Humidity and Indoor Allergies

Check out this info from the AAAAI on indoor allergies and humidifiers! http://www.aaaai.org/conditions-and-treatments/library/allergy-library/humidifiers-and-indoor-allergies.aspx

Tricky childhood symptoms of sinus infection

No, it's not a headache, stuffy nose, or even green mucus -- though these can accompany an infection of the sinuses.  The most common symptoms of a sinus infection in a child are a wet, mucusy cough, often along with vomiting of mucus.  While these can happen with a garden-variety "cold", or viral respiratory infection, symptoms will generally linger much longer when there is a true bacterial sinus infection present.  Be sure to check with your child's doctor if these symptoms continue beyond 7-10 days with no sign of improvement.

If your child has asthma, keep in mind that a sinus infection can trigger an asthma flare-up, and may require earlier diagnosis and treatment. 

Childhood Asthma and Reflux

Esophageal acid reflux can trigger asthma at any age.  A study recently published in the in the Journal of Asthma suggested that children with higher intensity acid reflux (with abnormal results on esophageal pH monitoring) had more frequent or difficult-to-control nighttime asthma attacks.

It is important to consider GERD, or gastroesophageal reflux, in young children with asthma whose nighttime asthma control is difficult, especially if they are found to have no underlying allergies triggering their asthma.   The age of onset of nighttime uncontrollable asthma was younger for children with abnormal pH results:  3.63 vs. 5.77 years.

This study raises the possibility that some asthmatic children may have coexisting GERD in need of treatment.

Kwiecien J, Nachura E, Halkiewicz F, et al: Clinical features of asthma in children differ with regard to the intensity of distal gastroesophageal acid reflux.  J Asthma. 2011; 48: 366-373.

How Do Kids Describe Their Asthma Symptoms?

It is often difficult to tell what a child is feeling, and they may have a hard time describing symptoms to a parent or the doctor.  A recent study published in the medical journal, Chest, looked at the most common words used by children with moderate to severe asthma, ages 8-15 years, to describe their symptoms of moderate to severe asthma.

The most common descriptions were "My chest feels tight" and "I cannot get enough air in".  This is very similar to the way adults describe their breathlessness.  

But it is important to watch for nonverbal cues that asthma is causing trouble for your child.  Look out for night cough, or a cough triggered by cold drinks, laughter, or running.   Remember also that cough is a more common symptom of asthma than wheezing, which may or may not be heard without the aid of a stethoscope.

Harver A, Schwartzstein RM, Kotses H, et al: Descriptors of breathlessness in children with persistent asthma.  Chest. 2011; 139: 832-838.

Chronic cough could be associated with mold in musical wind instruments

Musical wind instruments can be a perfect place for mold growth: warm, humid inside surfaces during playing of the instrument, often not cleaned thoroughly, create a “biofilm” on the inner surface. Cases of chronic cough have been linked to inhalation of mold spores during trombone playing in one instance, and saxophone playing in another. The harmonica, which is played during both inhalation and exhalation, may be another potential source of mold exposure. In the case of the trombone player with an allergic lung condition triggered by mold from his trombone, cleaning of the instrument regularly with 91% isopropyl alcohol resulted in marked improvement of symptoms for 20 months, except when he neglected to clean the trombone for over a month.

Chest 2010 Sep; 138(3):754-6. Metersky ML, Bean SB, Meyer JD, Mutambudzi M, Brown-Elliott BA, Wechsler ME, Wallace RJ Jr. Trombone player’s lung: a probable new cause of hypersensitivity pneumonitis.

Chest 2010 Sep; 138(3): 724-6. Metzger F, Haccuria A, Reboux G, Nolard N, Dalphin JC, De Vuyst P. Hypersensitivity pneumonitis due to molds in a saxophone player.