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My Mom Had A Cough In November Month 2019, We

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Posted on Sun, 10 May 2020
Question: My mom had a cough in November month 2019, we took her to a ENT doctor who diagnosed her with brocantics, she came home did the treatment and was not imporving he then started to treat her for alergies also, still no improvement.
in January we took her to a regular doctor he ask for her history and we told him she smoked in her younger days, he took a look at her x-ray and said its probably cancer and there is nothing that can be done. He give her some steroids and sent her home. Around February she started to bring up a lot of sputum we took her to theoretical surgeon where he diagnosed her with pneumonia, he put her on antibiotics awaiting a culture test, when the culture test came back he started to treat her with Ciprofloxacin, 5 days after she started she was still getting worst so he administer her to the hospital where they give her some more powerfull antibiotics, she was feeling better and they released her 5 days after and she contunied the Ciprofloxacin. At the beginning of Match she was back to her old self coughing alot and being up alot of sputum and her shortness of breath keep getting worst, The doctor decided to do a CT Scan for Canger,
The CT Scan came back "Activity represents extensive pulmonary interstitial pneumonitis" " no mesiastinal mass is detected "tne mediastinal vessels and heart are grossly within normal limits, Visualized brests are morophologically normal". He kept her on the same course of antibiotics since he said that show the most from the culture test. She still cuntine the same way.. he did a bronchoscopy last Saturday, the patalogy lab said no signs of cancer and I am awating the medical results today.
I have over 10 Chest X-Ray scans, 1 CT Scan, 1 Bronchoscopy test. Still she doesn't seem to be getting better, and all he has her on is the antibiotics .

Current Medications she is taking
Ciprofloxacin 500mg (3 months + on this antibiotic)
Augmentin 625mg (2 Weeks 3 Days on this Antibiotic)
Doxycycline 100mg (3 Weeks on this Antibiotic)

Vitamin C and Zinc OTC Daily
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Follow up: Dr. Drkaushal85 (0 minute later)
My mom had a cough in November month 2019, we took her to a ENT doctor who diagnosed her with brocantics, she came home did the treatment and was not imporving he then started to treat her for alergies also, still no improvement.
in January we took her to a regular doctor he ask for her history and we told him she smoked in her younger days, he took a look at her x-ray and said its probably cancer and there is nothing that can be done. He give her some steroids and sent her home. Around February she started to bring up a lot of sputum we took her to theoretical surgeon where he diagnosed her with pneumonia, he put her on antibiotics awaiting a culture test, when the culture test came back he started to treat her with Ciprofloxacin, 5 days after she started she was still getting worst so he administer her to the hospital where they give her some more powerfull antibiotics, she was feeling better and they released her 5 days after and she contunied the Ciprofloxacin. At the beginning of Match she was back to her old self coughing alot and being up alot of sputum and her shortness of breath keep getting worst, The doctor decided to do a CT Scan for Canger,
The CT Scan came back "Activity represents extensive pulmonary interstitial pneumonitis" " no mesiastinal mass is detected "tne mediastinal vessels and heart are grossly within normal limits, Visualized brests are morophologically normal". He kept her on the same course of antibiotics since he said that show the most from the culture test. She still cuntine the same way.. he did a bronchoscopy last Saturday, the patalogy lab said no signs of cancer and I am awating the medical results today.
I have over 10 Chest X-Ray scans, 1 CT Scan, 1 Bronchoscopy test. Still she doesn't seem to be getting better, and all he has her on is the antibiotics .

Current Medications she is taking
Ciprofloxacin 500mg (3 months + on this antibiotic)
Augmentin 625mg (2 Weeks 3 Days on this Antibiotic)
Doxycycline 100mg (3 Weeks on this Antibiotic)

Vitamin C and Zinc OTC Daily
doctor
Answered by Dr. Drkaushal85 (1 hour later)
Brief Answer:
Inhalers and oral bronchodilator drug are advisable in her case.

Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
I have gone through the detailed history you have given.
By your history and description possibility of chronic non resolving pneumonia is more likely.
Along with Ciprofloxacin, she needs inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).
Oral bronchodilator, Acebrophyllin is also useful in her case.
Oral N acetyl cystine (NAC) is also recommended in chronic non resolving pneumonia.
It will be of great help if you can send me picture of bronchoscopy and last chest x ray.
I will be happy to help you further. Wishing good health to your mother. Thanks
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Drkaushal85 (0 minute later)
Brief Answer:
Inhalers and oral bronchodilator drug are advisable in her case.

Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
I have gone through the detailed history you have given.
By your history and description possibility of chronic non resolving pneumonia is more likely.
Along with Ciprofloxacin, she needs inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).
Oral bronchodilator, Acebrophyllin is also useful in her case.
Oral N acetyl cystine (NAC) is also recommended in chronic non resolving pneumonia.
It will be of great help if you can send me picture of bronchoscopy and last chest x ray.
I will be happy to help you further. Wishing good health to your mother. Thanks
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Drkaushal85 (32 minutes later)
Hi Doctor Bhavsar
I have attached
The Culture Report that was done after the Bronchoscopy
I have also attached the Bronghoscopy report
The CT Scan Report and here is a link to all the CT Scan Images
https://drive.google.com/open?id=1hpWkR3tQajG0zj0AsonELgF92wPzr4is

She is currently using one inhaler
I have uploaded a picture of the inhaler also
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Follow up: Dr. Drkaushal85 (0 minute later)
Hi Doctor Bhavsar
I have attached
The Culture Report that was done after the Bronchoscopy
I have also attached the Bronghoscopy report
The CT Scan Report and here is a link to all the CT Scan Images
https://drive.google.com/open?id=1hpWkR3tQajG0zj0AsonELgF92wPzr4is

She is currently using one inhaler
I have uploaded a picture of the inhaler also
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Follow up: Dr. Drkaushal85 (4 minutes later)
I will try to get you a copy of her last chest x-ray tomorrow, I will have to take a picture out with my phone not sure if it will work
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Follow up: Dr. Drkaushal85 (0 minute later)
I will try to get you a copy of her last chest x-ray tomorrow, I will have to take a picture out with my phone not sure if it will work
doctor
Answered by Dr. Drkaushal85 (1 hour later)
Brief Answer:
Start Augmentin and Clindamycin.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
I have gone through the reports you have attached.
In my opinion, she should start Augmentin and Clindamycin as both are sensitive and are superior than ciprofloxacin.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Drkaushal85 (0 minute later)
Brief Answer:
Start Augmentin and Clindamycin.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
I have gone through the reports you have attached.
In my opinion, she should start Augmentin and Clindamycin as both are sensitive and are superior than ciprofloxacin.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Drkaushal85 (6 hours later)
Good Morning Doc,
I have uploaded the latest X-Ray done on the 31st April 2020.

So I have a Couple questions
1) Medications she is currently using and recommended changes and dosages
----Current*
Ciprofloxacin 500mg ( 2 Times Daily ) (3 months + on this antibiotic)
Augmentin 625mg ( 2 Times Daily ) (2 Weeks 3 Days on this Antibiotic)
Doxycycline 100mg ( 1 Time Daily ) (3 Weeks on this Antibiotic)
Asabec Beclometasone Pressurrised Inhalation HFA BP 50 mcg ( Every 12 Hrs )

2) You have recommended her dropping the Ciprofloaxacin for Clindamycin, What dosage do you recommend?
3) Should she keep using the Doxycucline 100mb still?
4) The Inhalers you recommend can you tell me if the current one needs to be switched out for them and how often she needs to use the inhalers?
5) Do you see any signs so far of possible COPD?
6) Is there any other recommendations?


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Follow up: Dr. Drkaushal85 (0 minute later)
Good Morning Doc,
I have uploaded the latest X-Ray done on the 31st April 2020.

So I have a Couple questions
1) Medications she is currently using and recommended changes and dosages
----Current*
Ciprofloxacin 500mg ( 2 Times Daily ) (3 months + on this antibiotic)
Augmentin 625mg ( 2 Times Daily ) (2 Weeks 3 Days on this Antibiotic)
Doxycycline 100mg ( 1 Time Daily ) (3 Weeks on this Antibiotic)
Asabec Beclometasone Pressurrised Inhalation HFA BP 50 mcg ( Every 12 Hrs )

2) You have recommended her dropping the Ciprofloaxacin for Clindamycin, What dosage do you recommend?
3) Should she keep using the Doxycucline 100mb still?
4) The Inhalers you recommend can you tell me if the current one needs to be switched out for them and how often she needs to use the inhalers?
5) Do you see any signs so far of possible COPD?
6) Is there any other recommendations?


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Follow up: Dr. Drkaushal85 (16 minutes later)
The Current Doctor my mom is seeing is a Thoracic Surgeon we do not have any Pulmonologist in out country currently
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Follow up: Dr. Drkaushal85 (0 minute later)
The Current Doctor my mom is seeing is a Thoracic Surgeon we do not have any Pulmonologist in out country currently
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Follow up: Dr. Drkaushal85 (1 hour later)
Doc I also uploaded the video of her bronchoscopy to youtube if you would like to take a look. https://youtu.be/GBZR54Z8Rh0
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Follow up: Dr. Drkaushal85 (0 minute later)
Doc I also uploaded the video of her bronchoscopy to youtube if you would like to take a look. https://youtu.be/GBZR54Z8Rh0
doctor
Answered by Dr. Drkaushal85 (15 minutes later)
Brief Answer:
Yes add clindamycin 300mg twice daily.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Yes, replace ciprofloxacin with clindamycin 300mg twice daily.
Also stop doxycyclin tablet as it is already 3 weeks.
I don't understand your inhaler related question.
For possible COPD, she needs to get done PFT (Pulmonary Function Test). If PFT is showing obstructive defect then COPD is likely.
I will be happy to help you further. Wishing good health to your mother. Thanks

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Drkaushal85 (0 minute later)
Brief Answer:
Yes add clindamycin 300mg twice daily.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Yes, replace ciprofloxacin with clindamycin 300mg twice daily.
Also stop doxycyclin tablet as it is already 3 weeks.
I don't understand your inhaler related question.
For possible COPD, she needs to get done PFT (Pulmonary Function Test). If PFT is showing obstructive defect then COPD is likely.
I will be happy to help you further. Wishing good health to your mother. Thanks

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
default
Follow up: Dr. Drkaushal85 (1 hour later)
Hi Doc
You have recommended her using inhalers?
This is what you said in your first reply

"Along with Ciprofloxacin, she needs inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).
Oral bronchodilator, Acebrophyllin is also useful in her case.
Oral N acetyl cystine (NAC) is also recommended in chronic non resolving pneumonia."

Do I need to get the above and how do I use it if I get it?

Please advise

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Follow up: Dr. Drkaushal85 (0 minute later)
Hi Doc
You have recommended her using inhalers?
This is what you said in your first reply

"Along with Ciprofloxacin, she needs inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).
Oral bronchodilator, Acebrophyllin is also useful in her case.
Oral N acetyl cystine (NAC) is also recommended in chronic non resolving pneumonia."

Do I need to get the above and how do I use it if I get it?

Please advise

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Follow up: Dr. Drkaushal85 (1 hour later)
Doc please also keep in mind I have talked to you before on another website Your Recommendation were at that time along with the antibiotics.

Acebrophyllin 200 mg ( 1 Daily at Night )
Duolin Inhaler (4 Times Daily)
Budecort Inhaler (2 Times Daily)

Are these the inhalers you are recommending above?
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Follow up: Dr. Drkaushal85 (0 minute later)
Doc please also keep in mind I have talked to you before on another website Your Recommendation were at that time along with the antibiotics.

Acebrophyllin 200 mg ( 1 Daily at Night )
Duolin Inhaler (4 Times Daily)
Budecort Inhaler (2 Times Daily)

Are these the inhalers you are recommending above?
doctor
Answered by Dr. Drkaushal85 (0 minute later)
Brief Answer:
Yes, same Inhalers.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
Yes, same Inhalers.
Did you get those Inhalers?

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Drkaushal85 (0 minute later)
Brief Answer:
Yes, same Inhalers.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
Yes, same Inhalers.
Did you get those Inhalers?

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Drkaushal85 (41 minutes later)
I attached a picture those are the only inhalers the pharmacy has currently will any work? I am checking others pharmacies but so far no luck
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Follow up: Dr. Drkaushal85 (0 minute later)
I attached a picture those are the only inhalers the pharmacy has currently will any work? I am checking others pharmacies but so far no luck
doctor
Answered by Dr. Drkaushal85 (6 hours later)
Brief Answer:
May start Seroflo 250.

Detailed Answer:
Thanks for your question on 'Ask A Doctor' forum.
I can understand your concern.

I have gone through the image you have attached.
Start with Seroflo.

Hope I have solved your query.
I will be happy to help you further.

Wishing your mother good health.
Thanks


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Drkaushal85 (0 minute later)
Brief Answer:
May start Seroflo 250.

Detailed Answer:
Thanks for your question on 'Ask A Doctor' forum.
I can understand your concern.

I have gone through the image you have attached.
Start with Seroflo.

Hope I have solved your query.
I will be happy to help you further.

Wishing your mother good health.
Thanks


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Drkaushal85 (2 days later)
Good Morning Doctor
I have attached a picture of the inhaler I bought

Question 1: How often should she use this inhaler?

Update on her,
Coughing: Increased in the past 6 days
Shortness of Breath: Same
Sputum: With the change in medication 48 hrs after there is a 15-20% reduction in the amount of sputum but she has reported it seems a bit thicker than regular and she is coughing more to bring it up
Question 2: (Is this a good sign or a bad sign?)

Her taste for food had returned a little since you took her off the Ciprofloxacin.

Question 3: What are early signs to look for to know if the new course of medication is working?
default
Follow up: Dr. Drkaushal85 (0 minute later)
Good Morning Doctor
I have attached a picture of the inhaler I bought

Question 1: How often should she use this inhaler?

Update on her,
Coughing: Increased in the past 6 days
Shortness of Breath: Same
Sputum: With the change in medication 48 hrs after there is a 15-20% reduction in the amount of sputum but she has reported it seems a bit thicker than regular and she is coughing more to bring it up
Question 2: (Is this a good sign or a bad sign?)

Her taste for food had returned a little since you took her off the Ciprofloxacin.

Question 3: What are early signs to look for to know if the new course of medication is working?
doctor
Answered by Dr. Drkaushal85 (2 hours later)
Brief Answer:
This are good signs.

Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
In my opinion, all these are good signs.
Better to start chest physiotherapy so that she can expectorate secretions.
And encourage more food and water intake.
The inhaler you sent is correct.
Give twice daily.
Do gargles after taking inhaler.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Drkaushal85 (0 minute later)
Brief Answer:
This are good signs.

Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
In my opinion, all these are good signs.
Better to start chest physiotherapy so that she can expectorate secretions.
And encourage more food and water intake.
The inhaler you sent is correct.
Give twice daily.
Do gargles after taking inhaler.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Drkaushal85

Pulmonologist

Practicing since :2008

Answered : 15005 Questions

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My Mom Had A Cough In November Month 2019, We

My mom had a cough in November month 2019, we took her to a ENT doctor who diagnosed her with brocantics, she came home did the treatment and was not imporving he then started to treat her for alergies also, still no improvement. in January we took her to a regular doctor he ask for her history and we told him she smoked in her younger days, he took a look at her x-ray and said its probably cancer and there is nothing that can be done. He give her some steroids and sent her home. Around February she started to bring up a lot of sputum we took her to theoretical surgeon where he diagnosed her with pneumonia, he put her on antibiotics awaiting a culture test, when the culture test came back he started to treat her with Ciprofloxacin, 5 days after she started she was still getting worst so he administer her to the hospital where they give her some more powerfull antibiotics, she was feeling better and they released her 5 days after and she contunied the Ciprofloxacin. At the beginning of Match she was back to her old self coughing alot and being up alot of sputum and her shortness of breath keep getting worst, The doctor decided to do a CT Scan for Canger, The CT Scan came back "Activity represents extensive pulmonary interstitial pneumonitis" " no mesiastinal mass is detected "tne mediastinal vessels and heart are grossly within normal limits, Visualized brests are morophologically normal". He kept her on the same course of antibiotics since he said that show the most from the culture test. She still cuntine the same way.. he did a bronchoscopy last Saturday, the patalogy lab said no signs of cancer and I am awating the medical results today. I have over 10 Chest X-Ray scans, 1 CT Scan, 1 Bronchoscopy test. Still she doesn't seem to be getting better, and all he has her on is the antibiotics . Current Medications she is taking Ciprofloxacin 500mg (3 months + on this antibiotic) Augmentin 625mg (2 Weeks 3 Days on this Antibiotic) Doxycycline 100mg (3 Weeks on this Antibiotic) Vitamin C and Zinc OTC Daily