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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Persistant Dry Cough. Tired, Out Of Breath. Chest X Ray, Blood Test Normal. Insulin Dependent Diabetic. Tried Antibiotics, Steroid Injection.Suggestion?

Hi, I have had a persistent dry cough since 19 Feb, had xrays of chest all ok, blood tests seem to be ok, except something about my white blood cells, get out of breath easily, always tired, had 3 lots of antibiotics, dr taken me off blood pressure tablets, only a little coughing for 3-4 days after being taken off bp tabs and then back to coughing all day and night. My bp is ok, don't have a temp.Had a weird sensation on left side of neck about 2 weeks ago, told dr and she felt and said it was nothing. Recently I have developed a really sore throat and have coughed up blood with my phlegm on the odd occasion. Over the last few days my throat aches and I have developed a lump on my left jaw line which is very painful. I do not drink or smoke, am a insulin dependent diabetic.Dr also gave me a long lasting steroid injection as this helped me with my coughing 3 years ago, but has not helped this time. Hope you can help.
Thu, 25 Apr 2013
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General & Family Physician 's  Response
Hello,
Although blood pressure medicines like ACE inhibitors can cause persistent dry cough but these symptoms can be due to congestive heart failure ( cardiac asthma ).
You must consult a cardiologist and get relevant investigations like ECHOCARDIOGRAM done to look for any cardiac involvement.
The chances of cardiac involvement are much more in a longstanding diabetic.
The other possibility is asthmatic bronchitis.
In case you get a clean chit from cardiologist,then you may consult a pulmonologist for necessary investigations.
Treatment would depend upon finding the cause.
There is no point giving anti biotics or steroids without any rationale.
Thanks
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Pathologist and Microbiologist Dr. Dr. Basheer Ahamed's  Response
Hello, You are a known Diabetic and hypertensive on insulin.

Your white blood cells are abnormal. You are prone for infections. Your diabetes and steroid therapy will add to it.

You may be suffering from upper airway infection. Throat swab culture and sensitivity may help to choose appropriate antibiotic.
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Persistant Dry Cough. Tired, Out Of Breath. Chest X Ray, Blood Test Normal. Insulin Dependent Diabetic. Tried Antibiotics, Steroid Injection.Suggestion?

Hello, Although blood pressure medicines like ACE inhibitors can cause persistent dry cough but these symptoms can be due to congestive heart failure ( cardiac asthma ). You must consult a cardiologist and get relevant investigations like ECHOCARDIOGRAM done to look for any cardiac involvement. The chances of cardiac involvement are much more in a longstanding diabetic. The other possibility is asthmatic bronchitis. In case you get a clean chit from cardiologist,then you may consult a pulmonologist for necessary investigations. Treatment would depend upon finding the cause. There is no point giving anti biotics or steroids without any rationale. Thanks