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2yrs old suffering from chronic cough. No relief from strong antibiotics. Remedy?

Hi! My niece is now 2yrs old and has had a chronic cough which is mostly dry and occassionally wet. Has been seen by many who have prescribed upto very strong antibiotics with no marked improvement. Her father has a hx of asthma in their family. However, he hasnt had active asthmatic attack except for allergic rhinitis and sneezing . I kindly need your help. Austine from Kisumu, Kenya.
Mon, 18 Jun 2012
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Allergist and Immunologist 's  Response
no need for antibiotics
stop milk products diary products for one year
it is allergic
give syp fexofenadine 1 tsf twice a day
tab montelucast 4 mgm dispersible twice a day
syp tossex i/3 tsf thricea day
give for 3 weeks
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Allergist and Immunologist Dr. Sujoy Khan's  Response
Dear Austine,
I am sorry to note that your 2-year-old niece is unwell with a chronic cough that are not respnding to strong antibiotics.
I hope a Chest XRay has been done and has excluded a pneumonia. Sometimes pneumonia in little children can take longer to resolve leaving a chronic cough but if this prolonged, a cause must be established.
If infections with bacteria are common in her (such as sinusitis, pneumonia, skin etc) then a full blood count must be done and low lymphocyte count excluded. If low lymphocyte count persists, antibody levels with CD3/4/8/19 levels must be done with IgG,A,M levels to exclude an immunodeficiency (mostly antibody deficiency). This is very rare but most important to exclude.
A chronic allergy such as to house dust mite, cockroach is more common and a chronic cough (mostly dry very occasionally wet) is seen. Reflux disease in children is also a cause of chronic cough at nights allong with asthma. A trial of omeprazole syrup and salbutamol syrup/inhaler for 3-4 weeks can be recommended.
I hope this was useful.
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