How to manage acute productive cough with breathlessness?

Question

Hello doctor,

My wife is a 61-year-old. She was diagnosed with triple-negative breast cancer seven years ago and was treated with conservative surgery followed by chemotherapy and radiation. Since then, she has been under regular check-ups with the oncologist at intervals of six months. Of late, she has been suffering from an acute productive cough with breathlessness. She also has a history of asthma. The computed tomography scan reveals prominence in the right hilar and aorta knuckles. The doctor has prescribed the tablet Prednisone-5 and the tablet Azithromycin. She has started taking the medicine for two days, but there is no significant improvement. Presently, she is coughing occasionally with a discharge of white mucus from the throat and nose.

Can you please suggest on this?

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand your concern.

A prominent aortic knuckle is a normal finding in a 61-year-old lady, especially if she has hypertension. The right hilar prominence is possibly due to lymph node enlargement due to lung infection or lymph node infiltration.

She will need to get a few tests like RT-PCR (reverse transcription-polymerase chain reaction) test for COVID (coronavirus disease), blood tests like CBC (complete blood count), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), lDH (intradialytic hypotension), procalcitonin, ferritin, liver and kidney functions, blood sugar, and a CT (computed tomography) scan of the chest. In addition to current medications, I suggest she use inhalers containing bronchodilators and steroids.

Hope this is helpful. Kindly revert for further queries.

Regards.