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Infant with high fever, coughing fits, shortness of breath. Given antibiotics for pneumonia. Coughing up thick sputum. Is it some other disease?

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Pediatrician, Infectious Diseases
Practicing since : 2005
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My son is 2 1/2 and I took him to his doctor yesterday bc his fever had gotten up to 103 and he had been having coughing fits and hacking up clear mucus, weezing, shortness of breath, rapid heartbeat. They told me that it appeared to be pneumonia so we started antibiotics yesterday.

Tonight he had another cough fit and finally coughed up pink chunky matter and a piece of raw-chicken looking matter, probably 1"x1/2" and flat. I am concerned that this is not a symptom of pneumonia and that it could be something more serious.
Posted Thu, 12 Apr 2012 in Child Health
Answered by Dr. Hema Yadav 38 minutes later

Thanks for posting your query.

Pneumonia is caused by infection and inflammation of lung tissue and if severe it can cause such nights of cough and thick tenacious sputum production.

I have gone through the pictures provided by you. In your child the fibrous mucus plug coughed out may signify worsening of pneumonia itself causing such thick sputum or a bronchiectasis or bronchiolitis which can coexist or commonly occur as a result of lower respiratory infection in young children. It occurs due to inflammation and obstruction of the airways (bronchioles) with mucus /pus and fluid.

In any case, the child needs to undergo few investigations like x-ray chest, blood counts, blood gases, etc to confirm the diagnosis.

Even if the doctor diagnoses a pneumonia, the above investigations are recommended to grade the severity and assess for worsening or resolution of the pneumonitis.

As of now the treatment given is appropriate, but further management can be advised by his pediatrician only after the repeat clinical examination and investigations. Meanwhile if the child develops any breathlessness, blue discolouration of skin or lethargy, irritability, continuous fever, then do take him to an urgent care facility.

As of now you may take a routine early appointment.

I hope, I have answered your query well. Please accept my answer in case you have no follow up queries.

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