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Dry cough, cold and irritation in throat, CT Thorax shows infectious bronchitis. Pulmonary fibrosis or any lung disease?

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Hello,

My father has been having dry cough, cold and irritation in his throat for about a month. After treatment with antibiotics(his chest x-ray was hazy before antibiotics and clear after) did not help, his physician ordered a CT-Scan of Thorax and Neck on 09/09/2011. Below I am reproducing the abnormalities from CT-Scan:

CT-Thorax (09/09/2011):
a)Areas of fibrosis with traction bronchiectasis are noted in the anterior segments of right upper lobe. Under 'REMARKS', the report says, "Minimal areas of fibrosis with traction bronchiectasis are noted in the anterior segments of right upper lobe".

b)Few fibrotic lesions are also seen in the apical segment of right upper lobe.

c)Osteophytes are seen from the dorsal vertebral endplates.Early degenerative changes are noted in the dorsal spine.

My father had a similar month long bout with dry cough and cold in March/April 2009. A CT-Scan of the Thorax was done on 04/11/2009. Below, I am reproducing just the parts of the report that were abnormal:

CT- Thorax(04/11/2009):
a)There are focal areas of consolidation in the the medial segment of the right middle lobe and the anterior segment of the right lower lobe. Multiple centri-acinar nodules are seen in both lungs.These findings are probably suggestive of infectious bronchiolitis. For clinicopathological correlation.

b)Fibrobronchiectatic lesions in the anterior segments of the right upper lobe, are probably sequalae of old infection.

My father will be seeing a pulmonalogist on Monday. In the meantime, I would be grateful for any answers that you can give me to my following questions:

a)Does my father have pulmonary fibrosis and/or interstitial lung disease?

b)Do you see a progression of this condition when the CT-Scan of 09/09/2011 is compared with 04/11/2009?

c)Is this a chronic condition for my father? Is there any hope for alleviation of his symptoms or possibly any cure?
How life-threatening is his condition?

Thank you! XXXXXXX
Posted Wed, 2 May 2012 in Lung and Chest disorders
 
 
Answered by Dr. Dinesh Goyal 36 hours later
Dear,

It would be good to know the exact age of the person but I assume he is an elder. It would be good to know if he smokes or has medical history of asthma or allergy.

To summarize, he currently suffers from Dry cough, cold and some irritation in throat for 1 month
An antibiotic course was given to him but he did not show significant improvement.

A recent CT (Computed Tomography) Scan of the Chest showed the following:
Areas of fibrosis with traction bronchiectasis in the anterior segments of right upper lobe. Few fibrotic lesions are also seen in the apical segment of right upper lobe. Osteophytes are seen from the dorsal vertebral endplates. Early degenerative changes are noted in the dorsal spine.

I wish to comment here:

These lesions are unrelated to lungs and are related to bone and probably reprsents degenerative changes and osteoporosis and are age related you have to contact an Orthopedic Surgeon for the same.

Old CT chest (2009) findings are unrelated to present illness as site of lesion are different and your father recovered from that illness completely.

To answer your questions specifically:

Q;-Does my father have pulmonary fibrosis and/or interstitial lung disease?

Ans:- No, he should not have interstitial lung disease by the above findings. This is because interstitial lung disease basically effects the lower lobes of the lung and is present on both sides of the lung. It is also symmetrical except for few conditions namely occupational lung diseases.
Since your father has fibrotic changes in the upper lobe only and that to one side a possibility of interstitial lung disease is remote.

It would be good to know the person's occupation to rule the possibility of Occupational lung disease.

Q:-Do you see a progression of this condition when the CT-Scan of 09/09/2011 is compared with 04/11/2009?
Ans:- The two CT scan reports are unrelated to each other, improvement or worsening cannot be commented.

Expert Pulmonologist would be able to compare the films better and detail when you XXXXXXX him on Monday.

Q.; Is this a chronic condition for my father? Is there any hope for alleviation of his symptoms or possibly any cure? How life-threatening is his condition?

Ans:- It is not possible to know the diagnosis with the available information. Lung fibrosis and traction bronchectasis represent healed scar of old infection and are going to persist. Since these lesions are in upper lobe ask your doctor to rule out tuberculosis.

Recurrent infections in these scars are frequent. In such a case appropriate antibiotic usually solves the infection.

Condition is not life threatening as per details enclosed. Get PFT (Pulnonary function test) done to rule out COPD (Chronic Obstructive Lung Disease).

Hope I answered your query.

Regards,
Dr. Dinesh Goyal.
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