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Question
Sir,
my 18 mo old child just had an episode of B/L pneumonitis and was hospitalized for over a week. He goes to a day care center. He had mild fever and cough and the next day itself we took him to his Dr, started on Amox and Levolin. 2nd day onwards he had very high fever (104F)which was not comming down with paracetamol.And on the 3rd day he ended up in the ICU very sick.
On this I have the following queries;
1. Was it preventable?
2. In a child with a resp. infection, Is very high fever (104F)which is not responding to paracetamol suggestive of pneumonia?
3. What were the other signs which we should have closely monitored and informed his Dr.before things got worse
4. Was his disease not responding to the first antibiotic (Amox)?
5. upto what time/ how many days we should wait until the antibiotic takes an effect? 2 days?
6. two months back, he had another lower resp. infection which was treated by MOXCLAV. Was it wise for his Dr. to start with Amox insted of MOXCLAV this time?
7. why the child diagnosis is pneumonitis not pneumonia?
Thankyou in advance for you valuable time, concern and help.

Answer
Hi, Anu,

The only way pneumonias are potentially preventable is by ensuring vaccination to the various bacteria that can cause this type of infection.

A high fever with a resp. infection does not always mean pneumonia;  it just is on the long list of things we think about.  

Generally pneumonias involve a sick kid who is breathing hard and fast and has a fever.

His disease may well have been viral and would not respond to any antibiotic.  My choice also would have been amoxicillin, the recommended antibiotic for pediatric outpatient pneumonia.

Generally, if the disease is due to a bacteria that is sensitive to an antibiotic, two days is about right.

The choice of augmentin vs amoxicillin is up to the individual doctor.  One would have a tendency to use the broader spectrum antibiotic in this situation, but again, most of us would use amoxicillin first.

I don't distinguish between the two diagnoses.  I actually prefer the term "lower respiratory infection."

Hope this answered each individual question for you.

Good luck, Dr. Olson

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David Olson, MD

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I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.

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