Baby with Pneumonia Hospitalised Twice and Two Courses Antibiotics not Working

Dear Ask The Doctor: My daughter who is 17mths old was hospitalised 3 weeks ago with Pneumonia she had sudden onset of symptoms including shortness of breathe, rapid breathing, fever, flaring of nostrils, vomiting and just below her throat was being sucked in everytime she breathed. Thx ray showed it on her right lung, the bloods came back not showing much they said it could be bacterial or viral. She had a course of erythromicin which lasted for 6 days and came home from hospital after 2 nights. 10 days after finishing this she suddenly had some of the same symtoms as before but not as severe. Took her to my GP in the morning and he has put her on clarythromicin for 2 weeks and did another xray. Saw my doctor 5 days after she started the course and she was hospitalised again as the xray showed no improvement. Hospital wasn't very helpful just kept saying it was viral which should only take 10days to clear which I pointed out she's been like it for 3 weeks. I don't think they know what is causing this so sent home again after a nights stay and taking more blood with the remaining clarythromicin and an inhaler. She will have another xray in 2 weeks and has lost 2lb in weight. Her chest is very gargly but she has no cough which they have said she should as that is how it will clear. Can you suggest what this could be, she has symptoms of bacterial pneumonia but nothing showing in her blood??

Dear Sarah:

I realize how worried you are about your daughter’s condition. Apparently due to the constant testing of your child, we might be able to rule out by now a bacterial infection which is also not common in children that age. On top of that, the antibiotics that your daughter received might be enough to kill the most common Pneumonia producing bacteria.

Viral upper respiratory infections certainly are common in pediatric patients; they have the same symptoms as bacterial infections such as fever, mucus production, cough, rales etc. the only way to rule out one form the other is by having some blood work done which would increase certain types of white blood cells that increase when bacterial and/or viral conditions happen.

On the other hand, a viral pneumonia in a pediatric patient usually would last between 7 to 14 days, but this is just the process of the virus not the total recovery of the symptoms. You see, Children don’t have the ability to expectorate until they reach 6 to 8 years or age, the mucus could be trapped in their airways and that is why a viral infection could turn into a bacterial one. To avoid that, Pediatricians usually prescribe medications that would dissolve the mucus so that it could be easily eliminated from the respiratory tracts and just treat the symptoms until the viral process remits. If she is not taking any medication at the moment, I would suggest you to consult a pediatrician and give her plenty of warm fluids to help eliminate the mucus.