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Abstract: The child, a 4-year-old female, presented with cough and white mucous sputum after exposure to a family member with a cold. She had a 2-day history of cough and white mucous sputum after exposure to a family member with a cold. She was physically fit and denied any history of foreign body aspiration or allergy or chronic bronchitis. The outpatient chest X-ray showed increased texture in both lungs and a few patchy changes in the lower lung fields. The child was considered to have a pulmonary infection and was treated accordingly and discharged after 7 days of treatment.
Basic information】Female, 4 years old
Disease Type】Pediatric cough
Hospital】Jinan Children’s Hospital
Date of Consultation】June 2022
Treatment plan】Medication (meloxicillin sodium for injection, budesonide suspension for inhalation, ambroxol hydrochloride sodium chloride injection, pediatric cough syrup) + improvement of lifestyle habits
Treatment period】7 days of hospitalization
Effectiveness】Discharge after recovery
I. Initial consultation
The child, female, 4 years old, developed cough symptoms after being exposed to a family member with a cold. The following day, the child’s cough worsened to a paroxysmal, continuous cough with white mucous sputum and no fever, and she was seen at our outpatient clinic. The child had no history of foreign body inhalation and no history of allergy. The outpatient clinic completed chest X-ray, respiratory pathogen examination and inflammation index. Combining the child’s medical history, symptoms and chest X-ray results, the child was considered to have a pulmonary infection and was admitted to the hospital.
II. Treatment
Respiratory tract infections are usually predominantly viral infections in the early stages and are easily combined with bacterial infections in the later stages. Many children are clinically negative for common respiratory pathogens and have no specific changes in inflammatory indicators. In combination with this child’s chest radiograph, he was empirically and temporarily given injectable meloxicillin sodium intravenously and noted for disease changes; inhalation budesonide suspension was given as nebulized inhalation to reduce the airway inflammatory response; ambroxol hydrochloride sodium chloride injection was given intravenously to dilute respiratory sputum and promote sputum excretion; and pediatric cough syrup was given orally to stop coughing and resolve sputum. Children should improve their living habits during illness, including drinking more water, paying attention to rest, eating a light diet, and avoiding exposure to spicy and stimulating foods.
III. Treatment effect
On the second day after the above treatment, the child’s cough did not worsen; on the third day after treatment, the child’s cough symptoms improved significantly and the amount of coughing sputum decreased compared with the previous one, suggesting that the clinical treatment was effective; on the seventh day of treatment, the child had an occasional single cough without coughing sputum, and the general condition was good without other uncomfortable symptoms, so the clinical standard of cure was reached, so the drug treatment was stopped and the discharge was permitted. Before discharge, she was instructed to go home and insist on improving her living habits to promote recovery.
IV. Notes
We are glad that the child’s symptoms were relieved after treatment. After discharge, the child should drink more water, pay attention to rest, keep warm and avoid catching cold. Don’t contact with cold patients, take good personal protection and go to crowded places less often; pay attention to personal hygiene, bathe regularly and change clean clothes in time; pay attention to indoor ventilation and moderate outdoor activities when the weather is good. If the cough worsens again or if there is fever, phlegm or nasal congestion, you should seek medical attention again in time. Since children have poor awareness of hygiene and safety precautions, parents should take good care of their children to reduce respiratory tract infections and avoid choking on foreign bodies.
V. Personal insights
There are many causes of cough in children. When seeing a child with cough, we should first look for the cause of the cough, such as in this case, the child’s symptoms were caused by contact with a cold patient. When treating a child with cough, attention should be paid to improving the examination of respiratory pathogens, inflammatory indicators, chest X-ray or chest CT, and if necessary, bronchoscopy. The treatment plan, treatment course and prognosis differ from one etiology to another. In daily life, parents should pay attention to the care and try to avoid the triggering factors in order to avoid the disease in children.