Coughing in a child with fever

A cough in a child with a fever - that is, a combination of such a sign of inflammation as an elevated body temperature, with a protective reaction 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 cough in a child with fever

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

Flu begins to manifest itself with general malaise and symptoms of viral intoxication (aches, headache, etc.), but very quickly a cough appears in the child and a temperature of 40. Adenoviral ARVI is characterized by fever, cough and runny nose in the child, as well as lesions of the conjunctiva. The elevated temperature can last for a week and be accompanied by diarrhea.

When there is a sore throat, a sore throat when swallowing, a temperature of 37.5 and a cough in a child, then this may be a viral inflammation of the mucous membrane in the throat - pharyngitis. If the mucous membranes of the nose and throat are simultaneously affected by infection, then doctors diagnose nasopharyngitis, which is characterized by dryness and pain in the throat, difficulty breathing, dry cough, vomiting and fever in a child. Moreover, vomiting mucus is characteristic of the initial stage of this disease.

With laryngitis - inflammation of the mucous membrane of the larynx and vocal cords - the voice is hoarse, the throat is also scratchy, the child suffers from bouts of dry cough. Tonsillitis or angina (inflammation of the tonsils) is a complex disease: it can occur not only due to streptococcal or viral infection of the upper respiratory tract, but also with infectious mononucleosis or enteritis. In the latter case, the child develops a cough, fever and diarrhea.

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

The manifestation of bronchitis begins with a dry cough against the background of subfebrile body temperature. Then the cough becomes productive, that is, with the discharge of 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 - an acute infectious inflammation of the lungs with fever and cough - is caused by 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 lung membrane with the exudative form of pleurisy makes itself known as a wet cough and fever in a child, and if the cough is dry, then this is fibrinous pleurisy. In many cases, this pathology occurs as a complication of inflammation in the lungs.

The causes of cough in a child with fever may be hidden in the catarrhal form of whooping cough - an acute infectious disease of the respiratory tract caused by the bacterium Bordetella pertussis. In the prodromal period, whooping cough usually does not cause an elevated body temperature, and if the temperature rises, then insignificantly, having little effect on the general well-being of the child. In addition, despite the paroxysmal nature of the cough, some pediatricians are misled by the similarity of the initial phase of whooping cough with acute respiratory infections, and they prescribe treatment for a common respiratory infection. In the meantime (after about 8-10 days), coughing fits become stronger - with a whistle when inhaling, with viscous sputum that is difficult to cough up, with the transition of attacks of painful cough to vomiting. And no therapeutic measures relieve these symptoms, for which in the West the disease is called a 100-day cough

A good doctor in such circumstances, cough, vomiting and fever in a child should immediately prescribe a blood test for leukocytes and lymphocytes, as well as conduct a serological study of sputum and a smear from the nasopharynx. Because the mildest complication of whooping cough is bronchopneumonia, when the child's temperature is 38 and coughing with shortness of breath. And the most severe and sometimes irreversible is respiratory arrest.

Diphtheria is diagnosed when the pharynx and larynx are affected by the bacterium Corynebacterium diphtheriae, forming films that adhere to the tissues. A barking cough and fever in a child, swelling of the mucous membranes near local lymph nodes and hoarseness are signs of croup or diphtheria of the larynx. All this can lead to narrowing of the airways and their obstruction.

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

[ 4 ], [ 5 ], [ 6 ]

Treatment of cough in a child with fever

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

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

Etiological treatment of cough in a child with fever involves fighting a bacterial infection. If a child has a cough and a temperature of 40, antibiotics are needed. In such cases, pediatricians prescribe Amoxicillin (Amin, Amoxillat, Ospamox, Flemoxin), Clarithromycin (Klacid, Klimitsin, Clindamycin, Fromilid) or Azithromycin (Azitral, Zitrolide, Sumamed). Amoxicillin is given to children 2-5 years old at 0.125 g three times a day (after meals), to children 5-10 years old - 0.25 g three times a day. The dosage for adults is 0.5 g three times a day.

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

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

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

Thus, Ambroxol cough syrup (Ambrobene, Ambrogeksal, Lazolvan) should be used for children under 2 years old - 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 a child has an intense dry cough with fever due to laryngitis, tracheitis, pneumonia, then, starting from the age of 12, the use of Acetylcysteine (ACC, Acestad) is allowed - 100 mg three times a day.

The most recommended expectorant syrups in pediatric practice include:

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

An expectorant medicine based on the marshmallow root extract Mukaltin (in tablets) liquefies phlegm; children aged 3-5 are recommended to take half a tablet three times a day (you can dissolve the tablet in a small amount of warm water). After 5 years, you can use a whole tablet.

If a child over three years of age has a severe cough, vomiting and fever, then it is possible – only as prescribed by the attending physician – to use the cough reflex suppressant syrup Sinekod (Butamirate): children 3-6 years old - 5 ml of syrup three times a day, 6-12 years old - 10 ml, after 12 years - 15 ml three times a day.

Steam inhalations with soda (a teaspoon per glass of boiling water) or any alkaline mineral water will help to clear mucus and treat cough in a child with a fever. It is also useful to breathe in the steam of a hot infusion of pine buds or eucalyptus leaves.

[ 7 ]

Prevention of cough in a child with fever

The main prevention of cough in a child with a fever during ARVI consists of year-round hardening of children and systematic strengthening of their immune system. British pediatricians recommend giving children one gram of vitamin C per day during the most "cold period". Some say that this reduces the manifestation of cold symptoms such as fever, cough and runny nose in a child by 13%. Other doctors claim 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 anatomy of the respiratory system inherent in childhood - tend to manifest themselves for a fairly long time in the form of a subacute cough. Thus, after specific infections (for example, pneumonia), bronchial hyperreactivity in a child can persist from three to eight weeks. And even with adequate symptomatic treatment of cough and normalization of temperature, the risk of transition to chronic cough remains. For this reason, in some cases, doctors do not guarantee a 100% positive prognosis for cough in a child with fever.

In the prevention of cough in a child with a fever due to diphtheria, measles and whooping cough, the leading role is played by the corresponding vaccinations. According to WHO, more than 40 million people in the world suffer from whooping cough every year, of which approximately 290 thousand die. About 90% of those who become ill with whooping cough are children under 10 years of age. For almost 2% of children under one year of age infected with whooping cough (in developing countries - up to 4%), this infectious disease ends fatally.

So, a cough in a child with a fever, first of all, must be correctly diagnosed, which is only possible by contacting qualified pediatricians and pediatric ENT doctors.