Cough in a child with a fever

Coughing in a child with a temperature - that is, a combination of such a sign of inflammation as an elevated body temperature, with a protective response of the respiratory system in the form of a cough - is a typical phenomenon in various infections of the ENT organs and respiratory tract.

[1], [2], [3]

Causes of a child with a fever

Key causes of cough in a child with fever are associated with acute respiratory viral infections (ARVI), influenza, pharyngitis, rhinopharyngitis, laryngitis, tonsillitis, tracheitis, bronchitis, pneumonia, pleurisy, whooping cough, diphtheria, measles.

Influenza begins to manifest itself as a general malaise and symptoms of viral intoxication (aches, headache, etc.), however, coughing in the baby and temperature is very fast 40. Adenoviral ARVIs are characterized by fever, coughing and runny nose in the child, as well as lesions of the connective shell of the eye conjunctiva). Elevated temperature can last for a week and is accompanied by diarrhea.

When pershit in the throat, when swallowing the throat hurts, the temperature is 37.5 and cough in the child, then it can be a viral inflammation of the mucosa in the pharynx - pharyngitis. If the mucous membranes of the nose and pharynx are affected at the same time, the doctors diagnose the rhinopharyngitis, which marks dryness and sore throat, shortness of breath, dry cough, vomiting and fever in the baby. Moreover, vomiting of mucus is characteristic for the initial stage of this disease.

With laryngitis - inflammation of the mucous larynx and vocal cords - voice hoarse, in the throat is also pershit, the child suffers from attacks of dry cough. Tonsillitis or tonsillitis (inflammation of the tonsils) is not an easy disease: it can occur not only because of streptococcal or viral infection of the upper respiratory tract, but also with infectious mononucleosis or enteritis. In the latter case, the child appears cough, temperature and diarrhea.

Due to inflammation of the mucous membrane of the respiratory throat - tracheitis - the child has a severe cough and fever: cough is dry (mainly at night, the morning becomes more intense, with a coughing pain behind the sternum), but the temperature rises slightly.

Manifestation of bronchitis begins with a dry cough against the background of subfebrile body temperature. Then the cough becomes productive, that is, with the departure of the mucous and mucous-serous sputum. So a wet cough and temperature in a child can be signs of an inflammatory process in the bronchi.

Most often in children of the first two years of life pneumonia - acute infectious inflammation of the lungs with temperature and cough - causes staphylococci, parainfluenza viruses, respiratory syncytial viruses and Escherichia coli bacteria; in older children, the main pathogens of pneumonia are Streptococcus pneumoniae and Haemophilus influenzae. And the bacterium Chlamydophila pneumoniae causes chlamydial pneumonia with a prolonged dry cough and fever.

The inflammatory process in the pulmonary envelope with exudative form of pleurisy make itself felt as moist cough and temperature in the child, and if the cough is dry, then this pleurisy is fibrinous. In many cases, this pathology arises as a complication of inflammation in the lungs.

The causes of coughing in a child with a temperature can be covered in the catarrhal form of whooping cough - an acute infectious respiratory disease caused by the bacterium Bordetella pertussis. In the prodromal period of elevated body temperature, whooping cough usually does not give, and if the temperature index rises, then slightly, little effect on the overall well-being of the child. In addition, despite the paroxysmal nature of cough, some pediatricians are fooled by the similarity of the initial phase of whooping cough with ARI, and they prescribe the treatment of an ordinary respiratory infection. And in the meantime (approximately in 8-10 days) coughing attacks become stronger - with a whistle with inspiration, with viscous sputum, which is difficult to cough, with the transition of bouts of painful coughing into vomiting. And no therapeutic measures these symptoms are not removed, for which in the West the disease is called a 100-day cough

A good doctor under such circumstances, coughing, vomiting and fever in a child should promptly order a blood test to be given for leukocytes and lymphocytes, and also to conduct a serological examination of phlegm and a swab from the nasopharynx. Because the easiest complication of whooping cough is bronchopneumonia, when the temperature of the child is 38 and cough with shortness of breath. And the hardest and sometimes irreversible is stopping breathing.

The diagnosis of diphtheria is made when the throat and larynx are affected by the bacterium Corynebacterium diphtheriae, with the formation of films that are adhered to the tissues. Barking cough and temperature in the child, swelling of the mucous membranes near the local lymph nodes and the sifote - signs of croup or diphtheria of the larynx. All this can lead to a narrowing of the airway lumen and their obstruction.

The temperature, rash and cough in a child are signs of measles, caused by the virus of the genus Morbillivirus. When the measles is infected, the child has a fever of 39 and cough (dry, barking), as well as a rash on the skin (first on the face and neck, and after a couple of days and on the whole body). Cough with measles requires high humidity in the room where the sick child is. Among the most common complications of this disease is pneumonia.

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Cough treatment in a child with a fever

As with any therapeutic effect, cough treatment in a child with a temperature should take into account two underlying factors: the cause of coughing and elevated temperature indices, as well as the characteristics of the cough (dry or wet). Etiological treatment is aimed at the cause of the disease, and cough treatment itself refers to symptomatic therapy, which depends on the type of cough.

If the temperature of the child is 38 and cough, pediatricians recommend the use of antipyretics for children in the form of a suspension: Panadol Baby, Ibufen D or Ibufen junior. For example, the standard doses of Ibufen D are for children up to 1-3 years - 0.1 g three times a day, 4-6 years - 0.15 g, 7-9 years - 0.2 g, 10-12 years - 0.3 g three times a day. Panadol Baby in the form of syrup children 2-6 months take 2.5 ml; from 6 months to 2 years - 5 ml each; 2-4 years - 7.5 ml; 4-8 years - 10 ml each; 8-10 years, 15 ml each; 10-12 years - 20 ml each.

The etiological treatment of cough in a child with fever presupposes the fight against bacterial infection. If a child cough and temperature is 40, then antibiotics are needed. Pediatricians prescribe in such cases Amoxicillin (Amine, Amoxylat, Ospamox, Flemoxin), Clarithromycin (Clacid, Klimitsin, Clindamycin, Fromilid) or Azithromycin (Azitral, Zitrolide, Sumamed). Amoxicillin to children 2-5 years old give 0.125 g three times a day (after meals), children 5-10 years - 0.25 g three times a day. Dosage for adults - 0.5 g three times a day.

Dosage of Clarithromycin, recommended for the treatment of tonsillitis in children over 12 years of age (children not younger than this age, the drug is not prescribed) - 0.25 g twice daily or 0.5 g once a day (the minimum course of treatment is 5-7 days ). Azithromycin in the form of a syrup is prescribed at 10 mg per kilogram of body weight, the drug should be taken once a day for an hour before meals - for three days.

Antibiotics in pertussis make sense to apply within three weeks from the onset of the onset of symptoms of the disease, but antibacterial therapy in the future does not give positive results in most affected children. When pertussis in infants, it is recommended to use hyperimmune gamma globulin against pertussis. And effective methods of symptomatic cough treatment in this disease have not yet been developed.

The main task that symptomatic cough treatment in a child with a temperature should solve is to turn a dry cough into a wet cough and thereby speed up and facilitate the release of the respiratory tract from sputum.

So, syrup from cough Ambroxol (Ambrobe, Ambroghexal, Lazolvan) should be administered to children under 2 years - 2.5 ml 2 times a day; 2-5 years - 2.5 ml three times a day; after 5 years - 5 ml 2-3 times a day. If with laryngitis, tracheitis, pneumonia, an intense dry cough in a child with a temperature, then, starting at age 12, the use of the drug Acetylcysteine (ACTS, Acetastad) - 100 mg three times a day is allowed.

The most recommended expectorant syrups in pediatric practice are:

• syrup althea - apply to children up to 12 years on a teaspoon (dilute in 50 ml of warm water) to 5 times a day, children over 12 years - on a tablespoon 4-5 times a day (take after meals);
• Pertussin (Tussamag) - taken on a tea or dessert spoon three times a day;
• Bronchicum - children under 2 years are recommended to give half a teaspoon twice a day; 2-6 years - one teaspoonful; 6-12 years - one teaspoon three times a day; after 12 years - on a dessert spoon three times a day;
• Broncholitin - for children 3-10 years to give 5 ml three times a day, over 10 years - 10 ml 3-4 times a day (after eating);
• Bronchitis - is used from three months of age to 10 drops three times a day (after a meal), and from year to 10 drops, one drop should be added for each year of the child's life.

Expectorant drug based on the althea root extract Mukaltin (in tablets) dilutes sputum; children 3-5 years are recommended to give half a tablet three times a day (you can dissolve the pill in a small amount of warm water). After 5 years can be used for the whole tablet.

If a strong cough, vomiting and fever in a child older than three years, it is possible - exclusively for the prescribing doctor - the use of an overwhelming cough reflex syrup Sinekod (Butamirat): children 3-6 years - 5 ml syrup three times a day, 6-12 years - 10 ml, after 12 years - 15 ml three times a day.

They ease phlegm and help cough in a child with a temperature of steam inhalation with soda (a teaspoon per cup of boiling water) or with any alkaline mineral water. It is also useful to breathe steaming hot infusions of pine buds or eucalyptus leaves.

[7],

Prevention of cough in a child with a fever

The main prophylaxis of cough in a child with fever in ARVI is the year-round hardening of children and the systematic strengthening of their immune system. British pediatricians recommend in the "coldest period" to give children one gram of vitamin C per day. Some say that this reduces the manifestation of cold symptoms such as fever, cough and runny nose in a child by 13%. Other doctors argue that the preventive use of ascorbic acid does not reduce the incidence of colds, but reduces the duration of the disease by 8%.

Respiratory tract infections in children (especially in the first five years of life) - due to the inherent age of anatomy of the respiratory system - tend to have a long-term manifestation in the form of a subacute cough. So, after specific infections (for example, pneumonia), bronchial hyperreactivity in a child can last from three to eight weeks. And even with adequate symptomatic treatment of cough and normalization of temperature, the threat of transition to chronic cough remains. For this reason, in some cases, doctors do not guarantee a 100% positive prognosis of a cough in a child with a fever.

In the prevention of cough in a child with a temperature in diphtheria, measles and whooping cough, the leading role is played by appropriate vaccinations. According to WHO, in the world more than 40 million people suffer from pertussis every year, of which about 290,000 die. About 90% of whooping cough are children under 10 years old. Almost 2% of pertussis infected children under the age of one year (in developing countries - up to 4%) this infectious disease ends lethal.

So a cough in a child with a temperature, in the first place, should be correctly diagnosed, which is possible only when referring to qualified pediatricians and children's ENT doctors.