no past history

[ortigo]

I am a 46 year old female that had never smoked and had been in great health.  This year I developed bronchitis in April and was sick for two months. After taking antibiotics, allergy meds and inhalers, I recovered.  I continued on the allergy meds. A little over two months later the cough started up again. The doc put me back on Advair.  I used it for two months and continued getting worse. I saw the doctor and he put me on Ventolin with my Advair and antibiotic.  I saw him a week later worse and with thrush in my mouth and throat. He ordered a CT scan and put me in the hospital.  My right lung showed two small spots under 1 cm.  I relasped the afternoon he released me from the hospital with wheezing and a cough with phlem.  He put me back on some inhalers.  I finally started getting some better, but he wanted to order another CT.  This was done three weeks from the first one.  It showed the spots a little larger and a third one. This was done on the same machine. I saw a lung doc and he will order another CT on the 22nd of December. He feels 80% sure that it is not cancer due to my history. He also said that my lung condition now is not related to the spots. I am still on allergy meds and Advair. Some days my cough isn't as bad and other days my coughing is worse. My throat stays hoarse and irratiated most all of the time.  I have three questions; Should a PET be done? I am so dumbfounded by my coughing issue.  I have had this cough for over three months. Will I be cured? Should I see an allergist, due to having constant sinus drainage?  Thank you for time with these questions.

[National Jewish Health]

I assume your question about a PET Scan refers to determining if the nodules are benign or malignant. I don’t believe a PET Scan is warranted at this time.  Such small spots are most likely to be benign and a demonstrable increase in size within 3 weeks strongly favors an infectious or inflammatory cause of the spots, rather than their being tumors.  I agree with the pulmonologist that your history does not favor consideration of malignancy and with the recommendation of another CT scan next month.

A serious question is why a previously healthy, non smoking young woman with no prior history of lung disease, especially no history of asthma, would develop acute bronchitis with persistence of cough for several months.  Granted it could be asthma but other considerations would include hypersensitivity pneumonitis, inflammatory lung disease related or unrelated to autoimmune disease and recurrent aspiration bronchitis, secondary to gastroesophageal reflux disease.  Of course “constant sinus drainage” (presumably a new symptom for you) could be the cause of your cough in which case assessment of your nose and sinuses for infectious or inflammatory disease would be indicated.  Given that your problem, with the exception of the nodules, has been localized to the bronchi, bronchoscopy with examination of bronchial washings might reveal unconsidered bronchial disease.

In the meantime, your sputum should be carefully examined and cultured for bacteria and fungi.

Good luck

[aero63]

Have you been diagnosed with COPD?  Chronic bronchitis is a component of COPD as well as asthma.  I have COPD and I can tell you, you get colds and infections much easier.  Advair will cause thrush.  Rinse well and eatting yogurt can help.  There is no cure for COPD, but with proper meds, nutrition, and exercise.  Has your Alphas been checked, there is a gene that can cause COPD even if you haven't smoked.