Suggest Treatment For Persistent Cough And Cold

Posted on Tue, 31 Jan 2017

Question: i have a Dx of COPD and have had pneumonia recently. Last week i caught a cold. I went to my provider yesterday. I was examined and Rx's albuterol & prednisone QD X5. I have my 2nd dose on board. I have also been treating with spiriva X2 days and guaif. for the last 5 days.Also I take a HTN cocktail. Last night i noticed some blood in my sputum (witch i saved) and this morning it's much more prevalent (witch i saved). My recent CXR showed a spot = L lung and i am sched. for a CT scan next week. I just turned 65 What would you suggest?I have received the billing and account. info , but no the MD's response.

Answered by Dr. Vaddadi Suresh (3 hours later)

Brief Answer:
Many possibilities.

Detailed Answer:
Hi XXXXXXX

Sorry for the delayed response. Let me put some possibilities for blood in the sputum before i discuss the plan of management.

1. Pneumonia in a patient with COPD is a double blow and will have residual symptoms even after treatment is successful. So the blood you are seeing might be the residual disease you have in your lungs.

2. Sometimes, cough can cause micro trauma to the airways and the expectoration can show bloody sputum.

3. A spot in the lung is the most important clue here, is that the residual patch of pneumonia you had or something more serious needs to be determined immediately.

So, as scheduled, you need a CT, preferably HRCT of thorax which should tell the diagnostic possibility. If needed, you may be asked to undergo an invasive procedure like bronchoscopy/biopsy, which will confirm the diagnosis, whether it is a benign or a malignant lesion.

You may also need sputum culture for indolent organisms like Tuberculosis, fungal infections etc.

Mean while, cough suppressants can be of some help to you in reducing the severity of blood in sputum.

Hope I'm clear.
Feel free to ask if you have any queries.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Vaddadi Suresh (1 hour later)

Thank You Dr.
It's quite clear.
I'm not exp. much pain currently. I was when I got up & discovered that the amount of blood was increased. It was a bit startling. But 800 IBU has control.
I am not alarmed enough to seek ER Tx after your response. I will, if the situation escalates.
Thanks Again,
Gregg

Answered by Dr. Vaddadi Suresh (7 hours later)

Brief Answer:
Great

Detailed Answer:
That's good news.
Please make sure that they have a follow up of the patch in the lungs. Hope it disappears soon.
ALL THE BEST.

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