now he is getting foam on his lips while sleeping. Breathing is same, strained as before. What should I do?
doctor
Answered by Dr. Sujeet N Charugulla 2 hours later
Hello and thanks for your query.

I shall make an effort to provide you with good professional recommendations specific to your questions.

Your son's present status has obviously got you concerned. With this medical history, his ongoing fever indicates active infection. And I do not think administering Ibuprofen is a good idea for the same. His wheezing would need the appropriate bronchodilator drug therapy, which has already been used for his bronchiolitis episode earlier. Foaming in the mouth is a symptom that requires ruling out lung causes most commonly like pneumonia, considering your son's history. Hence, the wheezing and strained breathing.

I understand that Streptococcus had been ruled out with sputum examination. Of course this is the most common cause of pneumonia, but the possibility of other bacteria involved has to be looked into. Again, with history of bronchiolitis - a viral cause also may be one of the reasons - in which case symptomatic therapy is anyway recommended. Moreover, there are other investigations like blood tests, bronchoscopy, chest radiography that aid in the diagnosis to a clinican and may be ordered as per need.

The ideal treatment, in the case that a bacteria is identified eventually - would be appropriate antibiotics selected on the basis of susceptibility reports for a set duration.

His age is over the vaccine age group, but you could discuss the same only after complete treatment of the present condition.

Hence, keeping in purview all the above - I would suggest you to get immediate medical attention with a chest medicine specialist as it is already 4 days of fever.

Let me know if I have missed out any other concern in your question.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.

Sincerely,

Dr Sujeet N Charugulla,
MBBS, MD.
Consultant Physician.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Sujeet N Charugulla 11 minutes later
Thanks Dr XXXXXXX
My son does not have wheezing any more for two weeks now. He has been advised to continue steroid inhalers for the next few months as a preventive step.
His fever started with vomiting on Friday, December 07, which went away after a few hours. But the fever continued. On Saturday he developed sore throat and this has worsened. We took him to his pediatrician. She examined him thoroughly. His chest is clean, both on exam and X-ray. His strep test was negative. His fever responds to ibuprufen but returns after a few hours, especially at night. He has difficulty breathing when asleep as if there is congestion behind the nose; the nose is not watery otherwise. Today we gave him saline drops before putting him to bed. I don't know if the foam on his lips is because of this. In any case, what should we do and if it's a viral sore throat, what should be done? He had bronchiolitis in Nov and now sore throat and fever? What could be the cause of getting infections?
doctor
Answered by Dr. Sujeet N Charugulla 20 hours later
Thanks for the follow up reply, and adding further details about your son's condition.

Yes, those steroid inhalers do wonders as bronchodilators and are necessary to keep his breathing difficulty on the low.

Now, I realize that sore throat as examined by your pediatrician as inconclusive otherwise as evident by those negative tests. Saline drops are usually prescribed in children and give a reasonable symptom relief - hence needs compliance.

In this present obvious strong possibility of viral sore throat - the line of treatment as given by your doctors look good, as antibiotics are unnecessary, and only symptomatic therapy is indicated for fever, breathing difficulty.

Foaming in lips is an offshoot of certain breathing difficulty when asleep, and should subside as steroid inhalers take some time to attain peak clinical effect and lung airways get fully cleared.

Bronchiolitis does have a propensity to recur sometimes, and especially so during seasonal changes in the year. To be precise, the cause depends on age of child - 4 different viruses have been documented to cause this condition which is usually seen in infants and those less than 2 years. But, the treatment remains same.

I would suggest you to calm down and follow treatment for now, as I believe the course of your son's therapy looks good and rational. Later, when the steroid inhalers are gradually weaned away and your child is entirely well, you can think of ways to increase his overall immunity - as this is one area that protects from future viral infections.

Let me know if you need further clarifications.

Sincerely,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,  
Drug/Medication
Lab Tests

Recent questions on  X ray

doctor1 MD

Hello,My Name is Miguel, Im 18 years old and i am from Portugal.This monday I had an Math exam, I was a little nervous and i started cutting my nails with my mouth from the hand and accidently a nail got stuck in my throat. I went to the hospital next day and the doctor examined me and while he was examining he said that he touched the nail but when he does this its when i imideatly cough. He said that the nail was gone but i kept feeling the sensation that I still had something in my throat. Next day i went to the hospital again and the doctor made me a colonoscopy and he said he didnt detected nothing. I asked them for x-ray and once more they didnt saw nothing. But the question is that after 5 days i kept feeling the same sensation that i have something in my throat and im getting really really frustated and worried with this! Is there something that could make me better? :(Please, help me!

doctor1 MD

hi i about a month ago tool a detox tablet. i ordered it online and immediatly went to the hospital with heart rcing and high blood pressure. docs told me it was an over dose. now theyve put me on this 40mg heart blocker tablet which made me feel like i couldnt breath. now i have to halve the tablet. i keep getting random heart rate attcks with this weird sensation in my chest and head. im starting to get lots of pain in my chest. all bloods nowmal. x-ray normal. ultrasound normal. (fcheckd for gall stones and my appendix what could still be triggering this? when i was little i was born with a murmur and hole in my heart but docs said back then it was fine no re tetsts.

doctor1 MD

Hi I have a question about my Father he is 83 a couple of monthe s ago he fell and broke his neck ,he was at home with no treatment for a week and his GP just gave him painkillers for the awful pain,however as he did not improve he was fianally admitted to hospital x-rayed and diagnosed with a broken neck, and now has a collar to keep his neck stable.This has been on now for 6 weeks,he was x -rayed last week and they said it wasnt healing and he would need a CT the results of the CT were good and they now say he can have the neck brace off in 2 weeks . He was very pleased but ,is very distressed as he has suddenly become very deaf and has what he thinks are chilblains on his ear,also hes become extemely forgetful since all this happened, and has bad headaches and feels very unwell.He is seeing his GP again this week ,I wondered if you have any idea if his symptoms are connected with his broken neck ,and also can mistakes be made by a doctor when reading a ct scan ? Its very difficult for me as I live in Japan and my father in the UK, Thank you for any advice you can give me,from Shirley My father is 83 about 11stone has oestioporosis,and a history of broken bones.

doctor1 MD

Am querying current line of thinking by several consultants. Admitted to hospital May 2011; lumbar puncture showed elevated CSF protein of 1088 mg/L with 228 white cells, 95% lymphocytes. The working diagnosis was viral meningitis, and I was discharged after 2 days aciclovir. Negative for herpes simplex virus 1 and 2. Developed infection in leg early October 2011, followed by painful groin, then ulcers either side of scrotum - non painful, and diagnosed as shingles. Mid October 2011, following tinitus, buzzing , hearing different frequencies, then vertigo, admitted for 2 weeks in ID ward...CSF showed 614 white cells with 90% lymphocytosis. CSF protein raised at 1335 mg/L. Tested for everything under the sun, incl. HIV, syphillis, Lyme disease, Cat scratch fever (leg infection thought to have been through an insect bite). All negative, incl. ANA. Chest x-ray, MRI scan of brain and whole spine also negative. Admitted again 26th December 2011, aciclovir for seven days, now back home feeling well, if a little tired. Current thought is Mollarets meningitis, but more recently, rheumatology dept. thinking Behcets syndrome, as I suffer from mouth ulcers. My contention is this; I have sufferd from mouth ulcers since a teenager taking exams at school. If I have a job interview, I will get mouth ulcers after @ 48 hours. Dentist thinks stress induced, as do I. I have no aching joints and no eye irritation, also, just found out that HLAB51 negative. I am a 42 year old British male and caucasian. I can t help feeling there s a square peg being pushed into a round hole here. What about migraine; the tinitus, buzzing and vertigo? Also, I took a non-steroidal (Ibuprofen) prior to the first two episodes. Bickerstaff s encephalitis sounds just as plausible as Behcets...or am I in denial? I would appreciate any advice, even if it s to simply face the music . Thank you for your time.

doctor1 MD

I am having a frozen left shoulder kind of symptoms for last couple of months. My left shoulder doesnt rotate as smoothly as the right one. My second problem is I have constipation atleast few days a month and suffer from piles as a consequence

doctor1 MD

I have very shortness of breath will divan help this ?

doctor1 MD

I have to urinate often ..... if I stand up from sitting position or sleep position. And I empty out every time. My family Dr. thinks my bladder has fallen and there by impairing the normal muscle function that holds the urine until some normal...