My 4 year old girl Please help

Hi,

My 4.5 year old little girl ( previously very healthy, who never even had a chest infection) contracted bacterial tracheitus(hib, strep and staph) in conjunction with influenza A, par influenza and Adenovirus. She developed hiB pneumonia and by her 4th day on ventilator had developed ARDs. Doctors thought she wouldn’t make it and were considering Eccmo, but dialysis worked in removing fluid. She was extremely ill intubated and mechanically ventilated for 30 days. The first attempt to extubate did not work as she has a partial pneumothorax ( we were told it was really tiny) but not wanting to take a risk they reintubated her and put in chest drain. A few days later they successfully extubated her and she did very well breathing on her own. After withdrawals of a number of drugs she was sent down to ward and for two weeks was doing very well. All our focus was on rehabilitation and she is now walking( though still lots of physio to be done),talking and her mind is completely recovered. All doctors were happy with her progress until they did chest X-ray which showed bi-lateral deterioration. The visible line of the heart is not as ‘crisp’ and inflammation can be seen. The day after this X-ray she fell ill. She firstly complained of sore throat, then soon afterwards spiked a temperature. Her 02 levels remained fine but her heartbeat was elevated reaching up to 160 beats a minute at one stage, although mostly stayed in 130s. For a short while her breathing was much faster ( approx 45 breaths per minute). She had a mild dry cough since her infection but it worsened and developed into a productive wet cough. She was put on  taxocin iv. After two days her temperature returned to normal and her heartbeat decreased although it still is higher than normal ( varying between 110 to 130s when awake and 95- approx 105 when asleep). A week later her humour is fantastic. The colour has returned to her cheeks. She is eating and drinking normally and all examining doctors have said her both lungs sound good ( no wheezing or crackling with air moving well). However yesterday (7 days after her last X-ray) they repeated the X-ray and found no improvement ( no deterioration either). The bloods they took on the first day of temperature show that CRP is not elevated. They have checked for 30 most common viruses and none are present. They have now put her on oral azithromycin 3 days a week and continued with iv tazocin. A speech and language therapist has examined her and thinks aspiration is unlikely but they are still going to do a video fluoroscopy to check for silent aspiration. They are going to do a CT scan at the end of next week. Have you any suggestions as to what you think is wrong with her?

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