Can Anything be Done For My 4-Year-Old Who Coughs For Days At a Time?
- Friday, August 14, 2009, 23:08
- Asthma
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- Nancy: My 4-year-old daughter has asthma. When she has a virus for 3 to 4 days she gets a cough that sounds like croup, only while she’s awake. It’s constant; 10-15 coughs a minute, and a nebulizer doesn’t seem to give much relief. No retractions. Only Prelone for 2-3 days seems to help. Suggest anything?
- Dr. Kraemer: Croup is a well-recognized cough that occurs when the upper airways are inflamed or irritated. It sounds like a barking seal, often followed a harsh crowing inspiration. Epidemics of croup are due to a virus called parainfluenza. This appears mostly in young infants and toddlers. Some older children will have a recurrent croup with every viral URI. This has been called recurrent spasmodic croup. About half of them will also demonstrate the lung function findings of mild asthma.
I have also been disappointed in the use of nebulized bronchodilators in this group. It seems that the upper airways are not as responsive to those medications. Don’t despair. This condition does not last forever. The diameter of the throat will grow each year, and soon the symptoms will just go away. However, she may continue to have symptoms of mild asthma with each upper respiratory tract infection.
If recurrent croup is now a significant concern, ask your doctor about trying a daily asthma medication as a regular therapy during the cold and virus season. This has not been well studied, but I suspect it would have a great benefit. Also, once the nebulizer version of budesonide is released in the U.S., it may be an effective nebulizer corticosteroid to be used during croup episodes and would possibly avoid the need for the oral steroids.
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