Question

The baby has symptoms of nasal congestion and phlegm in the throat while feeding, with smooth breathing during sleep and a sound of phlegm in the throat when awake and active. The illness has persisted for over 60 days since the child was discharged from the hospital. The medical history shows that the child was hospitalized for 10 days due to bronchitis at 38 days old, with no runny nose, no throat sounds, no cough, and normal body temperature before admission.

Answer

Based on the description, the situation seems to match the symptoms of bronchitis. Treatment suggestions include:

  1. For infants with high fever and systemic toxic symptoms, regardless of whether white blood cells are elevated, a blood culture test should be performed, and a tracheal secretion culture test should be attempted.
  2. Mainly focus on symptomatic supportive therapy, increase environmental humidity, maintain fluid volume, and administer intravenous fluids appropriately based on the situation.
  3. Oxygen therapy is the primary measure, with a flow rate of 1-3L/min (nasal cannula method) or >3-5L/min (mask method). Check for changes in breathing and heart rate before and after oxygen administration, and adjust the oxygen flow rate accordingly.
  4. Antibiotics: For mild cases, antiviral oral liquids or intramuscular injection of ribavirin or oral erythromycin derivatives can be used. For infants under 6 months and severe patients, penicillin or erythromycin derivatives are preferred, and intravenous administration can be used when fluid replacement is needed.
  5. Steroids: For severely ill infants with severe wheezing hypoxia and widespread dense lung signs, short-term intravenous infusion of hydrocortisone or dexamethasone can be used, or oral prednisone can be administered.