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What Causes Random Cough When Suffering From Post Nasal Drip?

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Posted on Wed, 16 Jul 2014
Question: I do not smoke, am 50 years old and developed a cough in February. It seemed to be related to post nasal drip. I was tested for allergies, did not show anything. In XXXXXXX April, I still and the cough, took Doxicyclinefor 7 days as I was traveling and thought perhaps I had a sinus infection. Antihistamines do not make much difference. Cough is somewhat spasmodic and sounds like I might be choking and my face turns bright red. The cough is a random non predictive pattern. End of April, cough was much worse, doctor prescribed a different antibiotic (levoquin for 10 days) as I also had an enlarged lymph node on right side. Also was prescribed ventalin, which helped as sometimes with the sever cough, it felt like my throat was closing. antibiotic and ventalin seemed to help a little but the post nasal drip a bit (cough was now dry) but cough remained. In XXXXXXX saw an ENT who said the issue was not related to sinus.
Then one week ago in XXXXXXX had a CXR done and receive nasal steroids (nasonex once per day) and inhaled steroids twice per day (Dulera), felt worse for 3 days with profuse nasal drainage down the back of throat as well as nose blowing (clear color). It is now one week later, feel about the same as I did before taking steroids but have more post nasal drip. The CXR results that I took before starting steroids read, normal hear size came back today: normal hears size, no airspace disease or pleural effusions, os acute bony abnormalities. Diffusely coarsened bronchovascular markings. Cough still very intense and annoying.

I have had this cough since Feb and it is now mid XXXXXXX What does CXR results mean and any advice as to what to do to address the nasal drip and chronic cough as the nasal and inhaled steroids do not seem to be helping that much. It seems the cough is about the same as it was before I started taking them and the nasal drip is worse.
doctor
Answered by Dr. Indu Kumar (1 hour later)
Brief Answer:
CT Scan of thorax should be done.

Detailed Answer:
Hello XXXX
Thanks for writing to HCM

You need proper clinical examination.It is important to see whether there is any spasm in chest or not.
As you take maximum allergy medicines like nasal and inhalational steroids,you may need systemic steroids.
Before prescribing oral steroids it is important to know exact etiology and all possibilities should be ruled out.
Ideally,CT Scan of thorax should be done to rule out any hidden pathology.

Diffusely coarsened bronchovascular markings is non specific finding and it may be due to age related changes,bronchitis etc.
Routine hemogram should also be done.Further investigations can be done if needed.

You should consult pulmonologist for proper evaluation.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

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

Radiologist

Practicing since :2004

Answered : 6729 Questions

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What Causes Random Cough When Suffering From Post Nasal Drip?

Brief Answer: CT Scan of thorax should be done. Detailed Answer: Hello XXXX Thanks for writing to HCM You need proper clinical examination.It is important to see whether there is any spasm in chest or not. As you take maximum allergy medicines like nasal and inhalational steroids,you may need systemic steroids. Before prescribing oral steroids it is important to know exact etiology and all possibilities should be ruled out. Ideally,CT Scan of thorax should be done to rule out any hidden pathology. Diffusely coarsened bronchovascular markings is non specific finding and it may be due to age related changes,bronchitis etc. Routine hemogram should also be done.Further investigations can be done if needed. You should consult pulmonologist for proper evaluation. Get well soon. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX