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Abstract: The child, a 4-year-old girl, was brought to our emergency room by her parents. The parents reported that the child had a fever and cough for 5 consecutive days, and her temperature had been around 39°C. Her mental energy and appetite were not as good as before, and her cough was getting worse day by day. On auscultation of the lungs, a fixed fine rales could be detected, and the diagnosis of pediatric bronchopneumonia was confirmed by blood tests and chest radiographs. After treatment with symptomatic medication, the child’s condition was controlled and she recovered well.
Basic information】Female, 4 years old
Type of disease】Pediatric bronchopneumonia
Hospital】Shanghai Sixth People’s Hospital
Date of Consultation】February 2022
Treatment plan】Medication (cefoxitin sodium for injection + amiloride oral solution + budesonide suspension for inhalation + terbutaline sulfate nebulizer)
Treatment Period】7 days of hospitalization
Treatment effect] The child’s body temperature returned to normal and the cough symptoms improved significantly.
I. Initial consultation
The child was brought to our fever clinic by his parents in February 2022. The parents said that the child had a mild cold 1 week ago, but did not pay attention to it at that time, and still went to kindergarten every day. 5 days ago, the symptoms worsened and the fever started, and the temperature rose from 38℃ to 39℃.
On examination, there were diffuse fine rales in both lungs, and the respiratory rate was slightly shortness of breath. The child underwent routine blood tests and chest X-ray examination, and the blood tests showed C-reactive protein 30mg/L and leukocytes 16X10^9/L. The chest X-ray showed diffuse inflammatory exudates in both lungs, so the diagnosis of pediatric bronchopneumonia was made.
II. Treatment history
Based on the characteristics of the current condition and the laboratory indicators, the leukocytes and C-reactive protein were elevated, and neutrophils were predominant among the leukocytes, so we tended to think that it was a bacterial infectious bronchopneumonia. Therefore, after communicating with the child’s parents, the child was given cefoxitin sodium for injection and oral aminoglutethimide solution for symptomatic management, as well as inhalation budesonide suspension with terbutaline sulfate nebulizer solution to increase the therapeutic effect. As the child’s temperature was above 38.5°C, ibuprofen granules were used again to reduce fever.
III. Treatment effect
After 7 days of intravenous infusion, the child returned to the outpatient clinic for follow-up. According to the parents, the child’s fever decreased on the third day of intravenous infusion, and the cough became less and less frequent during these two days, and the child’s mental status and appetite gradually recovered. On re-auditing the child, basically no obvious rales could be heard in the lungs, and the child expressed himself that there was no obvious cough or shortness of breath after a little activity, so the clinical treatment was considered effective and the child was discharged from the hospital.
IV. Notes
We are glad that the child has gradually recovered after active medication. During the recovery process, the child should take good personal protection, open the windows and keep the air fresh indoors, and pay attention to keeping the room temperature and humidity appropriate. It is recommended that the child pay attention to nutrition, do not be picky about food, mainly vitamin and protein-rich diet, such as tomatoes, eggs, etc., drink more water to promote the body’s metabolic cycle, and rest more to help recovery. In addition, children with the disease should do more sports and exercise to enhance their physical fitness, which can help reduce the possibility of the disease.
V. Personal insight
Bronchopneumonia in children is a very common disease, and the early symptoms are usually fever and cough, which need to be taken seriously. In this case, the early symptoms of the child were so obvious that the parents first gave the child some cough suppressants and fever reducers at home, but found that the treatment was not effective and the fever persisted and the cough became more and more severe before the child went to the hospital. Therefore, it is recommended to go to the hospital promptly when you find that your child is unwell and to avoid private medication to avoid delaying the condition.