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Suggest Treatment For Cough And Difficulty Breathing

Posted on Tue, 23 Sep 2014

Question: Hi Doctor.

My mom aged 56 years( overweight, diabetic, high bp, mild depression) had been having a bad cough for quite a long time... She would tell that when she coughs greenish at times yellowish mucus spits popped... A month ago suddenly she complained one evening of breathing difficulty... Few days before this her voice had also gone down... subdued. That evening she said her chest on the right side is catchy and paining unbearably also she is not able to breathe... Immediately we rushed her to the doctor who advised ecg, blood and creatinine test + chest xray... and gave painkiller for the timebeing. The next day after seeing the reports he prescribed medicines and asked to get a hrct plain and contrast + PFT + 2D Echo done.. Attached are ecg, blood, xray, and prescription softcopies.

Request you to peruse the same and opine.

Thanks,
XXXX

Answered by Dr. T Shobha Deepak (2 hours later)

Brief Answer:
To consider ILD

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day

Dear Mr XXXX,

Presence of persistent cough associated with expectoration and in light of raised white blood cell count following possibility needs to be considered

1. Interstitial lung disease(ILD)
2. Tuberculosis
3. Bronchiectasis

As the Chest X ray is normal , the possibility of ILD is more likely, so requires further evaluation by CT scan and Pulmonary function test. I would also suggest to get sputum examination for AFB , bacteria and Bactec.

Do discuss it with your treating Physician.

Kindly keep me updated about developments

Take Care

Best Regards
Dr T Shobha Deepak
MBBS,MD

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

Follow up: Dr. T Shobha Deepak (44 minutes later)

Hi Doctor.

Thank you for the opinion. Attached are soft copies of the CT scan, PFT report + prescribed medicines by the physician after that. Also find 2D echo report attached. Please advice

Thanks,
XXXX

Answered by Dr. T Shobha Deepak (20 hours later)

Brief Answer:
Symptoms due to Pneumonia

Detailed Answer:
Hi

Dear Mr XXXX,
It is unlikely to be interstitial lung disease. It is due to Pneumonia involving middle lobe of right lung. The pulmonary function test suggest some amount of airway obstruction which is likely to be due to airway hyper reactivity associated with infection.
As bronchodilators and Antibiotics have been prescribed the symptoms will definitely improve.

I would also suggest the following apart from medicine prescribed

1. Warm Saline Gargling: Add 2 spoons of salt to glass of lukewarm water and gargle 3-4 times a day

2. Decoction: 1 cup of milk+ 1 teaspoon turmeric+ 2 gm of ginger+ 10 leaves of tulsi+ 2 black pepper+ 2 spoon sugar, bring it to boil. Serve it hot to her, few sips at a time. To take it 4 times a day.

3. Steam inhalation for 15 minutes every session 3 times a day

Take Care

Regards
Dr T Shobha Deepak

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

Follow up: Dr. T Shobha Deepak (15 hours later)

Dear Doctor,

Thank you for your reply.

The treating physician says that the CT scans suggest scarring and had prescribed additional medicine Deriphyllin M for 30 days.

I am confused now which is the correct diagnosis? Therefore request you to please guide.

Thanks,
XXXX

Answered by Dr. T Shobha Deepak (6 hours later)

Brief Answer:
Get back to me with CT images

Detailed Answer:
Dear Mr XXXX
Derphylline is a bronchodilator , it is used in airway hypersensitivity disease and also in Pneumonia. There is nothing to be worried about.
Do get back to me with CT images for further assessment.

Take Care

Regards
Dr T Shobha Deepak

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