How to manage persistent cough and chest pain?

Question

Hello doctor,

I am very worried about my sister’s health. She is 23 years old and has been coughing continuously for several weeks, along with struggling to catch her breath properly. Initially, we thought it might just be a common cold or flu, but her condition does not seem to improve, and something feels off.

She appears very exhausted throughout the day, and her body temperature fluctuates, often accompanied by shivering. Additionally, she is complaining of chest pain when breathing.

Despite trying antibiotics, her symptoms have not improved. Could this be something serious?
Could it be a bacterial infection, or is there another underlying cause we should be concerned about?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

While I will do my best to provide a detailed explanation and possible causes, a physical examination by a doctor in a hospital is a must at the earliest. Your sister’s persistent cough, shortness of breath, fluctuating fever, shivering, chest pain while breathing and overall exhaustion could suggest an underlying respiratory issue.

Must rule out pneumonia, which is a bacterial, viral, or even fungal infection of the lungs. Pneumonia presents with a prolonged productive or dry cough, chest pain that worsens with breathing or coughing, fever, chills, and difficulty catching one’s breath.

If the infection has not responded to antibiotics, it could suggest antibiotic resistance, an incorrect choice of antibiotic tuberculosis (TB), especially if she has had prolonged symptoms,

Tuberculosis is caused by Mycobacterium tuberculosis and diagnosis via sputum tests, chest X-ray, or Mantoux test is critical. Pleural effusion or empyema (accumulation of fluid or pus in the pleural cavity) can also present with chest pain, fever, and breathlessness. This condition can occur as a complication of pneumonia. A chest X-ray or CT scan is a must for diagnosis.

Pulmonary embolism (PE) should also be considered if she has severe breathlessness and chest pain, especially if the pain worsens with deep breathing. Infections like influenza or COVID-19 can cause prolonged respiratory symptoms, fever, and exhaustion. Asthma could cause prolonged coughing, breathlessness, and chest pain due to overworked respiratory muscles. Chronic obstructive pulmonary disease (COPD) or exposure to environmental pollutants could aggravate symptoms.

There is also the possibility of cardiac involvement, such as myocarditis (a rare but serious condition that occurs when the heart muscle, or myocardium, becomes inflamed) or pericarditis (inflammation of the pericardium, the sac that surrounds the heart).

Non-infectious causes like lupus or sarcoidosis, and malignancies, should not be overlooked.

A hospital visit immediately.
X-ray or CT scan to check for pneumonia and TB.
Complete blood count, CRP, and ESr.
A sputum test.

Ensure she stays hydrated, avoids physical exertion, and remains in a clean, well-ventilated environment. Monitor her temperature, oxygen saturation, and general condition closely.

I hope I have answered your query.

Let me know if I can assist you further.

Thank you.