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What Causes Persistent Cough That Is Unresponsive To Antibiotics?
Question: Cough that has lasted 2 and 1/2 months. 2 Chest X-rays both clear. No fever. O2 levels 100% in 4 urgent care visits. Multiple antibiotic prescriptions (4). Occasional chest tightness. Sputum white but occasionally small streaks of blood. Non-smoker, non-drinker. Avid runner 30 miles per week feels ok when I run. Meds nortryptoline 150 mg per day at bedtime, Prilosec , buspar 15 mg 2x per day, dextromethorphan. Only thing that provides relief is tussionex - have not taken since 05/17. Within a day or two of taking tussionex cough comes back. Medical conditions - IBS, Gerd (much better after started Prilosec 2 weeks ago)
Brief Answer:
GERD induced cough/ Acute Bronchitis.
Detailed Answer:
Hi,
Thanks for posting the query on HCM. After going through your query, I would like to comment the following:
1. You seem to be having cough since last 2 1/2 months. Your xrays have been normal with no response to antibiotics. You also suffer from IBS & GERD.
2. There is a possibility of you suffering from GERD induced cough and for this you need to continue Prisolec on a regular basis in consultation with your doctor. Also lifestyle modifications - avoiding spicy/oily diets & fast food, not remaining empty stomach for more than 4 hours, taking small frequent meals, etc. need to be done.
3. Since you had an episode of small streaks of blood in sputum, a HRCT Scan thorax is indicated.
4. Also do get yourself clinically evaluated by a pulmonologist as specialised tests like Pulmonary function test and Bronchoscopy are indicated in case of non response of symptoms to current line of management. There is a possibility of the cough being due to resistant infection / hyperresponsive airways.
I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
GERD induced cough/ Acute Bronchitis.
Detailed Answer:
Hi,
Thanks for posting the query on HCM. After going through your query, I would like to comment the following:
1. You seem to be having cough since last 2 1/2 months. Your xrays have been normal with no response to antibiotics. You also suffer from IBS & GERD.
2. There is a possibility of you suffering from GERD induced cough and for this you need to continue Prisolec on a regular basis in consultation with your doctor. Also lifestyle modifications - avoiding spicy/oily diets & fast food, not remaining empty stomach for more than 4 hours, taking small frequent meals, etc. need to be done.
3. Since you had an episode of small streaks of blood in sputum, a HRCT Scan thorax is indicated.
4. Also do get yourself clinically evaluated by a pulmonologist as specialised tests like Pulmonary function test and Bronchoscopy are indicated in case of non response of symptoms to current line of management. There is a possibility of the cough being due to resistant infection / hyperresponsive airways.
I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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