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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is severe cough emanating from behind the sternal notch a contagious symptom?

Answered by
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3474 Questions

Posted on Fri, 25 May 2018 in Ear, Nose and Throat Problems
Question: I have a severe cough emanating from behind my sternal notch but I'm coughing up very little phlegm. My doctor said i'm not contagious and prescribed:
Prednisone-20mg and AMOX/K CLAV-875-125 [Augmentin87mg]
however, my assistant reports that she now has a inflamed sinuses and chest cough since working around me yesterday.
QUESTIONS: 1. How can you tell if you are contagious?
2. Are you only contagious if your temp is above 100 degrees?
3. At what temp are you considered to have a fever?
4. How can you tell if you have the flu? (My doctor said he did/t think I had the flu but he said that he didn't have the proper equipment to detect it)
5. What equipment is used to determine if you have the flu or not?


I asked the doctor if i had a bacterial or viral infection. He said he didn't know but prescribed Prednisone and AMOX/K CLAV-875-125 [Augmentin87mg].
1. How does one determine if it is bacterial or viral (is there a test for this?)
2. and which one is an anti-biotic used for?
3. I am taking both for 10 days. Do I need to taper off of them or just stop at the 10th day?
4. Is the phlegm that I'm experiencing coming from my sinuses, bronchial tubes or trachea?
5. Why does the Prednisone (or any steroid) keep me awake?
6. What does it increase my blood glucose level?
7. Is it ok to continue doing my cardio on my stationary bike?
8. Will the biking reduce the phlegm and coughing or make it worse?
Answered by Dr. Panagiotis Zografakis 1 hour later
Brief Answer:
many questions so please read the full answer...

Detailed Answer:

for a new case of cough the infectious causes are the most likely ones. All infectious causes are potentially contagious! Some more than others but all are potentially contagious. The fever has nothing to do with the infectivity of a pathogen. Anything higher than 98.9F is usually called fever (low grade if less than 100.4F). There are special tests for influenza which may detect influenza in samples taken from the back of the nose and throat.

You can't easily distinguish bacterial from viral infections but there are some clues. This question is too broad to discuss in detail here. I can only say that there is a helpful test that may help in some cases but this is not the sole determinant of bacterial vs viral etiology. C-reactive protein in high levels is usually caused by bacteria.

The choice of antibiotic depends on the type of infection and many other factors (like your medical history, previous antibiotic exposure, etc) so there is not a single antibiotic that fits all cases.
Corticosteroids taken for a few days can be stopped cold turkey without any anticipated consequences. The same applies for antibiotics.

Your doctor can determine the source of infection (and phlegm) by examining you. There is no way that any doctor can tell where the phlegm comes from from afar.

Steroids may cause various side effects including insomnia and high blood glucose. It's OK to carry on with your physical activities if you feel up to them. During the course of infections though, the stamina is usually less than normal. Biking is not supposed to affect the phlegm, although more rapid and deep breaths may help to expel more phlegm.

I hope it helps!
Kind regards!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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