Pneumonia is inflammation of the lungs caused primarily by bacteria, viruses, or other organisms. The symptoms of pneumonia are rapid breathing, chills, fever, chest pain, cough, and bloody sputum. Children with low blood counts can rapidly develop a fatal infection and must be treated quickly and aggressively. Most cancer centers recommend an annual influenza shot to help prevent this cause of pneumonia.
My son received his high-dose methotrexate and vincristine injection just days before he was scheduled to go to the American Cancer Society's camp. His ANC was 1,200 and he looked so sick, but he begged to go and I let him. It was early in his treatment, and I didn't realize the pattern of his blood counts. They called me from camp on Friday to say he had a temperature of 103° and needed to go to the hospital. He was very weak and feverish; his WBC was 140, and his ANC was 0. Both lungs were full of pneumonia. I was furious at the doctor for giving him permission to go to camp and at myself for not paying closer attention to how quickly his counts dropped. I'm sure he had the pneumonia before he even went to camp. They started him on five different antibiotics, and his fever went up to 106° that night. We didn't know if he would live or die. He started to improve the next morning and was completely recovered in a week.
At the beginning of interim maintenance, Justin developed a fever. His oncologist said to give him Tylenol and to call if it didn't go down. The next day he was breathing faster and his little hands and feet were turning purple. We rushed him to the hospital, and the chest x-rays showed pneumonia in both lungs. He rapidly deteriorated over the next 48 hours, so they tried an experimental constant flow ventilator that had only been used on premature infants. It was the last-ditch effort to save his life. He gradually improved. He spent a total of five months in the hospital, four more months on a portable ventilator at home with full-time nursing care, and he breathed through his tracheostomy until he completed his treatment two years later. It was a miracle.
Erica complained that her back hurt for two days. Then she woke up in the night crying, and she couldn't move because it hurt her too badly. She was blazing with fever, and screamed if I touched her. Her x-ray showed that her left lung was half full of fluid. They put her on antibiotics, and within 24 hours she was on the mend.
Children taking steroids (prednisone, dexamethasone, hydrocortisone) are at increased risk for contracting serious and potentially life-threatening lung infections from an organism called Pneumocystis carinii. In most cases, the infection can be completely prevented by taking trimethoprim-sulfamethoxazole (Septra, Bactrim) two or three consecutive days per week.
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