1/23/2024 0 Comments Rhonchi lung sounds in baby![]() The PA view of the chest appears to be normal, without evidence of localizedor generalized air trapping or peribronchial thickening. Despite his well appearance, the mother's concernand the noisy breathing prompt you to order a chest X-ray. Reactive airways disease may cause noisy breathing, and it can be episodic.Perhaps you have missed the symptomatic moments during previous visits.The noise seemed to be present on expiration, which usually indicates anintra-thoracic problem. Coulda foreign body aspiration be the cause of the noisy breathing? Again, theproblem seems to have been present since birth, and you have only heardthe noisy breathing today. And he has two siblings who may leavefood debris, Lego blocks, and other small toys all over the house. But then,airway noise that arises from extra- thoracic structures is usually heardon inspiration, and this noise seemed to be expiratory.Īt 9 months, the infant puts all sorts of things in his mouth, as demonstratedby the attempts with the table paper. ![]() His breathing did seem noisier when he was supinefor the ear examination, and this is typical of laryngomalacia. Perhaps he has a congenitalproblem, such as laryngomalacia, tracheomalacia, subglottic stenosis, orvocal cord paralysis. On the other hand,he had noisy breathing in the newborn nursery. He does have two older siblings, and they are likely to bringhome plenty of viral illnesses. Common things happen commonly,and this child has had his fair share of upper respiratory infections andotitis media. But why? Nasalpassages narrowed with mucus could do it. ![]() The change in the noise of breathing is quite obvious. His vitalsigns appear to be normal: heart rate 110 beats per minute, respiratoryrate 36 breaths per minute, height 76 cm (90th percentile), weight 10.3kg (75th to 90th percentile), and head circumference 46.5 cm (75th percentile).The physical examination seems normal, including the chest examination.You note that the child becomes agitated when you lay him down to examinehis ears, and that his breathing becomes noisy, especially on expiration.The mother quickly comments that this is the noise that bothers her. The infant is sitting up, smiling, and babbling as he rips the papercover on the examination table and tries to put it in his mouth. The baby lives at home with both parents and two preschool siblings.His mother smokes, but "never in the house." His immunizations are up to date.įamily history reveals that the mother, an uncle, and two of the infant'sgrandparents have asthma, and a 4-year-old sibling has multiple environmentalallergies. No difficulty with anesthesia was noted at the timeof the herniorrhaphy. He has been growing well, and his only hospitalization wasfor a hernia repair. His mother reports that he gagged on solids until he was about7 months old. He was breastfed until 3 months of age, but afterswitching to cow milkbased, lactose-free formula, he had problems withspitting up. The infant was delivered at term, with no complications during the pregnancyand vaginal delivery. On one occasion you note that you heard rhonchi in his chest. Your records indicateseveral episodes of otitis media, often accompanied by a green nasal mucousdischarge. You look back through your office notes and see that this child has beenon oral antibiotics several times during his short life. The noise seems better now that winterhas passed, but it is always there, and worse at night. She states that her son hashad noisy breathing since birth in fact, the nurses in the well-baby nurserythought that he was very "mucousy." The mother calls the noisybreathing a "rattling in his chest" but denies that her son hashad a chronic cough or wheezing. Noisy breathing in a 9-month-old: No noise is good noiseĭuring a routine well-infant visit the mother of a smiling, chubby 9-month-oldexpresses concern about his noisy breathing. ![]()
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