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What Do The Following X Ray Reports Suggest?

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Posted on Wed, 26 Aug 2015
Question: Hello,
I have chronic cough for many years, post nasal syndrome, allergy for 11 triggers.
Morning cough for many years, smoker in the past.
Please explain me X- Ray report. Findings: There is prominence of the perihilar bronchial markings bilaterally suspicious for bronchial inflammation/bronchitis. There is some increased airspace opacity at the left base posteriorly suspicious for some superimposed early pneumonia.
There is no pleural effusion or pneumothorax. The cardiac silhouette is within normal limits.
Conclusion: Suspect bronchitis bilaterally with some early airspace disease/pneumonia at the left base. Follow-up chest x -ray in 4-6 weeks time post treatment is recommended to ensure resolution.
I am very nervous.
doctor
Answered by Dr. Drkaushal85 (1 hour later)
Brief Answer:
Get done PFT.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your situation and problem.
You are having allergic disease.
And long standing allergic disease can cause bronchitis.
Bronchitis is inflammation of airways.
Your x ray picture is classical of bronchitis.
So consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).
PFT is needed for the diagnosis of bronchitis.
It will also tell you about severity of the disease.
And treatment of bronchitis is based on severity only.
You may need inhaled bronchodilators and inhaled corticosteroid.
Antihistamines and anti allergic drugs are also useful.
All these drugs will be helpful to control your allergy and cough
So no need to worry much, consult pulmonologist and get done PFT,start appropriate treatment.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Drkaushal85 (15 minutes later)
Thank you very much for your prompt reply.
I am taking cetirizine as antihistamine medication, however, it is not helpful. I schedule an appointment with algologist.
I am nervous because of pneumonia. I took antibiotic clarithromycin for the week, but still have symptoms. I think last week I caught virus infection with running eyes, nose and sub febrile temperature.
Doctor, is any sign of cancer or tumor on X-ray? or symptoms?
I am worry why they asked me to do follow up X-ray
airspace opacity? I am afraid! please advise
Sorry for many panic questions.
Thank you in advance.
doctor
Answered by Dr. Drkaushal85 (1 hour later)
Brief Answer:
No need to worry for cancer,pneumonia.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
No need to worry for cancer or pneumonia.
Your chest x ray findings are classical of bronchitis.
And treatment of choice for bronchitis is inhaled bronchodilators and inhaled corticosteroid (ICS).
Were you never prescribed montelukast?
Please reply me answer of above asked question, so that I can guide you better.
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Drkaushal85 (4 hours later)
No, I never used montelukast.
Only antibiotics.
From January 2015- cetirizine which did not reduced or improve my cough.
Mucus has different colour and texture during day. No cough at night time, morning- when I wake up, nose starts running, cough and nose discharge with different colours- yellow or orange or brown or clear. sometime with blood streaks from nose sputum or cough.
Day time I do not cough a lot, may be 6-7 time with clear or yellowish mucus.
post nasal discharge almost all day. discomfort in post nasal area. I went to otolaryngologist, he physically checked and did not find any problem. Told me to treat the allergy.
I have some itchiness in my chest, some tension.
Doctor, what is airspace opacity means?
I am panicking and cannot sleep.
Thank you
doctor
Answered by Dr. Drkaushal85 (23 minutes later)
Brief Answer:
It is inflammatory changes in airways.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Airspace opacity increased means inflammatory changes in airways. Airways are usually containing air and hence they are rediolucent (appears black) on x ray.
When they are inflammed, their walls become edamatous and appears white on chest x ray.
So when airways visible on chest x ray, it is known as airspace opacity increased.
This clearly means you are having inflammation and hence bronchitis.
Your nasal symptoms are characteristic of allergic rhinitis.
This needs nasal spray containing steroid.
Antibiotics are not solution for your symptoms.
You need nasal spray, inhaled bronchodilators and inhaled corticosteroid, antihistamines and anti allergic drugs.
Please let me know, whether you used nasal spray in the past or not.
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Drkaushal85 (6 minutes later)
I used to use corticosteroid nasal spray. did not make huge difference.
when I had my allergy test, they found triggers, however, it was not sever reaction.
doctor
Answered by Dr. Drkaushal85 (2 minutes later)
Brief Answer:
No need to worry, start nasal spray, montelukast.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
No need to worry much for this.
Your all symptoms are due to uncontrolled allergy.
You will mostly improve with montelukast (anti allergic) and fexofenadine (antihistamines) combination, fluticasone nasal spray, inhaled bronchodilators and inhaled corticosteroid (ICS).
No need to worry for pneumonia or major Pulmonary diseases.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Drkaushal85 (9 minutes later)
Thank you for help!
I feel better now. Should I go for follow up x ray?
doctor
Answered by Dr. Drkaushal85 (3 minutes later)
Brief Answer:
First start the treatment.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
First start the treatment advised by me. See for improvement. If you are improving than no need to for follow up x ray.
Please let me know
1. Exactly on which date you had chest x ray which was showing bronchitis bilaterally?
2. Do you smoke? Or do you have any exposure to smoke at home or workplace?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Drkaushal85 (6 minutes later)
I had X ray on July 07, 2015
Clarithromycin from July 08, 2015
Cold symptoms from July 20, 2015

I was a smoker ( pack a week), quit smoking for almost 2 years. No smoker at home or work place.
doctor
Answered by Dr. Drkaushal85 (8 minutes later)
Brief Answer:
No need for repeat chest x ray if you are improving.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
No need for repeat chest x ray if you are improving.
Since you are previous smoker and suffering from allergy, possibility of allergic rhinitis and bronchitis is more.
So start montelukast - fexofenadine combination, fluticasone nasal spray, inhaled bronchodilators and inhaled corticosteroid.
No need for further antibiotics.
You will mostly improve in 1-2 weeks.
No need to worry for pneumonia or major Pulmonary diseases.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Drkaushal85 (2 days later)
Hello Doctor,
I am stressed out again.
I still have sub fibril temperature at evening, sweating at night and morning.
One mornings I do not cough a lot, another morning a lot. Night time is ok. Day time some cough.
Discharge from nose is clear like a water.
Discharge from post nasal is orange or clear with some blood.
Discharge with coughing is sticky white, or clear sticky with some blood blended in to mucus.
Sometimes I experience short breathing. I do not know if this condition due to my fears or because of bronchitis.
Auscultation does not show any sounds from bronchus.
I will see my allergy specialist on August 04, 2015
I am very afraid!
I read that even some blood in discharge is not good sign.
doctor
Answered by Dr. Drkaushal85 (28 minutes later)
Brief Answer:
You are having hemoptysis.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Blood in sputum is known as hemoptysis.
And most common cause for hemoptysis is bronchitis.
Your all symptoms are due to uncontrolled allergy and related bronchitis.
You need combination of antihistamine and anti allergic drugs, inhaled bronchodilators and inhaled corticosteroid (ICS) and intranasal spray containing steroids.
Do you have exposure to any form of smoke at home or at work place?
Please reply me answers of above asked question, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Drkaushal85 (23 minutes later)
Doctor, I answered this question.
No one at home or at work smokes.
Hemoptysis now not like blood strikes , it was blended in to discharge.
I am afraid of cancer or another life threatening disease
what about my sub fibril temperature at evening started last week.
short breathing?
I trust your expertise.

doctor
Answered by Dr. Drkaushal85 (14 minutes later)
Brief Answer:
All symptoms are due to bronchitis.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.

No need to worry for lung cancer or major illness.
Your all symptoms including blood streaks are due to bronchitis.
Bronchitis is inflammation of airways.
So fever is inevitable.
Inflammation causes edema and narrowing of airway lumen. And narrowed lumen causes breathlessness.
This is the reason why bronchodilators and inhaled corticosteroid are needed.

Hope I have solved your query.
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Drkaushal85 (10 minutes later)
Doctor,
But now is not blood streaks only. blood is blended to the mucus.
this is why I am panicking
is this common for bronchitis? I did not have this symptom before.
doctor
Answered by Dr. Drkaushal85 (7 minutes later)
Brief Answer:
Hemoptysis is common in bronchitis.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
Yes, hemoptysis I seen in bronchitis.
In fact bronchitis is the most common cause for hemoptysis.
So no need to worry much. Consult doctor and discuss all these. Start drugs, which I have discussed with you.
You will mostly improve in 1-2 weeks.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Drkaushal85 (11 days later)
Hello Doctor,
I visited allergologist with all my concerns. As per your advice, I requested treatment. He prescribed me Teva-Montelukast one tablet before night time and nasal spray Omnaris once a day before bed time. I am taking this medication from August 04, 2015. I do not feel huge improvement for my symptoms.
What I notice is I breath better, easy in and out. I had problem with breathing out before. I still have morning cough and morning nasal problems. I have little bit less mucus with coughing, but post nasal dripping is almost the same. I have less tension in chest, however, still have some light pain in chest and some itchiness in chest close to throat.
What make me very nervous is that I still have sub fibril temperature during day. Morning time 36 degree ( which I have during year), after 1-2 hours I feel flushing, sweating, I check the temperature, it is 36.6-37 degree, after 1-2 hours it goes down.
I was expecting improvement in my symptoms.
And as you noticed, I am afraid of cancer, tumor and other major lung disease.
Is the early stage pneumonia on x-ray cancer? or in just inflammation?
I am sorry for repeating my questions, but all this symptoms and sub fibrile temperature make my extremely nervous.
Thank you in advance,
XXXX
doctor
Answered by Dr. Drkaushal85 (3 hours later)
Brief Answer:
why PFT is not done?

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.
No need to worry, you will definitely improve.
And you are seeing improvement with anti allergic drug and intranasal spray containing steroid.
Have you not told about bronchitis to the doctor?
Why PFT is not done in your case?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Drkaushal85 (19 minutes later)
Doctor,
I told allegologist that I have a bronchitis, he had my x -ray report in file.
He prescribe me montelukast and omnaris and advise to visit him in 6 weeks.
I lived in Canada so to visit specialist, you have to wait many months. My family physician is on vacation, I will visit him and ask to send me to pulmonologist, however, it will take months and months before I visit specialist.
Doctor, I am really nervous about not having significant improvement in treatment. Also I am worry about sub fibril temperature. When I read about my symptoms on internet I am panicking because this symptoms are common not for chronic bronchitis only.
That opacity they found is just inflammation? I know, I asked this questions before.
Based on my symptoms, fever, cough, hemoptysis, tension in chest and some pain and x-ray report, is any sign of major problems?
Doctor, please help!
doctor
Answered by Dr. Drkaushal85 (17 minutes later)
Brief Answer:
No need to worry for pneumonia or cancer.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
No need to worry for this. You are mostly having chronic bronchitis and related x ray changes.
And for this you need to get done PFT (Pulmonary Function Test).
You need to start inhaled bronchodilators and inhaled corticosteroid (ICS) for complete improvement.
Also get done repeat chest x ray to see improvement.
No need to worry for lung cancer or pneumonia.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Drkaushal85 (11 minutes later)
Doctor,
I got x-ray month ago, how soon should I do the test.
Also, what if there is no improvement. will it means that opacity is not just inflammation?
I red on internet that cancer may look like pneumonia and is not improving on x-ray.
I do not feel any improvement...
doctor
Answered by Dr. Drkaushal85 (10 minutes later)
Brief Answer:
You are not improving because you are not taking treatment for bronchitis.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Possibility of inflammation is more due to chronic bronchitis.
But better to get done repeat chest x ray after 1 month.
You are not improving in chest symptoms because you are not taking correct treatment for bronchitis.
Once you start inhaled bronchodilators and inhaled corticosteroid, you will definitely improve.
I don't understand why you need these much time to meet pulmonologist. Don't you go directly to pulmonologist? What is the need to first consult gp and than only pulmonologist?
This is more frustrating. Is the health system so poor there?
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Drkaushal85 (9 minutes later)
Doctor,
To visit the specialist, we must have referral from family doctor and wait for 2-3 months.
This is why I am asking all this questions.
what if I still have that opacity, will it means that it is cancer or tumor?
I am afraid to go...
doctor
Answered by Dr. Drkaushal85 (13 minutes later)
Brief Answer:
If opacities persists than you need CT thorax and bronchoscopy.

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.
This is very ridiculous system. What if patient worsens with treatment of GP?
If your opacities persists,than you need CT thorax and bronchoscopy.
CT thorax is needed to rule out pneumonia and cancer.
Bronchoscopy is also helpful in diagnosis.
Hope I have solved your query.
If you are not having further queries,than please close the conversation and rate my answer.
You can ask me directly on bit.ly/drkaushalbhavsar.
Wish you good health.Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Drkaushal85 (5 minutes later)
So it means I may have cancer or tumor?
early stages?
doctor
Answered by Dr. Drkaushal85 (8 minutes later)
Brief Answer:
Possibility of lung cancer is very very less.

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your cancer.
Honestly speaking ,possibility of lung cancer is very very less.
Possibility of bronchitis is more.
If repeat chest x ray shows similar opacities than possibility of pneumonia is more.
But this is true only after starting treatment of bronchitis and your x ray opacities persist. So better to start treatment of bronchitis.
Hope I have solved your query.
If you are not having further queries,than please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Drkaushal85 (21 minutes later)
Thank you, Doctor!
I wish you live in Canada!
Let me resume our conversation.
I have to push my doctor to send me to specialist and I will book an appointment with specialist as soon as he is available. I will do all tests to confirm bronchitis. It will no be any significant changes until I get right treatment. it will not be any improvement until I get treatment. Antibiotics and ibuprofen and other medication will not work with long term chronic bronchitis.
Once I receive appropriate treatment for bronchitis, I will follow the treatment and book x-ray after one month to make sure that treatment works and there is no sign of pneumonia.
At this time, I should not be worried about cancer.
All my symptoms mostly related with chronic bronchitis.
Thank you!!!!!!!!!!


doctor
Answered by Dr. Drkaushal85 (8 hours later)
Brief Answer:
Yes, your understanding is absolutely right.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
Yes, your understanding is absolutely right.
No need to worry for lung cancer.
I will be happy to hear your follow up and improvement in future.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks. Do let me know your progress.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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What Do The Following X Ray Reports Suggest?

Brief Answer: Get done PFT. Detailed Answer: Thanks for your question on Health Care Magic. I can understand your situation and problem. You are having allergic disease. And long standing allergic disease can cause bronchitis. Bronchitis is inflammation of airways. Your x ray picture is classical of bronchitis. So consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid. Antihistamines and anti allergic drugs are also useful. All these drugs will be helpful to control your allergy and cough So no need to worry much, consult pulmonologist and get done PFT,start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.