I have five weeks of cough, with mild yellow phlegm, malaised, chest pain, type one diabetic, and on Azathioprine for ulcerative colitis. Get exposure to Tb daily. Also finished rotation in peads. Tb test is negative, wcc and crp normal, mild hypoxia on blood gas, macrocytosis, and mild lymphopenia. Gastro doctor advised stopping Aza temporarily. 5/7 of Clarithromycin helped, still coughing and chest pain ct after antibiotics suggested atypical pneumonia vs. mycobacterium infection. Pulmonologist here not available for some days and I would like to go back to work. What would be the next step in terms of management?
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If your investigations are regular, why are we suspecting any infection? I would consider this allergic bronchitis. I would recommend you to go for anti-allergic like a combination of Levocetirizine and Montelukast once a day for two weeks. You may add up any bronchodilator like Doxophylline. I hope it helps you. If you have any further query, please ask me.
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Thank you doctor,
Due to being immunocompromised, having chest pain, and cough. CT chest shows diffuse calcifications of the trachea and main bronchi. Diffuse centrilobular nodularity with a tree-in-bud configuration with some more confluent consolidation evident as well as pleuroparenchymal banding within the left lower lobe. Features suggestive of an infective process, atypical viral pneumonia or a mycobacterial infection could be considered. Also, some changes are evident within the right apex.
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In that case, you may take Augmentin along with Clarithromycin or Levofloxacin. This would work wonder. If you have any further query, please ask me.
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