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Suggest treatment for cough, hoarseness and nausea when diagnosed with HIV

DOCTOR OF THE MONTH - Sep 2017
Sep 2017
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Answered by

Pulmonologist
Practicing since : 2008
Answered : 13033 Questions
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First I'm weary of consulting a doctor through a website and paying a fee. Regardless I'll give it a try if it's not too expensive. I'm HIV positive (diagnosed about 20 years ago). The virus is/has been undetectable for at least 18 years and my T-cells hover around 500. My cough started about three years ago, mostly at night. About two years ago I sought medical attention. I was prescribed an antibiotic regimen, twice. My symptoms persisted, and I was diagnosed with post-nasal drip. I was prescribed antibiotics (again), an oral medication, and two very expensive inhalers.
Fast forward to a year ago. I. changed doctors and a battery of tests were ordered. Everything was normal. My HIV doctor snuck in an additional test. I was diagnosed with a cryptococcal infection in my lungs and maybe my brain. A spinal tap was performed and the infection had not spread to my brain. I was prescribed fluconazole and have been taking it for about a year. I also have chronic nasal "shingles/scabs" which are painful and can obstruct my breathing.
A little over a week ago, I developed a cough, hoarseness, and nausea (no fever). For the past few days laryngitis and coughing have been persistent. Coughing gets worse when I try to use my voice. Sometimes cough produces white/yellow sputum. Sometimes it's just a dry cough. Physically I'm feeling okay, considering I'm tired from coughing.
I've been using/taking: Sudafed PE, Mucinex DM, Mucinex Fast/Max cough syrup, Mucinex Fast/Max inhaler, Rhinocort inhaler, atrovent inhaler, cold/flu tablets, cough/throat drops. The only thing that seems to help is the Mucinex nasal spray.


Thu, 24 May 2018 in Lung and Chest disorders
 
 
Answered by Dr. Kaushal Bhavsar 1 hour later
Brief Answer:
Get done PFT and chest x ray.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I have gone through the medications you have mentioned.
In my opinion, we should definitely rule out bronchitis and lung infection in your case.
So get done PFT and chest x ray.
PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only.
You may need longer acting inhaled bronchodilators.
Please let me know
1. Have you ever undergone PFT?
2. What is your last CD4 count?
3. Was chest x ray improved with fluconazole?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
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