[88M] Experiencing severe cough and wheezing

Patient Description

An 88-year-old male is reporting severe, spastic coughing that has been ongoing for two days. The cough is deep in the chest, and the patient is attempting to expectorate phlegm. The coughing episodes are severe enough to cause significant shortness of breath, rated at an 8 on a scale of 10, but this shortness of breath is only present during the coughing fits. The cough is described as usually dry but occasionally productive, with clear sputum and no blood. The patient has no history of similar symptoms and denies any chest pain, tightness, or swelling in the legs or feet. There is a noted fever and chills. The patient finds some relief using Robitussin, and the coughing episodes are constant throughout the day. There is no mention of smoking history or other medical conditions.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Acute Bronchitis: This is an inflammation of the bronchial tubes in your lungs. Symptoms include a cough that brings up mucus, shortness of breath, wheezing, and a mild fever. It's usually caused by a viral infection.

    • Treatment typically involves rest, fluids, and over-the-counter cough remedies. If your symptoms persist or worsen, your doctor may prescribe other medications.

  • Pneumonia: This is an infection that inflames the air sacs in one or both lungs. Symptoms can range from mild to severe and include a cough with phlegm, fever, chills, and difficulty breathing.

    • Treatment typically involves antibiotics, fever reducers, and cough medicine. Hospitalization may be necessary in severe cases.

  • Chronic Obstructive Pulmonary Disease (COPD): This is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing.

    • Treatment typically involves medications (such as bronchodilators and steroids), pulmonary rehabilitation, and supplemental oxygen. In severe cases, surgery may be necessary.

Please note that these are potential explanations for your symptoms, but there may be other causes. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Continue taking over-the-counter cough remedies as needed, but avoid those that suppress your cough as it's important to clear any mucus from your lungs.
  2. Drink plenty of fluids and rest as much as possible.
  3. Monitor your symptoms closely. If they worsen or persist for more than a week, seek medical attention.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe difficulty breathing or shortness of breath
  • Chest pain
  • Confusion or changes in mental function
  • Bloody or colored sputum
  • High fever

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, testing, and care.

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9 mo ago

People Also Ask

What are the common causes of a severe, spastic cough in elderly patients?

Common causes of a severe, spastic cough in elderly patients include acute bronchitis, pneumonia, and chronic obstructive pulmonary disease (COPD). These conditions can be triggered by infections, environmental factors, or chronic lung diseases.

How can I differentiate between acute bronchitis and pneumonia based on symptoms?

Acute bronchitis typically presents with a cough that may produce mucus, mild fever, and shortness of breath. Pneumonia often involves more severe symptoms such as a high fever, chills, and difficulty breathing, and the cough may produce colored or bloody sputum. A healthcare provider can perform tests to accurately diagnose the condition.

What home remedies can help alleviate coughing and shortness of breath?

Home remedies to alleviate coughing and shortness of breath include staying hydrated, using a humidifier, resting, and taking over-the-counter cough remedies. It's important to avoid cough suppressants if you need to clear mucus from your lungs.

When should I seek medical attention for a persistent cough and shortness of breath?

You should seek medical attention if you experience severe difficulty breathing, chest pain, confusion, bloody or colored sputum, or a high fever. Persistent symptoms that do not improve with home care also warrant a visit to a healthcare provider.

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