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Suffering from cold, blocked nose, cough and wheezing. High eosinophil count. Whom should I consult?

I have high eosinophils count (14.2%) in the blood. i am suffering from continuous cold, watery/blocked nose, sneezing , chest pain and cough in the night causes wheezing and breathing difficulties.. Sleepless nights.. dry eyes , itching in the eyes and throat...head ache. please advise which specialist doctor should i consult with... thanks..
Asked On : Sun, 4 Nov 2012
Answers:  3 Views:  292
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Lab Tests
General & Family Physician 's  Response
Symptoms described by you appears to be a case of asthma with allergic rhinitis. Please undergo pulmonary function test. Airflow obstruction with bronchodilator reversibility will establish the diagnosis of asthma. Please start Metered dose inhaler formoterol- budesonide(200) 2 puffs twice daily through spacer along with levosalbutamol inhaler 2 puffs 4 times daily initially and then as required. Also start tab Montelukast-levocetrizine 1 tablet 2 weeks followed by levocetrizine once daily. Also start fluticasone- azelastine nasal spray 1 puff through each nostril twice daily.You may use a diary card to record the symptoms you are having and a peak flow meter at home for objective measurement of asthma control.Asthma cannot be cured but it can be kept under control. You may consult a pulmonologist regarding further advise. Hope, I answered your queries.
Answered: Sun, 4 Nov 2012
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Allergist and Immunologist Dr. Sujoy Khan's  Response
Your symptoms and the raised eosinophil count would be consistent persistent allergic rhinitis with asthma. The IgE test helps only to document atopy but does not tell you what you are allergic to. You need specific IgE tests against the aeroallergens panel (definitely to moulds) or skin prick tests to identify the allergens.
Lung function tests with reversibility studies are also required. a CT scan paransal sinuses is currently not required if there is no loss in smell and complete nasal blockage.
Fexofenadine 180mg in the morning followed by nsaonex spray 50mcg / spray 1 spray / nostril once daily and montelukast 10mg at night should suffice. You can use Olopatadine eye drops upto three times a day if required.
You should consult an Allergy specialist or a respiratory physician with interest in Allergy.
Answered: Mon, 5 Nov 2012
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Pediatrician, Cardiology Dr. Pradeep Kumar's  Response
The clinical symptoms which you have described are suggestive of rhinitis, bronchial asthma and conjuctivitis. Increased eosinophil counts indicates that all are allergic in origin.

Laboratory investigations like Serum IgE level, pulmonary function test, chest X ray and if needed allergen test is needed to prove the disease.

I will suggest you to consult pulmonologist for proper clinical and laboratory evaluation and management accordingly.
Answered: Sun, 4 Nov 2012
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