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Is Airway Obstruction A Symptom Of COPD?

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Posted on Mon, 7 Apr 2014
Question: Hi, I am 37 yrs old male. Around 4 months back I suffered from cough, wheezing alongwith fever.After few days of over the counter medication when I did not get relief, I got myself admitted in Hospital. Sharing below are some report findings - CT Chest - "Branching nodular oopacities scatterd in both lung with perihilar bronchiectasis.This imaging features suggest bronchiolitis." Rest of the report is normal. RESPIRATORY TRACT INFECTION PROFILE - Legionella pneumophila serogroup 1.1gM : Weak Positive, rest of the report was NEGATIVE. MYCOPLASMA PNEUMONIAE,IgG : POSITIVE, 47.20 CULTURE & SENSITIVITY, AEROBIC(Specimen - Sputum) - Gram positive cocci seen, Pus cell ->25/lpf Epithelial Cells -<10/lpf. Culture Report - Streptococcus viridans grown in culutre. SPIROMETRY - Normal FEV1/FEC ratio however FEF 25-75 is reduced(57% pred) suggestive of diminished flow in small airways. Rest of the report was normal. DOCTOR DIAGNOSIS before these test - Acute Exacerbation of COPD since I have a smoking history. Later after 3 months, again old symptoms started showing up but this time there was no cough or breathless symptoms. This time I suffered from high fever,severe sore throat and right eye redness & congestion. Following were the test reports - Radiograph Chest PA View( before medication) - Small area of soft tissue infiltration in the left para-cardiac region, suggestive of early consolidation. Rest of the report was normal. Radiograph Chest PA View( during hospitalization after 6 days) - Few fibrotic bands are seen in left mid zone. No obvious active lung lesion is seen. Rest of the report was normal. HRCT Chest - Subsegmental collapse consolidation is noted in the lingular lobe with ground-glass opacity in the apico-posterior segment of left upper lobe. No other pleuro-parenchymal lesion seen. Doctor first suspected Swine Flu which was negative on test. Throat Swab test Report - Left midzone Pseudomonas Pneumonia. For the above I am on following medication since 4th Mar'2014 - 1) CLARIBID 500 mg 2) LEVOFLOX 750mg 3) REMYLIN D 4) PANTOCID The current doctors are ruling out COPD. I am in a fix what exact is the issue with my health and whether current medication is alright. I don't feel breathless as I do atleast 8-10 km brisk walk daily. Have left smoking from past 4 months. Pls advice.
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Answered by Dr. Divya Kuttikrishnan (7 hours later)
Brief Answer: COPD needs to be ruled out Detailed Answer: Hi there. Thanks for writing in. First of all ,let me congratulate you for quitting smoking since the past 4 months. Keep it up :) Your doctor might be right. From your history and other investigations done so far, COPD definitely needs to be ruled out. According to the AAFP, In the correct clinical situation, a reduction in FEF25–75% of less than 60 percent of that predicted and an FEV1/FVC ratio in the low to normal range may confirm airway obstruction. Your FEV1/FVC was normal, FEF was 57%, and hence COPD might be possible. Another point in favour, you used to smoke cigarettes earlier. You had 2 exacerbations in the last 4 months. Streptococcus in the first episode and pseudomonas in the second. Both are seen in acute exacerbation of COPD. Yes,right now the medications given to you are ideal in treating the current infection. Yes, COPD definitely needs to be ruled out. Other advise I would like to give is: Drink warm water at regular intervals Do steam inhalation 3-4 times a day Once you are better and have recovered,do sign up for yoga classes.Deep breathing exercises are good for the lungs. Hope this information was helpful to you. Get well soon. Regards, Dr. Divya Kuttikrishnan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Divya Kuttikrishnan

General & Family Physician

Practicing since :2000

Answered : 969 Questions

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Is Airway Obstruction A Symptom Of COPD?

Brief Answer: COPD needs to be ruled out Detailed Answer: Hi there. Thanks for writing in. First of all ,let me congratulate you for quitting smoking since the past 4 months. Keep it up :) Your doctor might be right. From your history and other investigations done so far, COPD definitely needs to be ruled out. According to the AAFP, In the correct clinical situation, a reduction in FEF25–75% of less than 60 percent of that predicted and an FEV1/FVC ratio in the low to normal range may confirm airway obstruction. Your FEV1/FVC was normal, FEF was 57%, and hence COPD might be possible. Another point in favour, you used to smoke cigarettes earlier. You had 2 exacerbations in the last 4 months. Streptococcus in the first episode and pseudomonas in the second. Both are seen in acute exacerbation of COPD. Yes,right now the medications given to you are ideal in treating the current infection. Yes, COPD definitely needs to be ruled out. Other advise I would like to give is: Drink warm water at regular intervals Do steam inhalation 3-4 times a day Once you are better and have recovered,do sign up for yoga classes.Deep breathing exercises are good for the lungs. Hope this information was helpful to you. Get well soon. Regards, Dr. Divya Kuttikrishnan