Q. I have severe cough with phlegm and breathing difficulty even after taking medicines. Why?

Answered by
Dr. Shyam Kalyan N
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 08, 2019 and last reviewed on: Dec 09, 2019

Hello doctor,

I am having this problem for more than two months. I have severe cough, the whole day I used to spit phlegm normally and suddenly dry cough starts mostly in the night. I face difficulty in breathing and less spitting of phlegm. My blood test report shows

AEC 532 cells/mL.

ESR-07 mm/hrs.

HB-15.2 g%.

TLC- 7600/cumm.

I have taken a number of medicines, but the problem remains the same again. Now what I have to do? Please suggest.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)


Welcome to icliniq.com.

Many patients come to me with similar complaints. Especially during the winter season when it is windy.

As per your description, you seem to suffer from bronchitis. The presence of thick phlegm indicates it is a bacterial infection. The values of hemoglobin, ESR (erythrocyte sedimentation rate) and TLC (total leukocyte count) are within normal limits. Absolute eosinophil count (AEC) is slightly towards the higher side. High AEC is mostly due to the infection that you are suffering from.

For these complaints, I would suggest a course of antibiotics which have good action on the respiratory system, a course of anti-inflammatory tablets, mucolytics and antihistaminics for a week. During the course of treatment please refrain from smoking, going out in dusty weather, drinking or eating spicy, cold, and oily foods. Take steam inhalation thrice a day and drink plenty of warm water.

A small chance is that it could be due to asthma or allergy. For the same, you need to take a course of the above medications and see if still no respite then we can give you specific treatment for allergic bronchitis or asthma.

I hope this helps.

The Probable causes:

Allergy, infection, hypersensitivity.

Treatment plan:

I suggest you the following measures, kindly follow those and let me know how you feel.
Course of Levofloxacin 500 mg one tablet per day for five days.
Chymoral Forte (Trypsin/ Chymotrypsin) tablet before food twice a day for two to three days.
Accocontin tablets (Ambroxol hydrochloride) twice a day before food for five days.
Montec-LC (Montelukast and Levocetirizine) in the night for five days.
Brodil (Levosalbutamol) cough syrup 5 ml thrice a day for four days.

Preventive measures:

Steam inhalation.
Avoid smoke, dust, and cold weather.
Avoid cold foods, drinks, and spicy foods.
Take plenty of warm water.

Regarding follow up:

Do contact me if you need further support. If above measures fail we can do some investigations and check for an allergic etiology in you.

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