10 doctors weighed in:

How would you treat a patient with possible chronic respiratory disease who present with 1 day hx congestion,clear sputum, afebrile, no SOB, or rales?

10 doctors weighed in
Dr. Corey Clay
Internal Medicine - Allergy & Immunology
5 doctors agree

In brief: Agree with Dr Gupta

...with comments: need to determine any cause of chronic respiratory disease (asthma? copd?).
Asthma can certainly be exacerbated by environmental allergies, which can also trigger allergic rhinitis (nasal itching/congestion, sneezing, drainage). Both cause cough. As an initial test, blood tests for allergies poorly predict allergy sensitivity compared to skin testing and symptom history.

In brief: Agree with Dr Gupta

...with comments: need to determine any cause of chronic respiratory disease (asthma? copd?).
Asthma can certainly be exacerbated by environmental allergies, which can also trigger allergic rhinitis (nasal itching/congestion, sneezing, drainage). Both cause cough. As an initial test, blood tests for allergies poorly predict allergy sensitivity compared to skin testing and symptom history.
Thank
4 comments
Dr. Corey Clay
Last comment: 1-day history of congestion is not typical for allergy, unless an exacerbation of baseline symptoms. Viral infection may be more likely and thus rest, hydration and healthy eating is the best means toward relief. Good luck!
Dr. Payel Gupta
Agree. More patient history will help in determining if viral vs chronic cause.
Dr. Payel Gupta
Internal Medicine - Allergy & Immunology
4 doctors agree

In brief: More evaluation

Patient may be suffering from allergic rhinitis.
Send to an allergist or send for blood testing for IgE to environ triggers like dust mite, cockroach, tree pollen etc. Also start intranasal steroid spray (if no contraindications- nose bleeds or increased intraoccular pressure) because that will help with both allergic and non allergic rhinitis and also use decongestant - sudafed (if no htn).

In brief: More evaluation

Patient may be suffering from allergic rhinitis.
Send to an allergist or send for blood testing for IgE to environ triggers like dust mite, cockroach, tree pollen etc. Also start intranasal steroid spray (if no contraindications- nose bleeds or increased intraoccular pressure) because that will help with both allergic and non allergic rhinitis and also use decongestant - sudafed (if no htn).
Thank
1 comment
Dr. Karen Glover
Appreciate your answer. Space limited further information. Was a senior gentleman, not sure if he had COPD. Did recommend the steroid nasal spray. 2 days later, he went to ER with fever and more cough and congestion. My issue is could the ER visit have been prevented?
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