[26F] With chronic respiratory symptoms and extensive medical history

Patient Description

A 26-year-old female presents with chronic yellow phlegm and a moderate cough that worsens with fluid intake, persisting for nearly 2 years following mold exposure. She experiences post nasal drip and occasional upper respiratory infections. The patient has a history of smoking marijuana but is not currently smoking. She has a complex medical history, including Dysautonomia (P.O.T.S), Ehlers Danlos Syndrome Type 3, Stage 3 Endometriosis/Adenomyosis, Celiac Disease, Interstitial Cystitis, Degenerative Disk Disease, EBV Disease, Gastroparesis, ITP, Colonic Inertia/Paralyzed Colon from Endometriosis, Dysphagia, Psoriatic Arthritis, Hidradenitis Suppurativa, Chronic Migraines, Chronic Fatigue Syndrome, Lymphoid Hyperplasia, and Occipital Neuralgia with cervical spine abnormalities. She has allergies to multiple medications, including Flonase, Azithromycin, Augmentin, Reglan, Amoxicillin, Hydrocodone, Clindamycin, Omeprazole, Benzoyl Peroxide, Amitiza, Vancomycin, and Fentanyl. The patient is currently taking Sulfasalazine (500mg 1-2 times daily) for at least 6 years and Ceftin, as well as prenatal vitamins, vitamin D, and acidophilus probiotics.

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Arora's Assessment

What might be happening

Based on the information you provided, possible explanations for your symptoms include:

  • Chronic Bronchitis: This is a type of chronic obstructive pulmonary disease (COPD) that causes inflammation in the bronchial tubes, leading to cough and phlegm production. It's often caused by smoking, but can also be triggered by long-term exposure to irritants like dust, chemical fumes, and mold.

    • Treatment typically involves bronchodilators, steroids, and possibly oxygen therapy. Lifestyle changes, such as quitting smoking and avoiding lung irritants, are also important.
  • Allergic Rhinitis: This is an allergic response to allergens like dust, mold, and pollen. It can cause symptoms like post-nasal drip, cough, and recurrent upper respiratory infections.

    • Treatment usually involves avoiding the allergen, using nasal sprays, antihistamines, and possibly allergy shots.
  • Asthma: This is a condition that causes your airways to become inflamed and narrow, leading to symptoms like cough, wheezing, and shortness of breath. It can be triggered by allergens or irritants in the air.

    • Treatment typically involves the use of inhalers to relax the muscles around your airways and reduce inflammation.

Given your multiple chronic conditions, it's also possible that your symptoms are a side effect of one of your conditions or medications. For example, gastroparesis can cause chronic cough due to acid reflux.

What you can do

You should consult with your doctor about your symptoms. They may want to perform tests such as a chest X-ray, lung function tests, or allergy testing to determine the cause of your symptoms. In the meantime, you can try the following:

  1. Avoid known allergens and irritants as much as possible. This includes mold, dust, and smoke.
  2. Stay hydrated and use a humidifier to help soothe your throat and loosen mucus.
  3. Over-the-counter cough suppressants or expectorants may help manage your symptoms.

What you should look out for

Please seek medical attention immediately if you experience:

  • Difficulty breathing or shortness of breath that's getting worse
  • Chest pain
  • Coughing up blood
  • High fever or chills
  • Unexplained weight loss

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, diagnosis, and treatment.

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1 yr ago

People Also Ask


What are the common symptoms of chronic bronchitis and how is it treated?

Common symptoms of chronic bronchitis include a persistent cough that produces mucus, wheezing, shortness of breath, and chest discomfort. Treatment often involves bronchodilators, steroids, and lifestyle changes such as quitting smoking and avoiding lung irritants.


How can exposure to mold affect respiratory health?

Exposure to mold can lead to respiratory issues such as coughing, wheezing, and shortness of breath. It can also trigger allergic reactions and exacerbate conditions like asthma and chronic bronchitis.


What lifestyle changes can help manage symptoms of allergic rhinitis?

To manage allergic rhinitis, it's important to avoid known allergens, use air purifiers, and keep windows closed during high pollen seasons. Medications like antihistamines and nasal sprays can also help alleviate symptoms.


How does gastroparesis potentially contribute to chronic cough?

Gastroparesis can cause acid reflux, which may lead to a chronic cough. This occurs when stomach acid irritates the esophagus and throat, triggering a cough reflex.


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