[36M] Experiencing severe cough with phlegm and nasal scabs

Patient Description

A 36-year-old male presents with a severe cough that has persisted for 2 to 3 weeks. The cough is productive, with phlegm that is sometimes white and foamy, and at other times white, thick, and sticky. The patient also reports scabs in the nose, which are managed by keeping them moist with Vaseline, and a dry throat. The cough started suddenly and is aggravated by periods of not talking, which seem to dry out the throat quickly. The patient experiences constant wheezing and shortness of breath but denies any fever, chills, nasal congestion, or sinus pressure. There is a history of tobacco use, with the patient having smoked for 18 years. There is no known exposure to recent respiratory infections or significant changes in the environment. The patient has not been diagnosed with any lung conditions such as asthma or COPD and has not attempted to quit smoking previously. No other significant medical history or chronic illnesses were reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described—coughing up phlegm, scabs in the nose, dry throat, loss of voice, and wheezing—there are a few possible explanations:

  1. Chronic Bronchitis: This is a type of chronic obstructive pulmonary disease (COPD) often caused by long-term exposure to irritants like tobacco smoke. It can lead to a persistent cough with phlegm, wheezing, and chest congestion.

    • Treatment typically involves quitting smoking, using inhalers to open airways, and sometimes medications to reduce inflammation.
  2. Upper Respiratory Tract Infection: This could be a lingering viral or bacterial infection that has caused inflammation in your airways, leading to coughing, phlegm production, and nasal issues.

    • Treatment may include rest, hydration, and over-the-counter medications to relieve symptoms. Antibiotics may be prescribed if a bacterial infection is suspected.
  3. Allergic Rhinitis or Sinusitis: Allergies or sinus infections can cause nasal scabs, throat irritation, and coughing due to postnasal drip.

    • Treatment involves avoiding allergens, using nasal sprays, and possibly antihistamines or decongestants.
  4. Laryngitis: This is inflammation of the voice box, often due to infection, overuse, or irritants like smoke, leading to voice loss and throat discomfort.

    • Treatment includes resting your voice, staying hydrated, and avoiding irritants.

What you can do

  1. Quit Smoking: This is crucial for improving your respiratory health. Consider seeking support from a healthcare provider or using resources like nicotine replacement therapy or support groups.

  2. Stay Hydrated: Drink plenty of fluids to help thin mucus and soothe your throat.

  3. Use a Humidifier: Adding moisture to the air can help ease throat and nasal dryness.

  4. Avoid Irritants: Try to avoid exposure to smoke, strong odors, and other irritants that can worsen your symptoms.

  5. Track Your Symptoms: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider.

What you should look out for

  • Seek medical attention if your symptoms worsen, you experience difficulty breathing, or you develop a high fever.
  • Watch for signs of infection, such as yellow or green phlegm, which may require antibiotics.
  • Consult a healthcare provider for a thorough evaluation and to discuss smoking cessation options.

Remember, while this information can be helpful, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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24 d ago


People Also Ask


What are the common symptoms of chronic bronchitis?

Common symptoms of chronic bronchitis include a persistent cough that produces mucus, wheezing, shortness of breath, and chest discomfort. It is often caused by long-term exposure to irritants like tobacco smoke.


How can smoking affect respiratory health?

Smoking can damage the airways and lungs, leading to conditions like chronic bronchitis and COPD. It can cause inflammation, reduce lung function, and increase the risk of respiratory infections.


What are some effective methods to quit smoking?

Effective methods to quit smoking include using nicotine replacement therapies (such as patches, gum, or lozenges), prescription medications, behavioral therapy, and support groups. Consulting a healthcare provider can help tailor a plan to your needs.


When should I seek medical attention for a persistent cough?

You should seek medical attention for a persistent cough if it lasts more than a few weeks, is accompanied by difficulty breathing, chest pain, or if you develop a high fever. These could be signs of a more serious condition that requires medical evaluation.

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