Question

BJ. is a 5-year-old boy who has suffered from repeated upper respiratory infections since he was 16 months old. At 4 years of age, he was diagnosed with allergic asthma. The following winter, at age 5, he was admitted to the hospital twice for acute asthma with a secondary bacterial pulmonary infection.

At the second admission, a complete blood count, sputum culture, and immune status work-up were ordered.

Laboratory Data

Assay                                        Patient Results          Reference Range

Hemoglobin                                13.5 g/dL              11.5-14.5 g/dL

Hematocrit                                    40% 33-43%

Total WBC count 16.2 x 10⁹/L          4-12 x 10⁹/L

Lymphocyte Count 4.3 x 10⁹/L             2.7-5.4

T lymphocytes                             2.4 x 10⁹/L             2.7-5.3

B lymphocytes                              1.0 x 10⁹/L            0.6-1.4

1. What is the etiology of this patient’s recurring infections? Explain your answer.

Answer 1

Asthma is a condition in which the swelling and narrowing of airways causes difficulty in breathing. Extra mucus is produced and it causes wheezing and feels shortness of breath. In children the airways can be inflamed when they are exposed to allergens like pollen or due to cold and respiratory infections. It can be genetic as well. It is also found that prenatal tobacco use, stress and antibiotic use by the mother also may increase chances of allergy to the offspring. This cannot be cured but the symptoms can be controlled by the right treatments. The major symptoms are frequent cough, wheezing sound while breathing, trouble sleeping due to wheezing, fatigue

In the case of B.J he has been suffering from respiratory infections since he was 16 months old. He is diagnosed with allergic asthma. The main causes for allergic asthma are: - Allergens such as pollen, dust, smoke, animal fur etc. -Cold weather, breathing cold air. -Respiratory infections like cold. - Food allergies caused by preservatives or sulfites added to food and beverages.

In the case of this child he is allergic and has been suffering from respiratory infections. The secondary bacterial pulmonary infection is an infection that occurs during or after treatments for another infection. The treatment taken for respiratory infections might have changed the child’s immune system. This makes child vulnerable to infections.This causes a secondary infection. From the laboratory data the white blood cells count is found to be above normal range that shows the presence of infection. This needs to be treated with antibiotics. Repeated episodes of asthma attacks and infection may lead to Pneumonia. So the best ways to prevent asthma is

- avoid the triggers leading to asthma. - do not smoke around child. It is a common trigger for children. - monitor the breathing for any symptoms to identify the attacks early.    - take medications as prescribed.