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Suggest Treatment For Chronic Cough And Difficulty In Breathing

Posted on Wed, 8 Oct 2014

Question: Have had the following since Sept 2011-- chronic cough non productive, constant throat clearing, difficulty in breathing in-SOB. These come and go every 1 to months. Occasionally the cough will taste infected. Have had cardiac testing, pulmonary testing and allergy testing. All normal. Coworkers and family comment that the above seem to be getting worse and more frequent. No one can tell me what is wrong.

Just an addition- had mold on our bedroom wall several years ago. Thought that might be causing/contributing to the problems. Dry wall was removed and replaced with new. No changes to health.

Answered by Dr. Sudhir (1 hour later)

Brief Answer:
I suspect a chronic mild/subclinical infection.

Detailed Answer:
Hello,

With those symptoms,I suspect a chronic mild/subclinical infection.These are often seen with mild cases of asthma.

A sputum examination can help to know if there is infection. Also get a chest xray done if not done since complains started.

Other approach is try empirical treatment with course of antibiotics.

One more thing to be considered, is tuberculosis, if there is weight loss, evening fever, loss of appetite, mild breathlessness etc.Sputum analysis will help rule out this as well.

Hope this helps.Please ask if there are doubts.Regards.

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

Follow up: Dr. Sudhir (46 hours later)

I work in the health care field and have a TB test done yearly. It is always negative. I live in Michigan in USA. There is a very low occurance of TB in this area. It would be very rare. Can you describe exactly what is meant by a subclinical infection? A very mild infection? Any chance of my condition being Valley Fever (I periodically visit my sister in Arizona USA) or vocal chord dysfunction?

Thanks for your attention XXXX'

Answered by Dr. Sudhir (3 hours later)

Brief Answer:
In that case I would suggest CT thorax.

Detailed Answer:
1. Subclinical infections are milder infections which dont show entire spectrum of symptoms.Such infections are generally chronic and not found on most tests.Generally in such cases there is small focus of infection , which body immunity is not able to clear.
2.Yes, valley fever can present like this.But this would be just guesswork without investigations .
3. You can get a HRCT thorax done with vocal cords included done, with and without phonation.This will evaluate lung parenchyma and also vocal cord.But primary I dont feel it looks like vocal cord dysfunction.
4.One more thing that cropped up in my mind is interstitial lung diseases, these can slo present like this.HRCT should help in this as well.
5.Even valley fever or subclinical infections can be better ruled out with HRCT.

So I guess a HRCT can be undertaken.Regards.

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

Follow up: Dr. Sudhir (34 hours later)

No other question for you. Thank you very much for your expert input. This gives me some options to explore with my local medical community. Regards also

Answered by Dr. Sudhir (11 hours later)

Brief Answer:
You are welcome.

Detailed Answer:
It was pleasure assisting you.Please feel free to ask if anything crops up in your mind.Till then bye.Regards.

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