Q: My child has a rattling breathing sound but no cough or fever. Could it be pneumonia even after 12 days of antibiotics?

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Question:

My third-grader has been on different antibiotics for 12 days now. At the beginning of this cold, there was some coughing with phlegm, but that's gone. Now, the only symptom is a rattling sound from their chest when they breathe out deeply. It's loud enough to be heard by others and hasn't improved. My child feels fine and doesn't have a fever or much of a cough. I'm worried because this sound isn't going away. Should we get an X-ray? Could this be something other than bronchitis? Is it possible to have pneumonia without a fever or cough?

Answer:

It must be worrying that the breathing sounds are continuing despite 12 days of antibiotic treatment.

【Summary of the Current Situation】

• Third-grader, on antibiotics for 12 days.

• Rattling sound on deep exhalation (audible to others).

• No cough or fever, child feels well.

• Initial cough with phlegm has improved, but the sound persists.

【🟠 Recommendation: Re-evaluation by a pediatrician today】

See a doctor today if any of the following apply:

• The rattling sound has not improved in 12 days.

• There's no improvement despite changing antibiotics.

• You notice an increased breathing rate (for a 3rd grader, >30 breaths/minute when at rest), retractions (sinking in below the rib cage), or changes in lip color.

【Questions to Ask Your Doctor】

1. "Have the lung sounds changed on auscultation compared to our initial visit?"

2. "Is a chest X-ray necessary at this point?"

3. "What could be the reason for the slow response to antibiotics—could it be a resistant bacteria, a viral cause, or something else like an asthma exacerbation?"

4. "While the chance may be low, is it possible to have atypical pneumonia (like Mycoplasma) without a significant fever or cough?"

【What to Do at Home for Now】

• Maintain indoor humidity at 40-60% and ensure adequate fluid intake.

• Count their respiratory rate when they are calm and at rest (number of chest rises and falls in one full minute).

• Continue to give the antibiotics exactly as prescribed until the course is finished.

【🚨 Go to the Emergency Room Immediately for These Symptoms】

• Lips or fingernails turning blue or purple.

• Retractions (sinking in of the skin below the rib cage or above the collarbones).

• Difficulty speaking or gasping for breath.

• Sudden lethargy or decreased responsiveness.

To summarize the key point: Even if your child feels well, a persistent sound for 12 days may require re-evaluation with a stethoscope and possibly imaging. It's a good idea to contact your pediatrician today and discuss the questions above.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

https://fevercoach.us