Continuing pneumonia problem

Hi, I am a 29 year old female, healthy weight, never smoked and beside this issue no other medical history.
I have had a chronic cough and throat clearing for three years that brings up small amounts of clear sputum.  In April the cough changed and I begin to feel a rattle in the left side of my chest, the doctor did an xray and it showed mild pnuemonic consolodation in the mid and lower left lung, I should add this was really mild, I had no fever and continued on feeling fine beside the cough and rattle. I was given a course of oral antibiotics and returned for a repeat xray in June, that xray showed that while the majority of the consolidation had cleared there maybe a subtle amount of residual opacification in the lower left zone.  The doctor was unconcerned but after I returned complaining of the original symptoms I was given another course of antibiotics.  In August I had another xray and the conclusion was clear lungs.  I still have the original cough, which produces small amounts of clear mucous and more disconcerting to me is that I still feel a rattle in my left lung when I breathe deeply especially when lying down.  Three doctor when listening to my chest have said it sounds clear. Can/should a doctor listen to your chest while lying down as well? What is the significance of a rattle felt by me but not hear by the doctor?  Can this ever be normal 5 months after pneumonia, could it be residual fluid?  I should add that I had normal (better than average) spirometry last week that ruled out athsma as a cause of my symptoms. What do I do now, should I be worried about something serious like cancer?

[J.M. Keyes, MD]

Hi,
If you are 29, otherwise healthy, don't smoke, and have no symptoms such as fever, unexplained weight loss, coughing up blood, significant shortness of breath, it is very unlikely that your problem is being caused by anything serious, such as cancer.
The fact that your chest sounds clear, a normal chest xray since the episode of pneumonia, and normal spirometry, are all things that make something significant in your lungs unlikely.
Chronic cough as you describe is more likely caused by either post nasal drip (caused by allergies or chronic sinus problems), or esophageal reflux, since your lungs look and sound good.  Both of these can be worse when lying down.  I would talk to your doctor about these as possibilities if they haven't already been ruled out, as both can be often be easily treated.

Hope you're feeling better.
JMK MD

[sharee79]

Thanks for your response.  I will certainly ask the doctor to treat the possibility of gerd or pnd.  My concern is more the rattle though,  which continues to eminate from the left lung and in the area the pneumonia was originally diagnosed.