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Suggest Treatment For Persistent Coughing After TB

Posted on Thu, 3 Jul 2014

Question: Hello sir, my mom is 69yrs old, had suffered from tb around 4/5 yrs back but she still has coughing problem in between. Once in every three month we get her tft test done , doctor says there is lot of improvement in it. She normally gets cough due to dryness in the throat and she has frequent throat irritation as well due ti which throat gets red. After medication it gets cure but this problem gets cropped up every now and then. Could you pl suggest any treatment on the same.

Answered by Dr. Hardik Thakker (26 minutes later)

Brief Answer:
Please read the reply

Detailed Answer:
Dear XXXXXXX

Greetings from health care magic!!! I am Dr Thakker and shall be answering your question.

I understand your concern for your mothers health.

Can you please share the following with me:

Current x ray chest?

Last PFT test results?

Your mother can have post Koch's obstructive airway disease.

Pulmonary tuberculosis causes irreversible damage to the lungs. aAfter treatment these lesions in the lung heal with fibrosis . This causes narrowing of the airways and bronchiectasis. These changes are associated with excessive mucous production and cough which never completely resolves.

After seeing the above reports I may advice a HRCT to confirm our diagnosis.

In the mean time she can be given Ipravent inhaler and Reswas syrup for cough.

I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.

Yours sincerely,
Dr Thakker.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Hardik Thakker (31 minutes later)

Thanks dr thakker for your reply....will certainly mail u across the latest reports by today eod....

Answered by Dr. Hardik Thakker (4 minutes later)

Brief Answer:
thank you

Detailed Answer:
Dear XXXXXXX

Thank you for your reply. Awaiting the reports.

Dr Thakker.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Hardik Thakker (16 hours later)

Dear sir , as discussed y'day wrt to the latest pft and x ray reports, could you pl mail me your mail id so that I can mail it across because I am unable to attach these documents in this file....pl do the needful.....thanks and regards
Dear sir....have uploaded the latest x ray , pft and the doc prescription as well for your ref.....thanks

Answered by Dr. Hardik Thakker (7 hours later)

Brief Answer:
please read detailed response

Detailed Answer:
Dear Mr XXXXXXX

I have been through the X-ray image, PFT report and the prescription. Your mother has a mixed obstructive plus restrictive airway disease. This is a sequale to old tuberculosis.

Our next step of investigation would be a HRCT thorax. We also need an ECG and a 2D ECHO of heart to rule out pulmonary hypertension. This is a common complication of this disease. I would also recommend pneumococcal and influenza vaccination to her.

With regards to medications here are my suggestions:

she needs to take Duolin MDI, Foracort MDI, Acebrophylline. these are bronchodilator medicines which will help her. They will also reduce the cough and irritation. You need a written prescription for the same.

I also got to know that your mother has diabetes. She is on metformin right now. I wish to know her sugar levels, hba1c levels. She needs to be started on aspirin and statin like Razel. This is missing in her prescription.

I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.

Yours sincerely,
Dr Thakker.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj