Asthma Attack for 1 month please help!

Dear Doctor,
I had wheezing on exhaling and peak flow meter of 425 when usually it's 600-625 for a few weeks.  when I took prednisone and solumedrol I came down with sore throat and a bad infection that didn't respond to antibiotics and lasted 1 month.  I am still wheezing several months later.  what could have caused this and what can I do to treat it?  the doctor seems to say it is due to vocal chord problems.  
I noticed on 40-50mg of prednisone a day my FVC increased from 70 to 80.  
thanks so much!

[David Tinkelman, M.D.]

With a personal best peak flow measurement of 600-625, a drop to 425 is quite significant.  Your asthma was clearly uncontrolled and it may well have been necessary for your doctor to have prescribed prednisone/solumedrol.  You may have been predisposed to the throat infection by the steroids or the infection may have caused both the sore throat and aggravated the asthma.  We can only speculate on the preceding.  The good news is that the infection finally seems to have resolved.  It would be important to confirm that because if the throat infection has only resolved enough to stop hurting, the persistent infection might be the reason that you are “still wheezing.”  It would be wise to have your throat examined and cultured and any lingering bacterial infection treated.

Another possibility would be that the throat infection had spread to your vocal cords, resulting in what is called vocal cord dysfunction (VCD) and that this, not your asthma is responsible for the persistent wheezing.  So, what should be done.

Several things:  1) repeat throat examination and culture, 2) testing to see if your doctor is right about the “vocal cord problems.”  Such testing would include pulmonary function testing with special attention to inspiratory flow rates and/or direct examination of your vocal cords with the use of a fiberoptic laryngoscope by a doctor skilled in its use and, 3) work with your doctor to optimize your asthma therapy, ideally with the use of an inhaled steroid, so that you won’t have to take any more prednisone/solu-medrol.

Yes, this could be an allergic reaction to one of a number of fungi, most notably one called Aspergilla (ABPA or ABPM), that frequently occurs as an allergy or infection and aggravates asthma, not infrequently to a significant degree.  Sometimes the fungus can be seen in the sputum but the diagnosis is more often made by chest X-ray and blood testing.  I suggest that you discuss this possibility with your doctor.

[ill13632]

I tried many antibiotics including levaquin and was given IV cipro/flagyl but the wheezing still won't go away?
could it be fungal or amoeba?