Hello doctor, In a 17-month-old female child. We keep treating the symptoms but not the overall problem of why these things keep happening. Hardly any tests have been ordered, and we are constantly just treating the symptoms. The problems are: Bronchitis, and right ear infection for which antibiotics and nebulizer tx are given. A month after double ear infection and labored breathing for which antibiotics and nebulizer are given. Labored breathing continues along with fever, right ear infection and left ear drainage. Other histories,double inguinal hernia surgery when three weeks old. Tongue and lip tie surgery at 11 months. What could be causing this? What other tests should we be looking into?
Hello. Thanks for the detailed history. The history which you have described basically shows that the child is suffering from repeated lower respiratory tract infection, which usually presents as cough, fever, breathlessness for which nebulization and antibiotics were given. Our respiratory tract, ear, nose, and throat are interconnected organs and any issue with one of the structures especially nose and airway can indirectly involve the ear, so the child is having repeated ear infection which is technically known as acute suppurative otitis media. Now, the cause for repeated lower respiratory tract infection in a 2-year-old child are many, which may be innate deficiency of immunity, genetic problems with respiratory epithelial cells (for ex Kartageners syndrome, Immotile cilia syndrome). Rarely unnoticed foreign body in the bronchus can present with such repeated chest infections (lower respiratory tract infection). So unless a further evaluation is done it is very difficult to identify the cause. The child may need to undergo tests such as CT (computed tomography) scan of thorax, bronchoscopy, etc. You need to visit a pediatric pulmonologist for a detailed evaluation. One thing to say is such repeated lower respiratory tract infection with a middle ear infection is not very normal and proper diagnosis needs to be made.