You sound very distraught over your son?s health, and I?m glad you
wish to take action. It is painful to see young children feel poorly,
and most parents would do anything to see them recuperate immediately!
Please be aware that this answer is in no way intended to diagnose or
treat your son, and is not meant to replace sound medical advice from
a licensed physician. This answer is for informational purposes only.
There are hundreds of conditions or combinations of conditions,
that can be causing your son?s ailments, and obviously I would be
unable to list every condition, syndrome or disease that could be at
fault. An exhaustive list would take days to compile. I?ve attempted
to make a list of questions you can ask your doctor, along with some
useful diagnostic tests. Some of these ?possibilities? may sound
frightening, but please don?t be alarmed. I?ve included ?scary
sounding? things, not to be an alarmist, but to inform and help you.
Questions to ask the doctor:
Could my son have allergies? (Food, milk,substances, pets, etc.)
Could my son have Irritable Bowel Syndrome?
Could my son have Celiac Disease?
Could my son be Lactose intolerance?
Does he have any infected/abcessed teeth?
Could my son have a sinus infections?
Is my son a candidate for Pneumovax? (Pneumonia vaccine)
Could my son have infected ears? (Not all children complain about earaches)
Repeated ear infections can leave calcium deposits in the inner ear
that can break off and cause one to be dizzy and lose their balance.
Could my son be immunodeficient?
"Lacking immunity and so susceptible to infection"
?Common symptoms of immunoglobulin deficiency appear after the
infant is six months old. They include frequent ear and sinus
infections, pneumonia, and gastroenteritis. Certain viruses, such as
hepatitis and polio viruses, can also pose a threat. Children with XLA
grow slowly, have small tonsils and lymph nodes, and may develop
chronic skin infections. Approximately 20% of these children develop
arthritis, possibly as a result of joint infections.?
?Most people with selective IgA deficiency have few or no symptoms.
Others develop chronic respiratory infections, allergies, chronic
diarrhea, or autoimmune disorders. If given blood transfusions or
immune globulin that contains IgA, some people with selective IgA
deficiency produce antibodies against IgA. Such people may have a
severe allergic (anaphylactic) reaction (see Allergic Reactions:
Anaphylactic Reactions) the next time they are given a blood
transfusion or immune globulin. They should wear a medical
identification bracelet or tag to alert doctors to take precautions
against such reactions.?
Immunodeficiency disorders ?typically become evident during infancy or
childhood. There are more than 70 congenital immunodeficiency
disorders; all are relatively rare. Acquired immunodeficiency
disorders are much more common. Some immunodeficiency disorders
shorten lifespan, others persist throughout life but do not affect
lifespan, and a few resolve with or without treatment.
Immunodeficiency disorders are grouped by which part of the immune
system (see Biology of the Immune System: Introduction) is affected.
They may involve problems with antibodies (due to abnormalities in B
lymphocytes, a type of white blood cell), T lymphocytes (a type of
white blood cell that helps identify and destroy foreign or abnormal
cells), both B and T lymphocytes, phagocytes (cells that ingest and
kill microorganisms), or complement proteins. The affected component
of the immune system may be missing, reduced in number, or abnormal
?People with an immunodeficiency disorder tend to have one infection
after another. Usually, respiratory infections develop first and recur
often. Most people eventually develop severe bacterial infections that
persist, recur, or lead to complications. For example, sore throats
and head colds may progress to pneumonia. However, having many colds
does not suggest an immunodeficiency disorder.
Infections of the skin and the membranes lining the mouth, eyes, and
digestive tract are common. Thrush, a fungal infection of the mouth,
may be an early sign of an immunodeficiency disorder. Skin infections
by bacteria or viruses are also common. Bacterial infections (with
staphylococci, for example) may cause pyoderma, in which the skin is
covered with pus-filled sores. Warts (caused by viruses) may occur.
Many people lose weight. Children tend to develop slowly. Other
symptoms vary depending on the severity and duration of the
?Some children are born with defects in their immune systems. Those
with flaws in the B cell components are unable to produce antibodies
(immunoglobulin). These conditions, known as agammaglobulinemias or
hypogammaglobulinemias, leave the children vulnerable to infectious
organisms; such disorders can be combated with injections of
Other children, whose thymus is either missing or small and abnormal,
lack T cells. The resultant disorders have been treated with thymic
About the immune system
?The diagnosis of clumsiness in children is often missed because
parents may not recognize their child's uncoordination as a
significant medical problem. When parents mention their child's
awkwardness to a physician, their concerns may be dismissed;
physicians commonly reassure parents that children will outgrow
clumsiness. In the past 20 years, however, research has demonstrated
convincingly that in the majority of children, these motor deficits
tend to persist throughout, rather than resolve during, adolescence
?While it is not uncommon for clumsy children to have lifelong delays
in achieving motor milestones, such delays are most significant when
they begin to interfere with social-adaptive development. Motor delays
may interfere with a child's ability to play with other children;
difficulties with tasks such as riding a bicycle or catching a ball
are common. Problems in early schooling may arise because of a crude
pencil grasp and an inability to cut paper on a straight line.7
Increased friction in the home environment may result from delays in
self-care skills such as buttoning clothes and tying shoelaces.?
?A family history must be obtained to determine the presence of
familial clumsiness, ADHD, learning disabilities, or other
neurodevelopmental disorders. It is important to ask about a family
history suggestive of serious neurodegenerative disorders, typified by
a history of wasting and/or early death.16
The physical examination should begin with the recording of vital
signs, height, weight, and head circumference. A general physical
examination may alert the physician to alternate explanations for
This site has several charts, particularly Chart 3 and 4 that you may
want to print out and show your doctor, and ask for your son to have
his motor coordination tested.
Clumsiness is sometimes misdiagnosed as Attention Deficit Disorder (ADD)
?Norman Swan: Are they misdiagnosed as other behavioural disorders such as ADD.
Dr Ahern: Absolutely. ADD actually masks it a lot. One of the other
studies I did was looking at clumsiness with ADD and learning
Norman Swan: ADD being, I'm sorry I should have said, Attention Deficit Disorder.
Dr Ahern: Attention Deficit Disorder which is the hyperactivity,
basically the hyperactivity these children manifest with. Some of the
girls have the more day dreaming type, non hyperactive. But what I
found is that if you have Attention Deficit Disorders as a child, and
clumsiness, the Attention Deficit Disorder tends to mask the
clumsiness so it's actually slower, it takes longer to be diagnosed as
clumsy, than if you just had clumsiness in isolation.
Norman Swan: But with all the controversy about Attention Deficit
Disorder and the extent to which it is over-diagnosed, particularly in
Western Australia, could it be that the children acting out to cover
up their clumsiness could be mis-interpreted as Attention Deficit
Dr Ahern: Absolutely An Attention Deficit Disorder is so hard to
diagnose as it is, it is, I mean, as you said it's over-diagnosed and
some are not diagnosed in people that can probably legitimately call
Attention Deficit Disordered. But again, with these kids, it's a very
clever way of actually, and I've called it indirect avoidance, so
that, of a task, so if a teacher or a parent asks the child to tie
their shoelaces, rather than say specially in public and in school - I
don't know how or I can't, the child will either openly refuse, which
I've called direct avoidance - no I wont do it, in which case they're
naughty and they'd rather be considered naughty or bad or misbehaving,
or indirect avoidance which is distracting - look over there, or they
pretend that they get distracted so that that could look like
Attention Deficit Disorder when in fact it's actually the child
choosing that behaviour to hide the shame and embarrassment of having
to say I can't do it.?
?Finally, in the 1990s, we have strong evidence that the difficulties
of these children do not disappear with increasing age and that
failure to address their problems may lead to academic, behavioural,
physical, and psychosocial consequences. Increasing awareness of the
problem, combined with studies which demonstrated prevalence estimates
of 5-6% around the world, have prompted recognition by the American
Psychiatric Association (1994) and the World Health Organization of a
distinct movement skill syndrome which they have classified as
"Developmental Coordination Disorder."
?Children with developmental coordination disorder (DCD) comprise
around 5% of the population and are sometimes labelled clumsy or
dyspraxic. These children have difficulty with activities such as
handwriting, self-help and playing games and the condition progresses
through childhood with long term effects on academic achievement,
emotional and social behaviour. Without help, most children do not
Cuts and wounds that do not heal can indicate diabetes. Is there any
diabetes in your family? Diabetes is often hereditary, but not always,
and some researchers feel a viral infection can precipitate diabetes.
Wade through the clutter on this page to take a diabetes symptoms test
Some diabetes symptoms
· Frequent urination
· Excessive thirst
· Extreme hunger
· Unusual weight loss
· Increased fatigue
· Blurry vision
?Parents of a child with "classic" symptoms of diabetes may notice
that their son or daughter is abnormally thirsty, needs to urinate
frequently, and has been losing weight in spite of a good appetite.
But this is only one possible set of symptoms. Sometimes, the first
sign of diabetes is bed-wetting in a child who has always been dry at
You say your son has been tested for Hepatitis C up until he was 2.
Ask your doctor for your son to be tested again, and this time request
a Hepatitis C RNA test along with the usual Hepatitis C tests. The
Hepatitis C RNA tests for the virus itself, and not just the antibody.
Some people may not produce antibodies, but still harbor the virus.
?Sometimes, there are no symptoms at all. Some individuals with viral
hepatitis may develop fatigue, nausea, vomiting, diarrhea, abdominal
discomfort, muscle and joint aches, and changes in the color of urine
and stools. A few of the individuals with viral hepatitis may develop
jaundice. Jaundice means that the skin and whites of the eyes turn
yellow. Itching of the skin may also occur with jaundice.?
?Hepatitis C. About 2.8 percent of the world is chronically infected
with hepatitis C. Because it takes years for liver disease to develop,
many adults and children do not yet know they?re infected. Explore how
the virus infects, replicates and damages the liver.?
?CMV is a common virus that infects most people at some time during
their lives but rarely causes obvious illness. It is a member of the
herpes virus family. Other members of the herpes virus family cause
chickenpox, infectious mononucleosis, fever blisters (herpes I) and
genital herpes (herpes II). Like other herpes viruses, CMV infection
can become dormant for a while and may reactivate at a later time. The
virus is carried by people and is not associated with food, water or
animals. Most children and adults who are infected with CMV do not
develop symptoms. Those who develop symptoms may experience an illness
resembling infectious mononucleosis and have fever, swollen glands and
?CMV is also the virus most frequently transmitted to a developing
child before birth. CMV infection is more widespread in developing
countries and in areas of lower socioeconomic conditions. For most
healthy persons who acquire CMV after birth there are few symptoms and
no long-term health consequences. Some persons with symptoms
experience a mononucleosis-like syndrome with prolonged fever, and a
mild hepatitis. Once a person becomes infected, the virus remains
alive, but usually dormant within that person's body for life.
Recurrent disease rarely occurs unless the person's immune system is
suppressed due to therapeutic drugs or disease. Therefore, for the
vast majority of people, CMV infection is not a serious problem.?
FUO (Fevers of Unknown Origin)
Causes of FUOs:
HIV (late stage)
Other miscellaneous infections
Solid tumors (hypernephroma)
Collagen vascular disease
Giant cell arteritis
Systemic lupus erythematosus
?Definition: Fever of unknown origin (FUO) is a term applied to a
febrile illness with temperatures exceeding >101°F (38.3°C) that is at
least 3 weeks' duration and remains undiagnosed after 3 days in the
hospital or after 3 outpatient visits. This is further categorized
1. Neutropenic (neutrophils </= 500): check for perianal,
periodontal infections and candidemia, aspergillosis. (Nuetrophils are
a type of White blood cells, and neutropneia means a very low white
2. HIV associated: mycobacterium avium, mycobacterium TB,
non-Hodgkin's lymphoma, drug fever and CMV.
3. Nosocomial FUO: septic thrombophlebitis, clostridium difficile
colitis and drug fever.
4. Classic FUO: infections, malignancies, inflammatory diseases and drug fever.?
More on FUOs
Second hand cigarette smoke
?The impact of second-hand smoke on kids health
Second-hand smoke (which is sometimes called environmental tobacco
smoke or ETS) contains toxic substances, over 40 of which cause
cancer. Some of these substances are in stronger concentrations in
second-hand smoke than they are in the smoke that goes directly into
ETS is causally linked with a number of adverse health effects in
children (under 18), including:
·lower respiratory tract infections (i.e. croup, bronchitis and pneumonia)
·increased fluid in the middle ear
·upper respiratory tract irritation
·reduced lung function
·additional episodes of asthma
·increased severity of asthmatic symptoms in children
·reduced oxygen flow to tissues, comparable to children with anemia,
cyanotic heart disease or chronic lung disease ?
ETS is also associated with:
·Sudden Infant Death Syndrome (SIDS)
·acute middle ear infections (otitis media)
·cancers and leukemias in childhood
·adverse neurobehavioural effects
·upper respiratory tract infections (colds and sore throats)
·unfavorable cholesterol levels and initiation of atherosclerosis (heart disease)
?Breathing secondhand smoke can be harmful to children's health
including asthma, Sudden Infant Death Syndrome (SIDS), bronchitis and
pneumonia and ear infections. Children's exposure to secondhand smoke
is responsible for: increases in the number of asthma attacks and
severity of symptoms in 200,000 to 1 million children with asthma;
between 150,000 and 300,000 lower respiratory tract infections (for
children under 18 months of age); and, respiratory tract infections
resulting in 7,500 to 15,000 hospitalizations each year.
The developing lungs of young children are severely affected by
exposure to secondhand smoke for several reasons including that
children are still developing physically, have higher breathing rates
than adults, and have little control over their indoor environments.
Children receiving high doses of secondhand smoke, such as those with
smoking mothers, run the greatest risk of damaging health effects.?
?A chest infection, or pneumonia, can occur in a previously healthy
child simply as a result of 'bad luck'. If certain viruses and
bacteria are breathed in and manage to travel down through the main
tubes in the lungs and get deposited in lung tissue, they may be able
to multiply and set up a significant infection which could produce
symptoms including a cough, mucky phlegm, difficulty breathing, a high
temperature, vomiting, loss of appetite and a general feeling of being
unwell. Antibiotics will often clear such an infection rapidly and the
child may get better quickly and have no further.?
?Pneumonia is often classified into two categories that may help
predict the organisms that are the most likely culprits.
· Community-acquired (pneumonia contracted outside the hospital).
Pneumonia in this setting often follows a viral respiratory infection.
It affects nearly 4 million adults each year. It is likely to be
caused by Streptococcus pneumoniae, the most common pneumonia-causing
bacteria. Other organisms, such as atypical bacteria called Chlamydia
or Mycoplasma pneumonia are also common causes of community-acquired
· Hospital-acquired pneumonia. Pneumonia that is contracted within the
hospital is called nosocomial pneumonia. Hospital patients are
particularly vulnerable to gram-negative bacteria and staphylococci,
which can be very dangerous.
Causes of pneumonia in young children
Viruses: parainfluenza viruses, influenza virus, adenovirus, and
respiratory syncytial virus (RSV).
Atypical organisms: Mycoplasma pneumoniae.
Bacterial: Pneumococcus, mycobaterial tuberculosis.?
As an animal lover myself, I do hate to incriminate pets as a source
of infection, but it does happen. You may want to consider having your
birds and dog cutured for pneumonia organisms, and Cryptosporidium
and Salmonella. Dogs have been the cause of repeated strep throat and
pneumonia by harboring the strep organisms. Cats can transmit
Bartonella (Cat scratch fever) and toxoplasmosis. I?m not saying your
pets ARE to blame, but if no other causes are found for your son?s
symptoms, it?s something to consider checking. (You don?t need to get
rid of your pets, you can test and treat them.)
?Chlamydophila psittaci infection in birds resulted in an outbreak of
pneumonia among the staff at the Copenhagen Zoo? ?Fleas also serve as
the intermediate host for one tapeworm species that could infect
children. Numerous other animal helminthes may infect humans
fecal/orally or through contact with animals or contaminated earth.
Parasite control through veterinary care and sound husbandry coupled
with hand-washing reduces risks associated with ecto- and
?Organisms linked to human disease outbreaks due to animal contact in
exhibition settings include Escherichia coli O157, Campylobacter,
Salmonella, and Cryptosporidium.8-16 Although these reports usually
document cattle, sheep, and goats as sources for infection, pets,
wildlife, and exotic animals should not be overlooked as potential
sources of enteric infections.
The primary mode of transmission for enteric diseases is the
fecal/oral route. Since animal fur, hair, skin, and saliva17 can
become contaminated with fecal organisms, transmission may occur when
people pet, touch, or are licked by animals.?
?Due to risk of infection with psittacosis, psittacine birds such as
parrots, parakeets, budgies, and
cockatiels should be allowed only if children do not handle them or
clean their cages. Cages should be clean and the bird?s wastes
contained.? Page 17
?Laboratory tests are needed to confirm the diagnosis of
immunodeficiency and identify the type of immunodeficiency disorder. A
blood sample is taken and analyzed to determine the total number of
white blood cells and the percentages of each main type of white blood
cell. The white blood cells are examined under a microscope for
abnormalities. Antibody levels, the number of red blood cells and
platelets, and the levels of complement proteins are determined. If
any results are abnormal, additional tests are usually performed.
A laboratory test using a chemical to stimulate lymphocytes or skin
tests may be performed if the immunodeficiency is thought to be due to
a T-lymphocyte abnormality. The skin test resembles the tuberculin
skin test, which is used to screen for tuberculosis: Small amounts of
proteins from common infectious organisms such as yeast are injected
under the skin. If a reaction (redness, warmth, and swelling) occurs
within 48 hours, the T lymphocytes are functioning normally. No
reaction suggests a T-lymphocyte abnormality. These skin tests are not
useful in children younger than 2 years.?
CBC and manual diff
(Not automated diff only) ? this multi-test checks for white
blood cells (WBCs) and the kinds of WBCs, red blood cells (RBCs) and
the size and shape of RBCs, platelets, hemoglobin (for anemia), and
supplies clues to many disorders.
Comprehensive Metabolic Panel
Hepatitis C RNA
Liver Function Tests
Stratagene autoimmune test
CMV antibodies (Cytomegalovirus)
CMV PCR ? to check for the virus itself
EBV antibodies (Epstein Barr Virus)
Quantitative immunoglobulins (nephelometry)
Urinalysis and C&S (Culture and sensitivity)
Stool for diarrhea causing organisms, parasites and amoeba
Finally, is your son getting plenty of healthy foods like fruits and
vegetables, and few empty calories like snacks, soda and candy? A
healthy diet low in sugar and processed foods and exercise can help
your son regain his health, if he is not already on a healthy diet.
Are his teeth in good health too? An abscessed or infected tooth can
challenge a child?s immune system.
?The immune system is one of the most important mechanisms for
fighting disease and preserving health. As we age, the ability of our
immune system to function at normal levels decreases and the
likelihood of getting infections increases. Nutrition has a
significant role in determining the strength of the immune system.
Simply put, good nutrition is an important factor in maintaining a
healthy immune system. Articles in this section deal with certain
immune-boosting foods, vitamins, and supplements that increase your
odds of staying healthy.?
?The best nutrition for the immune system is love and attention.
Children need to be held, hugged, rocked, massaged, nursed, touched
and kissed regularly. When they feel loved and sense that the people
around them love each other, they are secure and happy. There have
been many studies done that show that laughter and positive thoughts
and feelings stimulate the cells of the immune system. The more
children laugh and enjoy life, the better their immune function and
the healthier they will be. Emotional stress and unhappiness may
deplete the immune system and lower a child's resistance to disease.
An important way to guard against emotional stress and promote
positive feelings in an infant or toddler is by frequent and extended
breastfeeding. The comfort they receive from this reassures them and
can ease the sometimes-stressful situation of being a little person in
a big world.
Giving your child a massage is another wonderful way to relieve stress
and stimulate the immune system. You can easily learn to massage your
baby or child.?
There you go, Angel56. I hope this answer helps you pin down the cause
of your son?s trouble. Don?t be afraid to ask your son?s doctor all
the questions you need to. If you feel you are not getting your
doctor?s attention, or adequate answers to your questions, find a new
If any part of my answer is unclear, please do not close this question
by rating it, until you request an Answer Clarification. An Answer
Clarification will enable me to assist you further, if possible.
I wish you and your son the best.
Motor coordination + children
Weak immune system + children
Diabetes + pediatric