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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed With Asthma, Bronchitis, Chronic Pneumonia. Taking Medicines. Pneumonia Persists. Treatment?

I have been diagnosed with asthma, recently with bronchiectasis , and I also have chronic pneumonia . I still currently get sick very frequently and my doctor and I can not find the solution to my treatment. In the past year I have had two CT scans, a bronchoscopy (which showed I was growing strep-pneumonia) and last week an open lung biopsy (which I was told only showed inflammation on the pathology results, and currently still growing cultures). I usually take either bactrim or levaquinn with prednisone for a period of time to treat my pneumonia but as soon as I get back off of it I get e pneumonia right back. Can you please suggest any further treatments or any further disease possibilities or autoimmune diseases. My dr thought it may be autoimmune but nothing showed up on the biopsy.
posted on Tue, 18 Dec 2012
Twitter Tue, 25 Dec 2012 Answered on
Twitter Wed, 26 Dec 2012 Last reviewed on
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Pulmonologist,  's  Response
Hi,
You seem to have been diagnosed as a case of asthma with bronchiectasis with on and off pneumonia episodes. A diagnosis of ABPA (Allergic Broncho Pulmonary Aspergillosis) can be considered in such a scenario. Do get your total serum IgE levels, Serum IgG and IgE specific for aspergillus, sputum fungus examination. If it is detected then oral steroid therapy will have to be started to which your condition should respond. Regrading the autoimmune profile, if your physician is suspecting then collagen vascular diseases are a possibility for which you may undergo a extranuclear antigen profile. For episodes of pneumonia antibiotics will have to be taken as per culture sensitive reports of the organisms isolated from the sputum/ bronchoscopy samples. Also you may consider yearly flu shots and 5 yearly pneumococcal vaccination for prevention of repeated infections.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
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Diagnosed With Asthma, Bronchitis, Chronic Pneumonia. Taking Medicines. Pneumonia Persists. Treatment?

Hi, You seem to have been diagnosed as a case of asthma with bronchiectasis with on and off pneumonia episodes. A diagnosis of ABPA (Allergic Broncho Pulmonary Aspergillosis) can be considered in such a scenario. Do get your total serum IgE levels, Serum IgG and IgE specific for aspergillus, sputum fungus examination. If it is detected then oral steroid therapy will have to be started to which your condition should respond. Regrading the autoimmune profile, if your physician is suspecting then collagen vascular diseases are a possibility for which you may undergo a extranuclear antigen profile. For episodes of pneumonia antibiotics will have to be taken as per culture sensitive reports of the organisms isolated from the sputum/ bronchoscopy samples. Also you may consider yearly flu shots and 5 yearly pneumococcal vaccination for prevention of repeated infections. Regards Dr. Gyanshankar Mishra MBBS MD DNB Consultant Pulmonologist