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On Medication For Cough And Fever. Getting Shortness Of Breath With Normal Activity. How To Get Rid Of This?
Question: Hi,
Female age 44 with a with a sudden onset of barky cough that started on th 13/10/12. 2/52 T 38, GP started Doxycycline and 10 days later, an other Dr ordered Augmentin, low grade temps after 4 days of Augumentin. GP has now started Bactrum.
CXR- streaky changes in R) ML, no consolodation
sputum micro- serratia marcescens +++, reistant to lots, S to bactrum.
I get short of breath with normal activities after a while.
I have coughing spells that are relieved by Ventolin.
How infectious am I? Is this an incidental finding of normal bacteria, how can I make sure I get rid of all og it. Im a diver (and an RN)
Female age 44 with a with a sudden onset of barky cough that started on th 13/10/12. 2/52 T 38, GP started Doxycycline and 10 days later, an other Dr ordered Augmentin, low grade temps after 4 days of Augumentin. GP has now started Bactrum.
CXR- streaky changes in R) ML, no consolodation
sputum micro- serratia marcescens +++, reistant to lots, S to bactrum.
I get short of breath with normal activities after a while.
I have coughing spells that are relieved by Ventolin.
How infectious am I? Is this an incidental finding of normal bacteria, how can I make sure I get rid of all og it. Im a diver (and an RN)
Hello,
Thanks for posting your query.
Considering the details you have provided its most likely that you are suffering from a nosocomial (hospital acquired )infection with serrratia marcescens. The fact that damp moist conditions predispose to such infections and that you are a diver further increase your susceptibility .These bacteria are known to cause pneumonia which are resistant to many antibiotics and if your culture is sensitive to bactrim then your treatment started is appropriate . Though there is no consolidation seen I would consider it a lower gastrointestinal etc ) however hand to hand transmission from healthcare workers is the major cause for its spread . Also spread is more likely before the symptoms have developed . As of now you can practice good hand hygiene and universal precautions to prevent the spread of the infection.
To get it completely cured you might need additional parenteral antibiotic like amikacin if its susceptible .
Your doctor might repeat your investigations to ensure eradication of the bacteria . It's advisable to avoid diving till you recover completely .
Hope I have answered your query.
I'll be available for any follow up queries.
Regards
Thanks for posting your query.
Considering the details you have provided its most likely that you are suffering from a nosocomial (hospital acquired )infection with serrratia marcescens. The fact that damp moist conditions predispose to such infections and that you are a diver further increase your susceptibility .These bacteria are known to cause pneumonia which are resistant to many antibiotics and if your culture is sensitive to bactrim then your treatment started is appropriate . Though there is no consolidation seen I would consider it a lower gastrointestinal etc ) however hand to hand transmission from healthcare workers is the major cause for its spread . Also spread is more likely before the symptoms have developed . As of now you can practice good hand hygiene and universal precautions to prevent the spread of the infection.
To get it completely cured you might need additional parenteral antibiotic like amikacin if its susceptible .
Your doctor might repeat your investigations to ensure eradication of the bacteria . It's advisable to avoid diving till you recover completely .
Hope I have answered your query.
I'll be available for any follow up queries.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
Thanks so much. I forgot to mention that I first had this cough about 7 years ago, I was sick for 8 - 10 weeks with the same symptoms as now - except I don't know about Temps. Since then, I have had several episodes like this, but I did not have a sputum or a CXR. I was treated with Ventolin and steroids by an afterhours Dr, a year ago he diagnosed me with croup.
In the last 3 moths I have had this 'barking' cough twice just for a few hours and then it stopped with Ventolin.
I live in a house that was built in 1954 and last year I changed the water pipes under the vanity in the bathroom.
Also, 2 weeks prior to becoming sick this time, I had been doing laps in the pool at lunch time. I breath through a swimmers snorkel due to an old neck injury.
Does any of this change the case?
Thanks again :)
Thanks so much. I forgot to mention that I first had this cough about 7 years ago, I was sick for 8 - 10 weeks with the same symptoms as now - except I don't know about Temps. Since then, I have had several episodes like this, but I did not have a sputum or a CXR. I was treated with Ventolin and steroids by an afterhours Dr, a year ago he diagnosed me with croup.
In the last 3 moths I have had this 'barking' cough twice just for a few hours and then it stopped with Ventolin.
I live in a house that was built in 1954 and last year I changed the water pipes under the vanity in the bathroom.
Also, 2 weeks prior to becoming sick this time, I had been doing laps in the pool at lunch time. I breath through a swimmers snorkel due to an old neck injury.
Does any of this change the case?
Thanks again :)
Hello,
Thanks for the follow up.
Considering the new information you have provided I would like to mention the following ,
1. Snorkel swimmers are at an increased risk of pulmonary edema which is a serious lung injury characterised by pink frothy sputum breathlessness and water accumulation in airways , however it is not so prolonged and is more sudden, short lasting or life threatening .
2. Repeated episodes of cough and breathlessness relieved by ventolin and steroids point more toward a hyperreactiveness of airways like bronchioloitis rather than infective pneumonia .
If at all each of those episodes were diagnosed as lung infections in your case then your doctor might want to investigate you for immunocompromised status because low immunity might predispose to frequent infections .
I would recommend you to consult a pulmonologist for a confirmation of diagnosis who might order further investigations like lung function tests and high resolution CT scanof chest which can point out the exact etiology of your illness so that you can have a curative and specific treatment rather than symptomatic supportive therapy .
Considering the first episode was long back and the present episodes might not be related to it , I would still recommend the same line of management ( pulmonologist referral )as it would be the best next appropriate step in your case.
Hope I have answered your query .
Kindly accept my answer if you have no further queries.
Wishing you a speedy recovery.
Regards
Thanks for the follow up.
Considering the new information you have provided I would like to mention the following ,
1. Snorkel swimmers are at an increased risk of pulmonary edema which is a serious lung injury characterised by pink frothy sputum breathlessness and water accumulation in airways , however it is not so prolonged and is more sudden, short lasting or life threatening .
2. Repeated episodes of cough and breathlessness relieved by ventolin and steroids point more toward a hyperreactiveness of airways like bronchioloitis rather than infective pneumonia .
If at all each of those episodes were diagnosed as lung infections in your case then your doctor might want to investigate you for immunocompromised status because low immunity might predispose to frequent infections .
I would recommend you to consult a pulmonologist for a confirmation of diagnosis who might order further investigations like lung function tests and high resolution CT scanof chest which can point out the exact etiology of your illness so that you can have a curative and specific treatment rather than symptomatic supportive therapy .
Considering the first episode was long back and the present episodes might not be related to it , I would still recommend the same line of management ( pulmonologist referral )as it would be the best next appropriate step in your case.
Hope I have answered your query .
Kindly accept my answer if you have no further queries.
Wishing you a speedy recovery.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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