question-icon

What causes severe cough,wheezing and chest congestion in a patient with acute bronchitis?

default
Posted on Thu, 21 May 2015
Question: Hi, I am on my second week of bronchitis. My cough is still very productive and my lungs are really congested. My cough is really bad and so very hard to clear. Wheezing etc. This is not uncommon for me, this is the third time I've had acute bronchitis (my own diagnosis) since November. I have had my right ear blocking up a lot, and today feel extremely dizzy as well (never had that before). I have also had recurrent tonsilitis (lots of white exudate on my tonsils ... it often travels down in to lungs). I have been having tonsil infections at least four times a year often more. :( I have not seen a specialist, and I don't want to have my tonsils out. Is it an infection? Could diet help?
To clarify I don't have tonsillitis right now (although they always feel a bit gummy). Just wondered if it was related. I don't want to take antibiotics every time because I would be taking them way too often. I took a couple of courses last year.
doctor
Answered by Dr. Kaushal Bhavsar (11 minutes later)
Brief Answer:
Better to get done PFT first.

Detailed Answer:
Thanks for your question on HCM.
I can understand your situation and problem.
Recurrent upper respiratory tract infection (URTI) in the form of tonsillitis is the most common cause for acute bronchitis.
But for the diagnosis you need to consult pulmonologist and get done
1. Clinical examination of respiratory system
2. Chest x ray
3. PFT (Pulmonary Function Test).
Chest x ray is needed to rule out lung infection.
PFT is must for the diagnosis of bronchitis.
Treatment is inhaled bronchodilators, antihistamines and antibiotic drugs.
So first consult pulmonologist and diagnose yourself and then start appropriate treatment.
Diet and fluids will not help much.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Kaushal Bhavsar (8 minutes later)
Thank you.

I had a course of antibiotics last year to clear up the tonsillitis but it keeps coming back.

Are you saying that the URTI is different to an infection in the lungs? (presumably that would be lower respiratory tract?).

If that is the case, is the treatment just more antibiotics, just stronger ones? Is this potentially related to a crap immune system in general?
doctor
Answered by Dr. Kaushal Bhavsar (10 minutes later)
Brief Answer:
URTI and LRTI are different things.

Detailed Answer:
Thanks for your follow up question on HCM.
URTI and LRTI (lower respiratory tract infection) are two different things.
Tonsillitis includes in URTI.
While bronchitis, pneumonia etc include in LRTI.
URTI is common predisposing factor for LRTI.
If you have recurrent tonsillitis then surgical removal is indicated and should be done to prevent recurrent attacks.
So at present you will need antibiotics along with inhaled bronchodilators and antihistamine drugs.
Yes, this can suggest poor immunity, but not in all cases.
Are you smoker?
Do you drink alcohol?
Do you have diabetes or other immunocompromised conditions?
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.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Kaushal Bhavsar (1 hour later)
Hi Dr Bhavser,

Thanks again.

No, I don't smoke, I do drink occasionally, maybe two nights a week I have one or two glasses of wine.

I don't have diabetes. I have low iron levels though, I'm about to have my bloods done again. I'm not anaemic though, another thing I'm confused about (how can I have low iron and the fatigue that goes with it and not be anaemic?).

I eat generally pretty well. Not so many grains, and not too much sugar, and mostly home made food with veggies and meat. Hardly any dairy.

Thanks again.
doctor
Answered by Dr. Kaushal Bhavsar (5 hours later)
Brief Answer:
Get done erythropoietin level.

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.
Low iron can cause poor immunity.
But it is unlikely to have low iron level without anemia.
Few conditions like kidney disease or low erythropoietin level can cause low iron level.
Malabsorption can also cause low iron.
So please let me know
1. Have you tested for erythropoietin level?
2. Have you ruled out Malabsorption?
3. Had you taken Influenza vaccine to prevent recurrent upper respiratory tract infection?
4. Which antibiotics you had previously for tonsillitis?
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.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Kaushal Bhavsar (15 hours later)
1 no i have never heard of this test?
2 how do i know if it is malabsorption? No i havent ruled it out.
3 no i havent taken flu vaccine
4 The last round were Clamoxyl Duo Forte - 875/125 in May 2015.

Have attached last round of blood tests showing iron levels.

Thank you. I moved from Melbourne to Amsterdam in November and not confident yet in health system here. I have a blood test order yet to visi lab.
t
doctor
Answered by Dr. Kaushal Bhavsar (21 minutes later)
Brief Answer:
That report does not show hemoglobin level.

Detailed Answer:
Thanks for your follow up question on HCM.
I have gone through the report, you have attached.
Your ferritin level is low. This means your iron stores are low.
Your report does not show hemoglobin level.
What is your hemoglobin level?
Malabsorption syndrome is one of the cause for low iron. When patient is eating well but iron is less absorbed then Malabsorption should be suspected.
You need to consult gastroenterologist for this.
And flu vaccine is given yearly. It is for the protection of recurrent upper respiratory tract infection.
So at present, first solve your acute illness, consult ENT doctor for tonsillectomy.
Also plan for flu vaccination yearly.
I will be happy to help you further.
Wish you good health.
Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14857 Questions

premium_optimized

The User accepted the expert's answer

Share on
What causes severe cough,wheezing and chest congestion in a patient with acute bronchitis?

Brief Answer: Better to get done PFT first. Detailed Answer: Thanks for your question on HCM. I can understand your situation and problem. Recurrent upper respiratory tract infection (URTI) in the form of tonsillitis is the most common cause for acute bronchitis. But for the diagnosis you need to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x ray 3. PFT (Pulmonary Function Test). Chest x ray is needed to rule out lung infection. PFT is must for the diagnosis of bronchitis. Treatment is inhaled bronchodilators, antihistamines and antibiotic drugs. So first consult pulmonologist and diagnose yourself and then start appropriate treatment. Diet and fluids will not help much. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.