Persistent Cough

[johnnyboy1979]

Hi, I'm a 28 year old male, non smoker. For the past three or four months I've had a cough that just won't seem to go away. The cough in the main is voluntary, i.e I constantly feel as though I need to make myself cough. Along with the cough I have an ever changing array of symptoms of differing severity, such as blocked nose, sore throat, mild chest pain, nausea etc. I've also coughed up some quite thick green sputum for the first time this morning. Sometimes the cough will appear to be getting better, but it will then come back with full force.

I've been to the doctor several times about this and as yet he has asked no questions regarding family history, or if I smoke etc. He seems convinced it is just anxiety. I'm also been suffering from muscle twitching for around the same amount of time. He has listened to my chest and says it sounds OK. Can anybody give me any advice? I'm quite concerned now this may be something serious. Maybe it is anxiety, time of year, a change in surroundings (I've recently moved home). Any help would be much appreciated.

[National Jewish Health]

If you truly have coughed-up green sputum, anxiety is not the cause.  You may be suffering from anxiety, regarding your social situation (moving home), or from worry about the symptoms you describe but the bottom line is:  green sputum is an indicator of physical disease, of disease somewhere in your respiratory system.  A likely site would be your nose and sinuses, either infectious or allergic.  Since the cough seems to have begun after you moved back home, allergy or infection to something in the home, including mold, is a possibility.  Postnasal drip, along with gastroesophageal reflux and asthma is one of the 3 leading causes of chronic cough.  In most of these cases, however, the mucus is clear or faint yellow, not green.

The cough and sputum could also be coming from your lungs and that possibility is not ruled-out by your doctor's listening to your lungs and hearing clear breath sounds.  You should have, at minimum, a chest x-ray and careful examination of your nose and sinuses, including bacterial culture of the green mucus and maybe CT scan of your sinuses.

Another possible diagnosis, even with a clear chest X-ray, would be cystic fibrosis.

Note – a productive cough that develops in a healthy young man and lasts 4 months should be considered a serious medical problem.  You may have to see another doctor, if your doctor continues to attribute it to anxiety.