One should not treat a cough as a simple symptom. It is to be thoroughly investigated for the cause of the cough and to be treated accordingly. Cough due to upper respiratory tract infections or sinus infection will be controlled with antihistamines and suitable antibiotics. For sinusitis, even home remedies like putting turmeric in boiling water and inhaling the vapours give tremendous relief. The production of large quantities of purulent sputum with postural relationship is characteristic of bronchiectasis, is a chronic lung condition characterized by permanent damage and widening of the airways, making it difficult to clear mucus. This can lead to frequent infections and a chronic cough that produces large amounts of phlegm.
A lung abscess is a pus-filled cavity in the lung surrounded by inflamed tissue. It usually results from breathing bacteria that normally live in the mouth or throat into the lungs, leading to an infection. Symptoms of a lung abscess commonly develop slowly over weeks. They may include: Chest pain, especially while breathing in, cough, fatigue, fever, loss of appetite, night sweats, sputum (a mixture of saliva and mucus) with pus that’s often sour-tasting, foul-smelling, or streaked with blood and loss.
Several things can cause a lung abscess, including not being able to cough, alcohol or drug use, nervous system diseases, and sedation Further, people with gum disease are more likely to get an abscess. When the immune system isn’t working well this can let in germs that aren’t usually found in the mouth or throat, like fungi or the bacteria that cause tuberculosis, strep throat, and MRSA stands for methicillin-resistant Staphylococcus aureus, a type of staph bacteria that’s resistant to many antibiotics. MRSA is a contagious bacterial infection that can cause serious illnesses.
A blocked airway that is mucus can form behind a tumor or foreign object in the windpipe and lead to an abscess. If bacteria get into the mucus, the blockage stops from coughing it out or causes bronchopleural fistula. A Broncho pleural fistula (BPF) is an abnormal connection, or sinus tract, between the bronchial tree and the pleural space, the area between the lungs and chest wall. It can develop from various causes, including lung surgery, infection, trauma, or cancer. Anaerobic infection results in foul-smelling expectoration of large volumes of clear watery sputum in alveolar cell carcinoma.
Haemoptysis refers to coughing of blood. The amount may vary from small streaks mixed with secretions to massive, fulminant haemorrhage. Bleeding can occur anywhere in the respiratory tract, including the nose and mouth, and occurs because of congestion from inflammation, passively engorged blood vessels, mucosal ulcer, ulcerating tumour, erosion ofthe bronchial wall or aortic aneurysm. Haemoptysis has to be distinguished from Hematemesis, which also known as vomiting blood, is a symptom where blood is present in the vomit. It typically indicates bleeding in the upper gastrointestinal tract, which includes the oesophagus, stomach, and upper part of the small intestine. The blood may appear bright red or dark, like coffee grounds, depending on how long it has been in the stomach.
Rarely, bleeding from the respiratory tract may manifest as vomiting of swallowed blood. The nasal bleeding may drip from the back of the nose into the pharynx and may be subsequently coughed out.
The common causes of haemoptysis are Tuberculosis, Bronchiectasis, Lung abscess, Pneumonia etc. The sputum may be rusty in lobar pneumonia. Bleeding may appear as currant jelly in Klebsiella pneumonia. Pulmonary oedema is associated with pink, frothy sputum. There are bouts of brisk bleeding in tuberculosis. Bleeding is slight but persistent in bronchogenic carcinoma. Haemoptysis is unusual with pulmonary metastases, which are cancerous tumours that develop when cancer cells from a primary tumor in another part of the body spread to the lungs. This is different from lung cancer, which originates in the lungs. The spread can occur through the bloodstream or the lymphatic system.
Fever in respiratory disease signifies infection. In active tuberculosis, fever is irregular and the temperature increases in the evening. Patients often complain of night sweats. High fever is noted in pneumonia or lung abscess. Acute exacerbations of COPD (Chronic Obstructive Pulmonary Disease are associated with fever. There may be a history of pyrexia episodes from tumour necrosis or post-obstructive pneumonia in Bronchogenic carcinoma is a term primarily used to describe lung cancer.
Dyspnoea (shortness of breath, breathlessness) is a subjective sensation of difficulty in breathing. There is an unpleasant awareness of the muscular effort to achieve adequate ventilation.
The patient with organic disease finds it difficult to lie that due to a feeling of suffocation or wakes up at night with shortness of breath (asthma, left ventricular failure, chronic obstructive pulmonary disease). Shortness of breath on exertion has an organic origin. A sudden onset of dyspnoea may be due to pneumothorax, pneumonia or pulmonary embolism. In nearly 10 per cent of patients, dyspnoea is functional and related to mental tension or anxiety (psychogenic dyspnoea). It is noted at rest and not on exercise.
Wheezing is easily recognized by the patient and implies airways obstruction (bronchial asthma, COPD), and it is predominantly expiratory. Stridor is an abnormal, high-pitched, musical breathing sound. It is caused by a blockage in the throat or voice box (larynx). It is most often heard when taking in a breath. Refers to partial obstruction in the trachea or larynx and is inspiratory. A unilateral wheeze suggests a localised obstructive lesion, foreign body or localised stricture or Neoplasm which is an abnormal growth of tissue that can be (noncancerous) or malignant (cancerous).
Therefore, cough can be from a simple allergy to a complicated cancer of the lung. It is suggested not to neglect cough in the beginning stage.
