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Have Chest Tightness And A Lot Of Mucus. Took Inhaler With Zithromax And Prednisone. Any Effect?

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Posted on Fri, 1 Feb 2013
Question: I have had problems with chest tightness and a lot of mucus. I had serrarati marcescens bacteria found during throat culture beginning of dec and was on bactrim . I had been prescribed an inhaler from an ER visist. Itook the prescribed two puffs for what I thought was a bronchspasm. Prior to this I had woke up with mucous in my throat and could not clear it without getting up to drink some water. I was very scared. I thought i was dying. The inhaler cause my heart to rise and I went to the emergency room that night. They took me I had anxiety and gave me lozaerpam. I have since gone to an ENT he did not help much told me to stay after from Albertol inhaler and gave more more lozaerpam. I have been taking the lozaerpam each night since 12/15 at .5 mg. today the urgent care center told me seeing I still have chest congestion that I may have bronchitis and she prescribed me with Zithromax and prednisone. Scared to go to sleep and afraid I may have taken the lozaerpam too long. I have another appointment to follow with my primary but I am a new patient there and can't get in til Thursday of next week which seems like forever. I just have not been right since 12/1 when I thought I had trep but come to find out after on amoxicillin for 6 days the bacteria was resistant. Just want to get back to normal.

I also start with all this weighing 136 lbs. today at the urgent care center I weighed 116 lbs and that is from 12/1 to today. I am 5 ft 3 I had my thyroid checked as well one as slight high but ENT did not think it was a problem told me to et blood done again in 6 months and we will see.
doctor
Answered by Dr. Sujoy Khan (1 hour later)
Hello XXXXXXX,
Welcome to Healthcare Magic and thank you for writing to us.

Just to start with the throat culture report of growth of Serratia marcescens, it is very unusual for this rod-like gram negative bacteria to grow from throat culture, as it is usually seen in catheter associated bacteremia, and wound infection. Biofilms on teeth can have this bacteria but as you clean teeth daily, it should not be a problem. Also this bacteria can grow on throat swabs if you have been ill in hospital for a while. So, the point is, this bacterial report is something probably not worth pursuing too much unless you have been really unwell and required IV fluids, antibiotics etc.

The constant mucous and cough in your throat does not repeat check with a throat swab, culture studies, or sputum c/s if you are bringing up thick phlegm. A Chest X XXXXXXX is also a must.
However, if the mucous is white with no blood streaks, and a congested nose could mean (1) a viral infection that can affect airways in like having an asthma attack; or (2) allergic rhinitis/rhinosinusitis which can make you feel ill.
Allergy tests to exclude house dust mite, mould allergy will be important.
Also note that the serratia marcescens grows on bathroom tiles, shower corners so please get the areas cleaned with thick bleach using your home help. I would not recommend you do this at this time.

It is also best you use as less lorazepam as you can. Antihistamines such as cetirizine 10mg taken twice daily with a steroid nasal spray (like flixonase, or nasonex) will clear the nose and throat and are very safe medications. A blue inhaler (such as Asthalin, Salbair) for the lungs may prove useful.

I hope this helps.
Best Wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sujoy Khan (37 hours later)
They told me I had bronchitis and gave me zpac and prednisone with another type of inhaler and Flonase I am on second day of meds today just coughing alot not enough to bring anything up but feels like it may be breaking up.

Do I need to be coughing up mucus to really get rid of this or will the meds take care of it?

I go to family physician on the 10th just when I don't have anymore meds to take even though they still go on working. Another doctor my son's pediatric told me it sounded like walking pneumonia.
No one has done any Chet X-ray or throat cultures though. My husband has cleared with a bleach solution while I was gone. My parents gve us a clean air machine.I meant my husband cleaned the bathrooms with a diluted bleach solution while I was gone.
doctor
Answered by Dr. Sujoy Khan (9 hours later)
Hello,
Thank you for the update.

No, you do not need to be cough and force secretions out from the chest. The steroids (tablets/sprays) with the inhalers for the lung will do that for you. Steam inhalation helps the process. Happy to note that things are settling down, and that the bathrooms have been cleaned out.

Sorry I am not sure what the children's doctor meant by the term 'walking pneumonia'. Throat cultures and Chest X XXXXXXX will be necessary if things do not settle in the next 2 weeks.

Best Wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sujoy Khan (11 hours later)
Thanks I am starting to feel like it is loosing up just was not sure if I needed a productive cough which I don't have all the time. Thanks for all your help. I go to my primary doctor on the 10 th so it should work out perfect to be checked out to my sure I am clear.
doctor
Answered by Dr. Sujoy Khan (12 hours later)
Hello,

It is a good sign that you do not have a productive cough, fever, night sweats, rapid pulse rate that would be signs of a pneumonia.
You should get your lungs checked by the doctor or with a Chest X XXXXXXX if he feels it is required; allergy tests if possible; sputum c/s if required.

Best Wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sujoy Khan (18 hours later)
Ok thanks for all your help. I will have lot of questions for my new doctor on Thursday.I felt really good today until this afternoon. Now my throat is starting to feel scratchy, probably all the medicines and I feel like I can't get a XXXXXXX breath and chest feels tight but I keep reminding myself only on day 4 of 10 of antiboditic.
doctor
Answered by Dr. Sujoy Khan (5 hours later)
Hello,

Please use the antihistamine (cetirizine or fexofenadine) and the nasal spray with throat gargles (give 2 hours for the spray and then the throat gargles) for good effect.
Also use the salbutamol inhaler (maximum 10 puffs at one time) upto three times a day, until you see your doctor.
If any worse, get to an ER today.

Best Wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sujoy Khan (22 hours later)
I used the inhaler today did give me. More productive cough. I had an outing today and went to a restaurant I felt like I hd acid reflux after dinner. So took Zantac and I am feeling somewhat comfortable right now I jut can not eat alot without getting out of breath or feeling full so I think here my be a combination of things going on. I did not notice the scratchy throat today. Still earlier today I feel lik I hd to take short breaths not XXXXXXX normal breaths. My hands started to feel tinkling, my mom said I was hyperventilation I took my anxiety medicine and felt better to at least eat at the restaurant with the group we were with.
I did notice thy there were temperature changes in the room we were into today for my family thing that probably did not help. One room was really cold while the other room was warm with all the people in it.i am done with the sntiboditic and jut vh to take predinsone tomorrow I am going to continue the inhaler and Flonase tomorrow
doctor
Answered by Dr. Sujoy Khan (2 hours later)
Hello,
Gastric acid reflux can cause a cough, that is made worse on lying down.
Zantac (Ranitidine 150mg twice daily) or Rabeprazole 20mg once daily are good medications to lower gastric acid levels. Antibiotics and steroids will cause a degree of stomach irritation, hence the need to take them after food.

It is good that you are noticing less of the scratchy throat, so do continue on the nasal sprays.

The anxiety medication will help with panic attacks, and hyperventilation lowers the CO2 levels that causes pins and needles in your fingers. So keep them handy.

Things are settling down, and will be happy to help if you have any further queries.

Best Wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sujoy Khan (43 hours later)
Primary doctor prescribed me on Prilosec She said my lungs were clear breathing was good. I go back in a month to get rechecked She thinks so may medicines did a Number on my body Suggested to eat better my potassium was low so bananas for breakfast I really do notice more problems after eating
doctor
Answered by Dr. Sujoy Khan (4 hours later)
Hello,
I would suggest staying on the Rantac twice daily for now until the gastritis resolves.
Bananas are good (2 a day) to get your potassium levels high.

Glad to note that the chest was clear, and there was no need for CXR or other investigations.

Best Wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sujoy Khan (14 hours later)
Thanks for all your help. It is amazing that acid from my stomach can cause so many problems and make it seem like it was breathing or lung problems. I am still not 100% but can eat better now with the medicine. I find myself burping alot after lunch today. Lol. I have to take the Prilosec for at least 14 days straight. I find I have less anxiety now knowing there is not nothing majorly work with my chest.
doctor
Answered by Dr. Sujoy Khan (11 hours later)
You are most welcome.
Continue your medications for 14 days and get a review done at the Doctors if possible.

Best Wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sujoy Khan (17 hours later)
Stomach just hurts after eating. Is that normal in the beginnning? on the 2nd day. I am trying to eat smaller meals more than 3 times to keep up on nutrition and my weight I dont want to loose anymor any more weight already lost 15 pounds. I am lso trying to be selection in what i eat to not cause more problems.I still find myself needing to take deeper breaths. I yawn alot with my hand over my mouth to get what I need and I don't know why.
doctor
Answered by Dr. Sujoy Khan (4 hours later)
Hello,
You are doing the right thing in eating smaller amounts of foods but at more frequent intervals.
Try and get a good night's sleep and the anti-anxiety medication will help with that when you think you might need one.

High protein foods include cereals, nuts, dried fruits if you like these.

Best Wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sujoy Khan

Allergist and Immunologist

Practicing since :1999

Answered : 584 Questions

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Have Chest Tightness And A Lot Of Mucus. Took Inhaler With Zithromax And Prednisone. Any Effect?

Hello XXXXXXX,
Welcome to Healthcare Magic and thank you for writing to us.

Just to start with the throat culture report of growth of Serratia marcescens, it is very unusual for this rod-like gram negative bacteria to grow from throat culture, as it is usually seen in catheter associated bacteremia, and wound infection. Biofilms on teeth can have this bacteria but as you clean teeth daily, it should not be a problem. Also this bacteria can grow on throat swabs if you have been ill in hospital for a while. So, the point is, this bacterial report is something probably not worth pursuing too much unless you have been really unwell and required IV fluids, antibiotics etc.

The constant mucous and cough in your throat does not repeat check with a throat swab, culture studies, or sputum c/s if you are bringing up thick phlegm. A Chest X XXXXXXX is also a must.
However, if the mucous is white with no blood streaks, and a congested nose could mean (1) a viral infection that can affect airways in like having an asthma attack; or (2) allergic rhinitis/rhinosinusitis which can make you feel ill.
Allergy tests to exclude house dust mite, mould allergy will be important.
Also note that the serratia marcescens grows on bathroom tiles, shower corners so please get the areas cleaned with thick bleach using your home help. I would not recommend you do this at this time.

It is also best you use as less lorazepam as you can. Antihistamines such as cetirizine 10mg taken twice daily with a steroid nasal spray (like flixonase, or nasonex) will clear the nose and throat and are very safe medications. A blue inhaler (such as Asthalin, Salbair) for the lungs may prove useful.

I hope this helps.
Best Wishes.