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Asthma

Asthma and Pneumonia

06/09/2010

Question:

My 6 year old daughter has had pneumonia about 10 times now, she has asthma and has been tested for autoimmune disorders and cystic fibrosis, sleep tested with no success. negative for any disorders and with the cystic fibrosis she had one mysterious gene that was inconclusive but may be linked to cystic, they said she need two out of three to be positive for that. She also has acid reflux. we can`t find a trigger for the asthma and allergy testing came up negative, we really don`t know what to try next. any advice or any something we may have missed. thanks

Answer:

My response: The list of possible reasons a child might have repeated lung infections (pneumonia) is quite long. To make matters more complicated, some illnesses in which the lungs sound noisy, and have streaky pneumonia-like marks on a chest X-ray, are not actually pneumonia (infection) at all, but instead are part of an asthma attack.

 

Acid reflux itself can cause recurring bouts of pneumonia, or recurring unexplained flares of asthma.

 

Other reasons for recurring true lung infections range from problems with tiny amounts of aspiration (food going down the wrong pipe) while swallowing, to problems with immune system function, to problems with cilia (small hairs that help keep the lung clean) and more.

 

Sometimes clues obtained from a chest CT scan can help direct the evaluation. Pulmonary function testing can provide helpful clues as well.

 

If your current doctor is at a loss regarding what to do next, it is sometimes helpful to invite a new set of eyes (a second opinion) to take a look. When you go to the second physician, he/she will want to see copies of all the testing done so far and (very important) will want copies of the actual images (usually burned on a CD) of any previous x-rays that have been done. A pediatric pulmonologist would be the correct type of specialist to involve in this situation.Thank you for visiting NetWellness.

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Response by:

Elizabeth D Allen, MD Elizabeth D Allen, MD
Clinical Associate Professor of Pediatrics
College of Medicine
The Ohio State University