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What causes non stop coughing and is it treatable?

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Practicing since : 1979
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Cough for 4 wks no fevers mild shortness of breath. Ct done 2 wks ago mild left lower lobe bronchiolitis vs pneumonia showed tree in bud appearance. Repeat today minimal worsening of same pattern. Small nodes in left lower lung . Had a full course of doxy now on avelox. Had medrol dose pak 2 wks ago now started another one today. Also using pulmocort inhaler and xopenex when having expiratory wheezes. Serologies havent returned cbc with diff and comprehensive metabolic panel were normal. Influenza a and b screen negative now sent another for h1 n1. Overall symptoms wax and wane with a few good days then like today nonstop coughing. Also oxygen sat between 92-97%. Question : will this resolve because nothing seems to be working? And If this is h1n1 will it progress to respiratory failure or since ive already jad symptoms for a month do i stand a better chance of resolution? Thx Concerned Guy
Posted Wed, 22 Jan 2014 in Lung and Chest disorders
Answered by Dr. Shashi Dangwal 3 hours later
Brief Answer: It could be asthma or ILD. Detailed Answer: Hello, Thanks for posting your query on XXXXXXX From your description, there are three possibilities in your case: Infection Asthma Iterstitial lung disease(ILD) In my opinion, infection seems unlikely and asthma and ILD need to be excluded. I would like to know the following: Do you have any history of allergy like allergy to smoke and dust etc? Are your symptoms progressive? Any history of joint pains? Bronchiolitis and H1N1 are unlikely as they are acute conditions and won`t linger for so long. In view of x ray description of lt lower lobe tree in bud appearance and lymphnode enlargement, TB infection needs exclusion though it is rare in your part of the globe and the xray finding may suggest ILD as well Having said that i am still inclined to think of asthma and ILD. This is because you say that you feel better with medrol and pulmocort. You need to get a second opinion on your CT chest. If required, A HRCT may have to be done. You should also get a lung function study done. You should consult a pulmonologist in person who can review your case with all the facts and advise you accordingly.
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Follow-up: What causes non stop coughing and is it treatable? 41 minutes later
Hrct showed no fibrosis and similar findings as ct pft mod restrictive pattern i do have allergies to dust never smoked these findings on ct were very different than ct from 2011 what would be examples of ild thx
Answered by Dr. Shashi Dangwal 1 hour later
Brief Answer: Reticulonodular opacities are seen in HRCT in ILD. Detailed Answer: In ILD, patient has dry cough and shortness of breath which is normally progressive. In HRCt, there is reticulonodular opacities mostly in lower lung fields and bilateral. There may be other findings depending on stage of disease. In asthma patient has cough and shorness of breath but mostly chest x ray or ct is clear. There may be history of allergy. As suggested, do consult a pulmonologist.
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