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Dr. Andrew Rynne

Family Physician

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What causes persistent dry cough and daily pattern of chills and fever with history of bronchitis?

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Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2920 Questions

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Posted on Thu, 13 Sep 2018 in Infections
Question: I was diagnosed with bronchitis in early December. Did Z-pack, prednisone, steroid shot. All fine, but couldn’t lose dry cough. Back on more prednisone in mid-January. Still had cough. Went to Death Valley on photo workshop and cough seemed to ease, but still persisted. Returned home (Tulsa, Ok), and cough got worse. Then about a week ago I started getting chills in the afternoon, followed by fever of 102. Fever would break and I’d feel fine - except for cough. That chill-fever pattern has now continued daily. I’ve been dealing wi this for 10-12 weeks now.
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Answered by Dr. Muhammad Sareer Khalil 1 hour later
Brief Answer:
LRTI Induced exacerbation with possible secondary infection.

Detailed Answer:
Hello and welcome,

Based on your description and history, lower respiratory tract infection induced exacerbation of Bronchitis is the likely cause. The high-grade fever with chills suggests a bacterial cause.

Chest X-ray, blood counts (CBC) to look for a raised total leukocyte count, ESR and CRP should be done. These investigations will help in determining whether inpatient or outpatient management should be advised.

Instead of Z pack (Azithromycin), Moxifloxacin would be a better option especially since the Z-pack has already been tried.

Prednisolone is also a steroid. If the steroids have been taken for such a long time then they should not be stopped abruptly and tapered slowly before stopping. In case of an acute flare, they should be continued rather their dose should be optimised along with antibiotics cover.

Antihistamines like Cetirizine or Loratadine should also be added to this regimen to look for improvement regarding the cough symptoms.

Hope I have answered your query.

Wishing you the best of health.

Regards,
Dr. Muhammad Sareer Khalil, General & Family Physician


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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