What causes excessive phlegm formation following COVID-19?

Question

Hello doctor,

I was tested COVID-19 positive around 20 days ago. Now my latest RT PCR is negative. I do not have a fever but there is a lot of phlegm formation in my mouth with discomfort. I have enclosed my latest X-ray. Please advise the cause and treatment for this excessive phlegm formation. Also what exactly is the problem in my X-ray?

Answer 1

Hello,

Welcome to icliniq.com.

Following an URTI (upper respiratory tract infection) be it viral or bacterial, there is an attempt by the body's native defense systems to get rid of the offending agents by producing mucoid secretions and cough. The longer the infection persists, there occurs conditions of stasis and superadded infections, which give rise to a productive cough with phlegm. Further infections also affect ciliary motility to an extent that can further accentuate this cycle. The remedy is to use mucolytic agents and expectorants like Ambroxol, Acebrophylline, and others. The X-ray picture (attachment removed to protect the patient's identity) that shows deviated septum and some degree of sinusitis. This might also be contributing to the excessive phlegm production. I hope this helps. Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Sinusitis can be treated with nasal steroids and antibiotics. It would require a CT Scan for proper evaluation. Have you had a CT scan before?

Answer 3

Hello,

Welcome back to iciniq.com.

Well the CT shows maxillary sinusitis on the left side on and I guess it is just some mucosal hypertrophy. Inferior turbinates are bony prominences in your nose which you might be able to see. They are enlarged. The main problem seems to be deviated nasal septum with a spur. However, since you do not have nasal obstruction you may consider medical management of the sinus inflammation and hypertrophic turbinates with a course of intranasal steroids.

Answer 4

Hello,

Welcome back to icliniq.com.

If you could attach CT scan reports that would help me. However, from the reports it seems DNS is the main problem. There is also some degree of generalized mucosal thickening. Only one sinus is involved. Other sinuses are clear. Even stomatal complexes are patent. So intranasal steroids and antihistamines should be the first line of management.