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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Could Patch In Lungs With Persistent Cough Suggest?

Hi, our 4 year old has had a persistent cough for a number of weeks (worse at night, with a persistent 2 hours of almost convulsive coughing each night before settling down again) with no other symptoms (e.g. runny nose, etc.). As the pollen count in our area was very high at the time, our doctor prescribed some prednesol (3 day dosage) thinking it may be allergy related. This did not improve the cough so, after 3 days, we attended the local hospital. An x-ray indicated a patch in the lung and we were prescribed a 7 day course of clarithomycin. We are now on day 4 of the course and, after an initial improvement, it seems to be regressing as he has started coughing at night again (tonight) after 2 cough free nights. Any thoughts as to what may be happening and as to what we should do next? Should we just wait until the course has been completed?
Thu, 20 Nov 2014
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Pulmonologist,  's  Response
Thanks for your question on HCM.
In my opinion your son is having pneumonia and he is not responding to the treatment as he developed coughing again.
So better to get done repeat chest x ray. If improvement in chest x ray than no need to worry much, just continue clarithromycin.
But if shadow is same or worsening than better to get done culture and try to identify the organism. This will help us to guide the antibiotic therapy.
So get done fresh chest x ray and compare with old one.
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What Could Patch In Lungs With Persistent Cough Suggest?

Thanks for your question on HCM. In my opinion your son is having pneumonia and he is not responding to the treatment as he developed coughing again. So better to get done repeat chest x ray. If improvement in chest x ray than no need to worry much, just continue clarithromycin. But if shadow is same or worsening than better to get done culture and try to identify the organism. This will help us to guide the antibiotic therapy. So get done fresh chest x ray and compare with old one.