Expert: Moshe Adler, MD - 3/31/2004

Question
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Followup To
Question -
Hello doctor..bradley saw his allergist/immunologist yesterday, and we discovered that in addition to his egg and milk allergy, he is also allergic to our dog. He does not seem to have a problem in my eyes...so is this test really accurate ? He was tested by injecting the antigen just under the skin, and he developed a blister afterwards. He was also diagnosed with asthma, and will be taking singulair once a day now.  Should we get rid of the dog, or is it possible for the two to coexist without a problem ? I was told that a child's allergy will only get worse with time, as they are exposed to the dog. And could this help to explain why he gets so many infections?
His serum antibody levels were normal, but we are still waiting on the specific antibody tests. He has another double ear infection again..his second one since having his new tubes placed on March 2. He is using cipro drops as well as cefzil. His chest xray is still not clear, and we return next week for another...any insight has always helped a great deal !
Answer -
Well, it really is best not to be around the dog at all, but if you really want to keep the dog, there are things you can do to help.  Minimize his exposure to the dog--keep the dog out of his room, and vaccuum frequently.  Singulair may help, too, as will an antihistamine.  Ask the allergist if he has other suggestions.  Yes--congestion from allergies can lead to ear and sinus infections.  

What is showing up on his chest x-ray?  If it persists, he probably should see a pediatric pulmonary specialist.

Moshe Adler, MD

From my understanding it is a small area of infiltration that has been persistant since he was originally diagnosed with pneumonia in January. i asked the allergist about this and she said it could possibly be realted to the asthma..not sure I understand, but as I said we go next week again.  If there is still something showing I will be asking about a referral to the pulmonary specialist.

As for the dog, I think we will find him a home, for Bradley's sake I think it is much more fair. I will keep the dog until we find a suitable home ( it won't be easy to place an excitable 6 yr old lab )...


Answer
A persistant area on xray may be from pneumonia, but that usually clears within a few weeks.  A foreign body in the airway can cause it, too.  Kids do this a lot.  They put something in their mouths and don't realize it went down the wrong way.  There are also some malformations that children can be born with that will show up as a persistant infiltrate.  If it is still there, I would want someone to take a closer look.  He probably should have an MRI of his chest, or a bronchoscopy to actually look down the airway if it looks like it's in a place that is accessible to the scope.  

Moshe Adler, MD