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Children's Health

Chronic coughing up phlegm for 7 years

02/23/2009

Question:

My 9 yr old daughter has been coughing up phlegm for 7 yrs now 4-6 times a day. She had pnemonia 3 times before she was 3. We had her tested for cystic fibrosis at that time with the sweat test and it was negative. She continued with constant bronchitis,sinus infections, ear infections until age 5 or 6. During that time she was diagnosed with asthma but none of the asthma medicines worked. She was on steroids, albuteral etc and nothing helped. They didn`t do a thing. We had her sinuses and adenoids x-rayed and one ENT said the adenoids were a little large, take them out and another said they were fine, leave them in. So we left them in. She continued a productive cough all day, but never at night while sleeping. We had one full year without a cough between the age of 5 and 6. Then it started again. It seems to have left her lungs but her nose is always congested. She doesn`t wheeze any more and hasn`t for years. She is full of energy and never out of breath. Now she seems to be coughing up phlegm even more, 10 times a day. It is clear with a little yellow glob in it. We took her to the allergist and she is allergic to dust mites, dogs and roaches. The cough is always there, no matter where we are. If we are at the beach, it is still there. When we go somewhere on vacation, it is still there. The phlegm was sent to the lab and came back negative for bacteria. Singulair, nasonex, claritan do not work. Claritan helped for about a week. It lessoned the amount of times she coughed up phlegm per day, but not anymore. We put her on protonix to rule out GERD and it did not help at all. No one has ever smoked in our family. What can cause a child to have so much mucous that she clears her throat, and coughs and spits out phlegm. What are we missing? What is the next step I should take. All the doctors I have been to don`t have any new suggestions. They all think it is odd that she does not cough at night. She does sneeze in the morning and has to blow her nose. I am beside myself and she is suffering with this. Thank you for any new ideas we can pursue.

Answer:

It certainly sounds as if she has been seen by multiple physicians. The two that I might recommend if she has not recently seen them are a pediatric pulmonologist and a pediatric allergist.

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Response by:

Michael Spigarelli, MD, PhD
Formerly, Associate Professor of Pediatrics and Internal Medicine
College of Medicine
University of Cincinnati