Master of Science, Doctor Than Thi Thuy Linh, from the Department of Pediatrics at Tam Anh General Hospital Hanoi, noted that the patient was eating poorly, had a rapid pulse of 142 beats per minute, and moist rales in the lungs. Two weeks prior, the child had been diagnosed with otitis media, bronchopneumonia, and acute nasopharyngitis, and had received outpatient treatment with various oral antibiotics, but without improvement.

Haemophilus influenzae bacteria can cause otitis media and pneumonia. Mycoplasma pneumoniae often leads to atypical pneumonia, with symptoms easily mistaken for common respiratory illnesses. Parainfluenza virus is common in children under 5 years old and can cause laryngotracheobronchitis, bronchiolitis, and pneumonia. It also damages the respiratory mucosa, creating conditions for bacterial superinfection.

According to Doctor Thuy, all three agents can cause cough, runny nose, fever, fatigue, and poor appetite, making it easy for parents to mistake them for a common cold. Co-infection with bacteria and viruses prolongs the illness and slows treatment response, as each agent has different biological characteristics and antibiotic sensitivities.

Doctor Linh rechecks Baby Bao's condition before discharge. *Photo: Tam Anh General Hospital*

The doctors developed a treatment regimen to simultaneously control both bacteria. During the use of injectable antibiotics, the patient experienced a grade two anaphylactic reaction to the medication. The doctors detected this early and managed it promptly, then switched to a safer antibiotic regimen.

The child received respiratory support, ensured nutrition, and was closely monitored. After treatment, the patient no longer had a fever, ate better, had stable respiration, and was discharged.

Doctors advise that if a child has a high fever, increased coughing, labored breathing, or shows no improvement after several days of treatment, parents should take them to a medical facility for examination. Parents should not arbitrarily purchase antibiotics, reuse old prescriptions, or change medication themselves during treatment without a doctor's prescription.