A Child’s Battle with a Mysterious Lung Infection

Thoughts on maintaining a safe social distance

In retrospect, the first sign of a problem came during the night as Monday turned into Tuesday with what seemed like a harmless dry cough. Probably just spring allergies, the parents reasoned, these things can happen.

The cough’s frequency increased on Wednesday as hundreds of microorganisms quickly became thousands in the lowest lobe of the child’s right lung, unbeknownst to everyone.

On Thursday the girl stared off into space, poking at her favorite cereal without interest. The cough was still intermittent but a heaviness had begun in her breathing, and a slight rattling on the in-breaths. Worried palms met a still cool forehead; clearly something was amiss but there was no fever. Close watchfulness was now deemed essential.

Although watching didn’t hurt, listening revealed more. As late morning turned into afternoon, the dry cough turned into a bark, and the faint rattle graduated into a harsh vibratory noise, like knuckles raked across corrugated metal. In the perfectly warm and moist conditions of the lung, thousands had become millions in a malevolent mass that would resemble a silver dollar in an upcoming X-ray.

The phone at the pediatrician’s office sprang to life, both parties quickly agreeing that the time for medical attention had come.

Where the child had been infected was unknowable. Maybe the park, or the supermarket, or a group sing-along at the library. Speculation was pointless but inevitable. All along the parents had guessed croup because what did they know. Pneumonia, said the doctor, based on the chest X-ray and lung sounds. A pulmonary infection that seemed to come from nowhere on Thursday had likely been developing for four or five days.

And yet it had still been caught relatively early. It wasn’t until after leaving the clinic that the fever hit — the naive immune system finally mounting a proper defense against a contagion that had run unbridled for days.

Large doses of Ibuprofen disguised as raspberries were given for the next two days, just managing to keep the girl’s temperature below critical status. Antibiotics were forced down twice daily despite vehement protests. No amount of apple juice or chocolate sauce or vanilla yogurt could mask its bitterness. Finally, the combination of bodily and pharmaceutical defenses began to break down the tennis-ball sized mass of bacteria and fluid.

Though the illness had occurred in the early days of COVID-19’s spread across the U.S., before most even knew it was here, the immediate response to the antibiotic proved the girl’s pneumonia was bacterial, not viral, in origin. Perhaps a day or two before her first cough, a playmate had coughed, or sneezed, or touched a puzzle piece in a group setting. Scores or hundreds of bacteria held in a tiny droplet of mucus had somehow found their way into the girl’s nostril or mouth, and then down to her lung. There they lay, like burglars waiting for an alarm to sound after entering a dark and silent home. When none did, they began the work of multiplication — hundreds chaining into ten-thousand, and then a million, and so on.

Just two days after starting the antibiotic, the girl’s fever broke and the reckless enthusiasm of her spirit reemerged. The dry bark was replaced by a wet cough that indeed sounded how medical professionals described it: productive. Science had won the day; the child’s health was finally improving.

With equal parts gratitude and unease, the parents couldn’t help but wonder what might have happened if the infection had been untreatable. What if the cause had been viral, or if it had occurred in an era before antibiotics to combat it existed? The thought of a different outcome was briefly considered but then put aside, its implications too terrible.

Six months later and with the world still in the throes of a pandemic, my wife and I are determined to keep our family a safe distance from everyone else’s, for as long as it takes.

Unfortunately, parents of school-age children don’t have the luxury of just hunkering down at home, like we do with our toddler. Our hearts go out to all those having to make that awful decision during this difficult time.