Question

How should infant bronchitis be treated? Detailed illness and consultation purpose: The child makes a whistling sound while nursing, and there seems to be phlegm in the throat. The breathing is smooth during sleep. When awake and calm, breathing is normal, but when playing, it seems like there is phlegm in the throat causing a whistling sound. Current condition and duration of illness: Since the child was discharged from the hospital, the condition has persisted for over 60 days. Medical history: The child was hospitalized for 10 days due to bronchitis at 38 days old. Before admission, there was no runny nose, no hoarseness in the throat, no coughing, and the body temperature was normal. During admission examination (X-ray), it may have been due to excessive sweating from being too bundled up and being in a cold examination room, which led to the child feeling unwell and having a fever after the examination.

Answer

Treatment Key Points:

  1. For infants with high fever and systemic toxic symptoms, regardless of whether the white blood cell count is elevated, perform a blood culture test once and strive to perform a tracheal secretion culture.
  2. Symptomatic supportive therapy is the main approach, increasing air humidity to maintain fluid intake, and considering intravenous infusion of maintenance fluids as needed.
  3. Oxygen therapy is the primary measure; oxygen flow rate of 1-3L/min (nasal cannula method), >3-5L/min (face mask method). Check for changes in breathing and heart rate before and after oxygen administration and adjust the oxygen flow rate as necessary.
  4. Antibiotics: For mild cases, antiviral oral liquid or intramuscular injection of ribavirin can be used, or oral erythromycin can also be taken. For infants under 6 months old or severe cases, choose penicillin or erythromycin group as the first choice. Infants requiring fluid replacement can be administered medication via intravenous route.
  5. Hormones: For severely ill infants with severe shortness of breath, hypoxia, and widespread and dense lung signs, short-term use of hydrocortisone or dexamethasone intravenous infusion or oral prednisone can be considered.