This board has been so wonderful for sharing ideas about medical mysteries. Hopefully someone can figure out what's going on with my child. He's two years old, and he's had chronic sinus infections since he was approx. 2 months old. The pediatrician and the ENT are out of ideas what might be causing them.
We did skin testing at 20 months, and he tested positive only to peanuts. At the beginning of December (23 months), he had his adenoid removed (dr. said that it was really massive) and coblation of the turbinates (they were too big and further limiting drainage and airflow). The surgery has allowed him to breathe through the nose (he couldn't previously) and he no longer snores, but it did not accomplish its main goal of stopping the chronic sinus infections. In 1-1/2 months since the surgery, he's had two sinus infections--- and that's with being on antibiotics for a week after the surgery. He's currently on his 20-day course of Omnicef.
Two weeks ago, we did an immunoglobulin panel to see if his immune system is working properly. His IgA was 31 (low, but normal), total IgE was <2 (indicating he's not constantly congested due to an environmental allergy or another allergy that's a frequent presence in his environment), IgG was 583 (middle of normal range), and IgM was 148 (upper end of normal is 146, but the dr. wasn't concerned it was slighly over since he had a sinus infection at the time of the blood test). For the CBC, the white blood cell count was slightly elevated, but again that's not surprising since he had a sinus infection. Some number was 1.2 when it should be >1.5. Dr. wasn't concerned since it has been normal in the past. I couldn't understand what she was saying, so I don't know what it is. It was part of the CBC.
If nothing improves over the next couple of months, the ped. wants him to be tested for cystic fibrosis. That seems like a huge stretch because the only symptom he has is chronic infections. The ENT said it's possible there's something structurally wrong with his sinuses. He didn't want to put DS through a CAT scan of them because he can't do sinus surgery until he's at least six years old. The ENT thought that, although he doesn't have an immune system deficiency, the IgA and IgM are so close to abnormal that maybe that's why he is so susceptible to infections. If that's true, why has he never had strep throat, has had only a few ear infections, etc.? I guess each person has a spot where infections are more likely to develop, but it seems that more is going on here.
Does anybody have any ideas of what else we should explore?
Edited to add: He takes 1 tsp of Zyrtec daily to try to help dry up the congestion. He also takes daily 1 spray in each nostril of Nasonex to try to help open him up and improve drainage.
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Mookie---Mom to Devin (PA, born 2004) and Brendan (PA, TNA, SA; born 1999)
[This message has been edited by Mookie86 (edited February 01, 2006).]
This sounds exactly like what my DH has. Just a thought, was he checked for nasal polyps? Or a deveated septum? I know its a far stretch from your DS, but my DH has both of these problems. He's always getting sinus infections and is always stuffed up. He's supposed to have surgery to remove them but they go up his sinuses under his eyes and the doctors always state the risk of going after them and possibly affecting his eyesight.