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7 month old having continuous cough and chest infection. X-ray shows shadow on his lungs. Asthma?

I have a 7month old baby boy, who has had a cough and and continuous, chest infection, he has had antibiotix twice which has not cleared it, he had a chest xray and has a consequential shadow on hes lungs?? Can u tell me if this is a asthma condition or something else? Also he has always had very loose and smelly stools and i have read that this could be signs of cystic fibrious? many thanks.
Asked On : Fri, 8 Jun 2012
Answers:  2 Views:  599
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Allergist and Immunologist 's  Response
A 7-month old baby boy with recurrent chest infections and possible non-resolving gastroenteritis requires exclusion of an imunodeficiency disorder. I do not know of your family's origin (ie., Caucasian or Asian etc) but this is really of no consequence. Shadow on Chest XRay is usually against asthma and infection-induced asthma is more likely. Sputum or blood culture reports would have been helpful as recurrent bacterial infections would suggest an antibody deficiency. A full blood count (most importantly white cell count) is important and low lymphocyte counts would suggest an immune deficiency disorder. An unresolved infection also requires exclusion.

Any child with polyps in the nose has a high likelihod of cystic fibrosis but of course that also needs excluding in your boy (sweat test followed by CFTR genetics).

I would strongly suggest asking your doctor to get serum immunoglobulins (IgG, IgA, IgM), specific antibody levels (HiB, tetanus, pneumococcal) and lymphocyte subsets (CD4/8/19/56) are the most important initial investigations to exclude an immune deficiency.

Please let me know if I can be of any more help.
Best Wishes.
Answered: Sat, 9 Jun 2012
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Pulmonologist Dr. Arnab Maji's  Response
thank u for query
to be very frank that diagnose a case of asthma in just 7 months of age is very very difficult.........
if cough is associated with wheezing?????
if yes then the case may be diagnosed as a case of early transient wheezing illness of early childhood??
PFT CAN NOT BE DONE IN THIS AGE GROUP....difficulty arises here
in this respect the child needs to have antibiotics for around 14 days and followed up
another qn need to be there any family h/o allergy, atopy or asthma in family???
if yes then the child has more chance to have asthma
cystic fibrosis (CF) can not be diagnosed only on loose smelly stool
the most common cause of loose smelly stool in this age group is malabsorption, galactorrhoea etc
these have to thought first
to diagnose CF u need to have sweat chloride test to be done or genetic analysis of CFTR gene
consult with a pediatric pulmonologist he can guide u properly
thank u
Answered: Fri, 8 Jun 2012
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