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Suggest Treatment For Severe Cold And Cough

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Posted on Sat, 4 Oct 2014
Question: Doctor, I have a 4 year old son (XXXX) who is suffering from severe cold and cough problem since last 18 months. Due to regular cold n cough he has developed big adenoid and in last six months his tonsil has also increased very much. Due to adenoid he is unable to breathe through the nose and does mouth breathing and his sleep is also not very sound. His nose is blocked every time. Paediatricians say that he is allergic for which an allergy panel was done in July 2013 by SRL diagnostics which resulted negative for all the allergens and IGe was 106. Since then he has undergone various medications regularly like Asthalin, allegra, maxtra, livolin, buedocod puff but he does not seem to respond to them properly. Beudocod puff was stopped about a month ago (after giving for 5 months) as he had developed fungal infection along with massive tonsil. Currently, since last 1 month he again has severe running nose and allergic cough along with massive adenoid, tonsil n fungal infection and is not responding to any medicines.
I would also like to mention here that I deal in furnishing goods like mattress,carpets,foams,cushions etc and our shop and residence are in the same floor. Also, I am from a hill station (Shillong, Meghalaya) and he feels far better when he goes to a plain area . Kindly tell me doctor what can be the reason for his allergy as the panel test is negative. Is there any type of climatic allergy as he feels better in warm places and is there any test for such an allergy. Is there any other test or medicine that can help him. Kindly reply with details doctor.my num 0000 n email : YYYY@YYYY
doctor
Answered by Dr. Sujoy Khan (1 hour later)
Brief Answer:
This is not allergy - treatment of adenoids reqd

Detailed Answer:
Dear Mr XXXX,
Thank you for writing to us at Healthcare Magic.

The clinical history, blood tests do suggest that this is NOT an allergic process, and the fungal infection in the throat was likely due to use of the steroid inhaler.
Mouth must be rinsed always with XXXXXXX warm water after use of steroid inhalers especially in children and elderly.

The total IgE at 106 with negative specific IgE excludes allergy.

He will require to be checked out by an ENT specialist and consideration given towards a surgical option of adenoid-tonsillectomy.
Tonsils when big can get easily infected with streptococcal bacteria and can be difficult to manage.
More than 3 attacks of tonsillitis per year is an indication for surgery.

Furamist-AZ nasal spray 1 spray per nostril twice daily, cetzine syrup 5mg/5ml 5ml twice daily will be sufficient to partly control his symptoms but the surgery will prove more beneficial. There are NO adverse effects of tonsillectomy on the child's immune system.

I hope this helps.
Best Wishes.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Sujoy Khan (18 hours later)
Doctor, i have visited ENT n child specialist and they have said that its a case of ATOPY . They have suggested surgery of adenoid n tonsil but after age of 5 years. Now, he is having severe cold n cough currently without any help. Also cetzine syrup has been given regularly but gives only temporary releif. All doctors have always given him anti allergic medicines on seeing his condition and recently an ENT has also said that if this condition persisits he might develop permanent asthma. I am in a fix as to the cause of this allergy. Kindly help and if required i can also visit your clinic if its usefull. I am uploading past reports for your reference.
doctor
Answered by Dr. Sujoy Khan (6 hours later)
Brief Answer:
Needs symptomatic treatment

Detailed Answer:
It is possible that he can develop airways disease, but this is NOT atopy. The term is used incorrectly in several instances, and this is one of them.

The nasal spray and cetzine is important, occasionally I switch cetzine to Montek-LC KID that gives better control. Levolin inhaler can always be added until he is old enough for surgery.

Best Wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sujoy Khan (59 minutes later)
Dear Dr. XXXXXXX
Kindly clarify that if surgery of adenoid n tonsil is done , will the problem of regular cold n cough b solved coz doctors here have suggested that even after the surgery the problem of allergy will be there n only his mouth breathing will stop. Sir, plz excuse me for repeating the question but kindly tell that according to you is it a case of allergy or not as on physical examination all doctors till date have said it to be allergic cold n cough and have given anti allergic medicines everytime. What can be the other reasons for this regular cold cough n wheezing other then allergy.
doctor
Answered by Dr. Sujoy Khan (12 hours later)
Brief Answer:
Adenoids can cause such problems as well

Detailed Answer:
Please ask the concerned doctors as to what the allergy is - as I am unable to find anything on the extensive panel of tests that were done.

Even if this remains uncertain, the treatment I have recommended will stay the same as he is too youong for any sort of immunotherapy.

Best Wishes.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sujoy Khan

Allergist and Immunologist

Practicing since :1999

Answered : 584 Questions

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Suggest Treatment For Severe Cold And Cough

Brief Answer: This is not allergy - treatment of adenoids reqd Detailed Answer: Dear Mr XXXX, Thank you for writing to us at Healthcare Magic. The clinical history, blood tests do suggest that this is NOT an allergic process, and the fungal infection in the throat was likely due to use of the steroid inhaler. Mouth must be rinsed always with XXXXXXX warm water after use of steroid inhalers especially in children and elderly. The total IgE at 106 with negative specific IgE excludes allergy. He will require to be checked out by an ENT specialist and consideration given towards a surgical option of adenoid-tonsillectomy. Tonsils when big can get easily infected with streptococcal bacteria and can be difficult to manage. More than 3 attacks of tonsillitis per year is an indication for surgery. Furamist-AZ nasal spray 1 spray per nostril twice daily, cetzine syrup 5mg/5ml 5ml twice daily will be sufficient to partly control his symptoms but the surgery will prove more beneficial. There are NO adverse effects of tonsillectomy on the child's immune system. I hope this helps. Best Wishes.