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I Had An Urgent Care Nurse Practitioner Hear A Plural

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Posted on Fri, 27 Jan 2023
Question: I had an urgent care nurse practitioner hear a plural rub upon listening to my lungs. I've had only a night cough for several months. No other symptoms.
Is there any scenario where a plural rub isn't a serious disease?
Since I've been coughing for several months and no pain, he didn't think it was pleurisy or pneumonia.
I do have asthma and severe allergies to many things.
doctor
Answered by Dr. Drkaushal85 (18 hours later)
Brief Answer:
This might be allergic cough.

Detailed Answer:
Thanks for your question on Ask a doctor forum.
I have gone through the detailed history you have given.
By your history and description possibility of allergic cough is more likely.
You are known for allergies plus night time cough is more commonly seen with allergic cough.
I don't think it is pleurisy because you don't have pain, fever, chest congestion etc.
If possible get done chest x ray to rule out pleurisy and get done PFT (Pulmonary Function Test) for the diagnosis of allergic cough.
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. Kampana
doctor
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Follow up: Dr. Drkaushal85 (31 minutes later)
Can allergic cough cause them to hear plural rub sound? Thanks
doctor
Answered by Dr. Drkaushal85 (37 hours later)
Brief Answer:
Rarely allergic cough can cause pleural rub.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
Sorry for late reply as I was busy.
Yes, sometimes, rarely allergic cough can cause pleural rub.
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. Saisudha Kotla
doctor
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Follow up: Dr. Drkaushal85 (8 hours later)
I went to Dr the next day and she didn’t hear anything upon listening to my chest.

Nurse practitioner in the first appointment didn’t have me cough. The dr asked if nurse Practitioner had me cough upon hearing clear lungs.

I haven’t coughed in 3 nights.

If it was something serious like disease, wouldn’t I have cough other times like during the day? Or other symptoms?

I have panic disorder and just had a divorce finalized. The night cough started when I really started to panic about divorce several months ago which led me to think emotionally induced asthma coupled with the extreme allergies.

Thank you for any additional information.
doctor
Answered by Dr. Drkaushal85 (36 hours later)
Brief Answer:
Yes, if it is serious lung disease then you will have day time symptoms.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Yes, if you have any serious lung disease then day time symptoms like cough, chest pain etc will be there.
So I don't think it is any serious issue.
Your night time cough is mostly because of allergic cough.
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. Saisudha Kotla
doctor
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Follow up: Dr. Drkaushal85 (3 hours later)
Thank you for your response.

I had 4 nights without coughing. Tonight I have the cough again. If it was emphysema, COPD, bronchetitis or some other permanent condition or cancer, could the cough be sporadic or consistent?

Also I had bloodwork drawn. My ALP liver enzyme was mildly raised to 121. I don’t drink alcohol or take acetaminophen. What I read online sounds very bad. Especially if something was wrong with my lungs. What are your thoughts on this.

Thank you.
doctor
Answered by Dr. Drkaushal85 (25 hours later)
Brief Answer:
Yes, these diseases will have daily symptoms, not sporadic.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
Yes, if you have copd or lung cancer or lung infection, you will have regular night symptoms, daily symptoms, not sporadic symptoms.
And for ALP, I will suggest to get done repeat test after 1 month.
If it is still high then get done chest x ray PA view.
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 (3 hours later)
I saw that my lab from 2019 ALP was 111 then lower in last few years. 121 is considered within normal range for some labs? Or is that always high? Are you thinking high ALP, especially if it increases in a month, might indicate cancer? I did read journal articles about that. Thanks.
doctor
Answered by Dr. Drkaushal85 (26 hours later)
Brief Answer:
Yes, if it rises rapidly or if it is too high then think about cancer.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
No need to worry for this value.
This is normal only.
If it raises rapidly or is it too high like in the thousands then only think about cancer.
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 (3 days later)
Thank you for answering all my questions.

On some nights I have no cough. Last week there were 4 nights in a row. Then a few nights of it. Then non again for a few nights. Last night, I was up later doing stressful work. It came on where it feels difficult to breathe. I cough up thick phlegm. I use the Nebulizer and it’s better so I can sleep. It feels irritated the next day but always clears in the morning (even though it can feel still inflamed).

Can these symptoms be consistent with lung cancer, COPD, or any other lung disease? Where it has this unusual non-pattern since August.

I don’t remember if I shared this but I have CPTSD with the anxiety and recently got divorced. I’m under a lot of stress and anxiety. I do have the history of allergic asthma but didn’t have to use an inhaler for 30 years. I did my best to avoid things I was allergic too but I still was able to get help with allergy medicine alone.

My main question, which I know you already addressed somewhat, is whether these breathing issues could be consistent with the lung conditions mentioned above especially considering the 121 ALP level. Thank you for your time.
doctor
Answered by Dr. Drkaushal85 (34 hours later)
Brief Answer:
Lung cancer, copd are very very less likely in your case.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
Like I said earlier, lung cancer, copd are very very less likely in your case.
So no need to worry for them.
I again feel that this is allergic cough.
Allergic cough can be triggered by stressors.
So avoid stress and tension, be relax and calm.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Drkaushal85

Pulmonologist

Practicing since :2008

Answered : 15005 Questions

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I Had An Urgent Care Nurse Practitioner Hear A Plural

Brief Answer: This might be allergic cough. Detailed Answer: Thanks for your question on Ask a doctor forum. I have gone through the detailed history you have given. By your history and description possibility of allergic cough is more likely. You are known for allergies plus night time cough is more commonly seen with allergic cough. I don't think it is pleurisy because you don't have pain, fever, chest congestion etc. If possible get done chest x ray to rule out pleurisy and get done PFT (Pulmonary Function Test) for the diagnosis of allergic cough. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.