Question
A baby makes a wheezing sound while nursing and has phlegm in the throat, and breathing is stable during sleep. Breathing is normal during quiet times and play but there is a phlegmy wheeze in the throat. The symptoms have lasted for over 60 days since the child was discharged from the hospital. The child was hospitalized for 10 days due to bronchiolitis when they were 38 days old. Before hospitalization, there was no runny nose, no wheezing in the throat or cough, and normal body temperature. It is possible that the child sweated a lot and the examination room was too cold, which led to inaccurate X-ray results.
Answer
Key points of treatment include: One, if an infant has high fever and systemic toxic symptoms, blood culture should be performed regardless of whether white blood cell count is elevated, and sputum culture should be performed as much as possible. Two, supportive treatment based on symptoms, maintaining humidity and body fluid, and appropriate use of intravenous maintenance fluids as needed. Three, oxygenation is the most important measure, with an oxygen flow rate of 1 to 3 liters per minute (nasal cannula method), or 3 to 5 liters per minute (mask method), checking changes in breathing and heart rate before and after oxygenation, and adjusting the oxygen flow rate as necessary. Four, antibiotics: for mild cases, antiviral oral liquids or intramuscular injections of ribavirin can be used, or oral penicillin derivatives. Infants under six months old and those with more severe cases should prioritize penicillin or penicillin derivatives, and patients who need fluid replenishment can receive medication via intravenous infusion. Five, steroids: for infants with severe asthma attacks, severe hypoxia, and widespread dense lung signs, corticosteroids such as hydrocortisone or dexamethasone can be administered intravenously for a short period of time, or oral prednisone can be used.