symptoms of lung disorders
lung and airway disorders
Cough in Adults
Not every cough requires immediate evaluation by a doctor. The following information can help people decide whether a doctor’s evaluation is needed and help them know what to expect during the evaluation. In people with a cough, certain symptoms and characteristics are cause for concern. They include Shortness of breath Coughing up blood Weight loss Fever that lasts longer than about 1 week Risk factors for Tuberculosis (TB) , such as being exposed to tuberculosis, having Risk factors for HIV infection, such as high-risk sexual activities or use of illicit drugs by injection People who have warning signs should see a doctor right away unless the only warning sign is weight loss. Then, a delay of a week or so is not harmful. People who may have inhaled something should also see a doctor right away. People with an acute cough but no warning signs can wait a few days to see whether the cough stops or becomes less severe, particularly if they also have a congested nose and sore throat, which suggest that the cause may be an upper respiratory infection (URI). People who have had a chronic cough but no warning signs should see a doctor at some point, but a delay of a week or so is unlikely to be harmful. Doctors first ask questions about the person's symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause of the cough and the tests that need to be done (see table). Some obvious findings are less helpful in making a diagnosis because they can occur in several disorders that cause cough. For example, whether sputum is yellow or green or thick or thin does not help distinguish bacterial infection from other possible causes. Wheezing may occur with Acute Bronchitis , The need for tests depends on what doctors find during the history and physical examination, particularly whether warning signs are present. If people have any warning signs, tests usually include Measurement of oxygen levels in the blood with a sensor placed on a finger (pulse oximetry) A chest x-ray Skin tests, chest x-ray, and sometimes Computed Tomography (CT) (CT) of the chest, and examination and culture of a sputum sample for tuberculosis, and blood tests for HIV infection are also done if people have lost weight or have risk factors for these disorders. If no warning signs are present, doctors can often make a diagnosis based on the history and physical examination and begin treatment without doing tests. In some people, the examination suggests a diagnosis, but tests are done to confirm it (see table). If the examination does not suggest a cause of a cough and no warning signs are present, many doctors try giving people a medication to treat one of three common causes of cough: An antihistamine/decongestant combination or a nasal corticosteroid or nasal muscarinic antagonist spray (for postnasal drip) A proton pump inhibitor or histamine-2 (H2) blocker (for gastroesophageal reflux disease) An inhaled corticosteroid or short-acting beta-2-agonist bronchodilator (for asthma) If these medications relieve cough, further testing is usually unnecessary. If cough is not relieved, doctors typically do tests in the following order until a test suggests a diagnosis: A chest x-ray Pulmonary Function Testing (PFT) to check for CT of the sinuses to check for sinus disorders Placement of an acid sensor in the esophagus to check for Gastroesophageal Reflux Disease (GERD) None If people have a chronic cough, doctors usually do a chest x-ray. If the cough produces blood, doctors typically send a sputum sample to the laboratory. There, technicians try to grow bacteria in the sample (sputum culture) and use a microscope to check the sample for cancer cells (cytology). Often, if doctors suspect lung cancer (for example, in middle-aged or older adults who have smoked for a long time and who have lost weight or have other general symptoms), they also do CT of the chest and sometimes bronchoscopy. 