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Lung disorder,cough with sputum - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Lung and Chest disorders
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
Doctor :   Hi
User :   hi
Doctor :   Please go ahead with your query......
User :   i had my dr check me today for a cold and he did some percussions on my chest and lungs
User :   and he found that i had dullness in my left lung
User :   he thinks i may have a lung infection
Doctor :   ok
User :   may pneumonia or acute bronchitis
User :   but i am worried
Doctor :   ok
Doctor :   Was the chest X ray done?
User :   i have read info on the internet
Doctor :   Was the blood work(CBC ) done?
User :   i am having the x ray in 2 days
Doctor :   OK
User :   yes, wbc was done and all was good
Doctor :   Very good
Doctor :   Usually in Pnemonia, the WBC count is elevated . And there is a cough and sputun, and fever.
Doctor :   Do you have fever?
User :   my neutrophils were 1.9 and they they should be 2 as a minimum but he seems to think the antibiotics
Doctor :   Ok
User :   i have cough and sputum but no fever..
Doctor :   OK
User :   he seems to think the antibiotics may have caused me neutrophils to be low
Doctor :   Because the WBC count is normal, and no fever , I think it is not Pneumonia.I think it is acute bronchitis
Doctor :   OK
User :   my total wmb was 5.4 and the min is 4.9
Doctor :   OK
Doctor :   But still in normal range
User :   WBC was 5.4
User :   yes in the normal range..
Doctor :   We are worried about infection, in infection it is elevated. ANd usually more than 11
User :   ok
Doctor :   But still it is in lower limits excluding the infection
Doctor :   Bronchitis is local inflammation and infection
User :   i am worried about lung cancer especially with dullness in the lung
Doctor :   It usually does not spead
Doctor :   That is it does not become systemic infection
Doctor :   Ok
Doctor :   Lem me clear ur worries
Doctor :   *Let
User :   he thought as i dont smoke it would not be this this
Doctor :   1. Physical examination is unreliable. So we can not depend on it
Doctor :   2. How long u have cough
User :   about 3 weeks..started off with runny nose...sore throat and then started coughing
Doctor :   These symptoms are typical for viral infection, or atypical bacterial infection
Doctor :   Do you weight loss?
Doctor :   Do you smoke?
User :   no
User :   no
Doctor :   So based on these symptoms also , clinically we can delete the cancer
User :   i have actually gained wait whilst i have been sick
Doctor :   Then why u getting cancer thoughts?
User :   weight
User :   because of the coughing and phlegm...
User :   i read coughing is a symptom of lung cancer and the dullness in the lung..
Doctor :   But it started with runny nose...sore throat ,
User :   yes it did..
Doctor :   Cancer present with cough, with blood sputum, mild fever, weightless,
Doctor :   So I do not suspect cancer clinically
Doctor :   #. Atleast tosuspect canceer, we need chest X ray
Doctor :   In that chest xary there should be suspicious lesion/
Doctor :   You did not have thta?
Doctor :   *that
User :   i have not had the chest x ray yet thus i dont know about the lesion as yet..
Doctor :   There may not be any lesion....
User :   ok...
Doctor :   Cancer has clear cut hazyness in lungs
User :   so what is dullness in the lung
Doctor :   I am telling u different hears differently
User :   ok
Doctor :   What your physician hear may not be heard by another physcian
Doctor :   But I will expplain: User :   ok, i understand..
User :   what you mean..
Doctor :   Do you know bronchi
User :   yes
Doctor :   brochi has bunch of bronchioles
Doctor :   and then aloveioli
Doctor :   OK
Doctor :   #Alveoli
Doctor :   Did u get this
User :   yes
Doctor :   OK
Doctor :   Let us imagine a small ballon
Doctor :   now when all the alevoili are filled with infectious material/blood/fluid, then it is called consolidation
Doctor :   Nothing but filling the ballon with water
User :   ok
Doctor :   that material give dull sound
User :   ok
Doctor :   when the bronchi is blocked there is pooling of fluid /sputum behind the blockage
Doctor :   That gives infection
User :   i understand
Doctor :   This consolidation in lung gives White patches on chest ray
Doctor :   called infiltrates or haziness
Doctor :   If there any hazy spots, after 4-6 weeks they disappea, if it is due to infection
User :   does this go away on its own..
User :   ok
Doctor :   So repeat chest x ray if there any hazyness
Doctor :   if thereis no haziness dont do any thing
Doctor :   OK
User :   i have no pain...just the cough and phlegm as this stage...
Doctor :   DO u follow me?
User :   i do dr
Doctor :   Alright.
Doctor :   So let us wait for chest xary
User :   you have put me at ease...
Doctor :   Yea, some times we get frustrated because we do not have clear idea abt things
Doctor :   This anticipatory fear makes us nervous
User :   he took a sputum test yesterday and rang me back this evening
Doctor :   that is waste test
Doctor :   Dont even consider the results
Doctor :   I read it
User :   and told me i had heavy growth of upper resp tract flors
User :   flora
Doctor :   You had chat before
Doctor :   It is noraml
Doctor :   Thatis why I am telling u
Doctor :   It is not a standard test
User :   ok
Doctor :   It is done to get money
Doctor :   Did they do the culture of the sputum
User :   ok..thank u for explaining things to me
Doctor :   They dont do it
Doctor :   Because it is normal flora
Doctor :   There is bacterial sitting already in nose, pharynx
Doctor :   That is detected when u spit
Doctor :   I too get it when I get a sputum test
Doctor :   Yes, sputum has some importance when they want to change antibitcs
Doctor :   They do culture sensitivities on sputum and change antibitics accordingly
Doctor :   Do you follow me
Doctor :   But What Iam saying is, sputum test not the first test
Doctor :   Chest x ray is the first
Doctor :   Do yo follow me
Doctor :   Are you there?
Doctor :   Do you have any Qs?
User :   i understand what you have explained to me
User :   my dr seems to think there is a bad viral infection going round and my body will fight it
Doctor :   That is tru
Doctor :   e
User :   he claims he has patients with these symptoms or so weeks..
User :   8 weeks
Doctor :   POssible
User :   but it just started off with a sore throat and runny nose
User :   anyway..thank you once again...
User :   very professional.
Doctor :   Viral infection typically starts like that
Doctor :   Any way I am happy I cleared your Questions
Doctor :   Hope Chest x ray will be OK
Doctor :   Thank you for consulting
User :   so do i ..thank you
Doctor :   Have a Good Day
Doctor :   Bye
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