18y/o male c/o severe irritable dry cough continuously since 1week..no h/o of asthma,smoking,allergy.Vitals are spo2-93% a room air,bp 100/70,lungs clear,bae+ His investigation reports..kindly give me the relevant dDx, Rx and management further..



Hypoxia - normal CXR - asthma / copd - PE - spirometery/ CT angiogram/ d dimer for final diagnosis -

Hypoxia in young individual with normal looking x-ray can only be explained by (1) obstructive airway disease like Asthma Or (2) pulmonary embolism.. Incidently the upper zone Of the left lung shows sparse lung markings.. Perform a spirometry to exclude obstructive airway disease.. If normal.. Ct pulmonary angiography should be performed.. We can not ignore spo2 93% on room air...

Tropical eisinophilia

syp zedex plus dry cough tab montac lc 7 day in night tab omnacortil 10 mg 5 day. bd

First let us treat like common lower respiratory tract infections with steam inhalation antibiotics & observe to get more clinically relavant information

x-ray appears grossly normal

needs cbc esr mox cv broncho dilator levoceyriz with monteleu cough sedatives like code in syp

PT.is having no h/O fever ,it is better to treat him as allergic bronchitis using antiallergic ,bronchodilator, mucolytic and steroids for a week .if no improvement found then go for thorough investigations to make diagnosis.

ddx...postnasal drip syndrome or UPPER AIRWAY COUGH SYNDROME ( UACS ), GERD, laryngopharyngeal reflux, non allergic eosinophillic bronchitis ( NAEB ), etc...r/o upper respiratory tract disorders like allergic rhinitis/sinusitis,NAEB responds to steroids, gerd responds to acid suppression...may be a cough variant asthma..in cough variant asthma only prominent symptom is cough...

eosinophilic pneumonitis..tab DEC 100mg tds,tab levocet 5mg Hs,syp DPH,tab azithro 500mg od,tab fluconazole 150mg stat,inh salbutamol 2 puff bd...

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