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Doctors Lounge - Chest Answers
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| Leena
- Sat Sep 02, 2006 4:07 am |
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[color=blue]My friend who is a 42 year old male is diagnosed with Bronchial Asthma. He was also twice treated for Pulmonary tuberculosis in 1988 and 1999. He also had Bronchitis in September 2005.
Last year, when he had a cold with nasal congestion, he had broncospasms. He used nasal sprays and inhalers for nine months before he stopped using them. After sometime, he began to get dry coughs and it gradually became productive coughs. His PFT readings, when he had a productive cough, showed “FVC is 109% of the predicted normal, FEV1 is 90%, FEV1/FVC ration 67%, and FEF 25-75 is 58% of the predicted normal and evaluation after Salbutamol nebulizer did not show clearly responsive airways”.
His X-ray shows Fibrotic opacities. He is currently feeling weak and have cold like symptoms in the evenings with chest tightness and pin pricking like sensations. His breathing is also not smooth. He is also having some phlegm. All tests are normal except for the PFT. Can you please tell what is this medical condition and whether any further tests such as CT scan or MRI or any other tests need to be done?
Thanking you for your kind advise and help.[/color]
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| Theresa Jones, RN
- Wed Sep 13, 2006 6:14 am |
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 Hi Leena,
Asthma typically presents with abnormal PFT's. Fibrotic Opacities may represent old granuloma disease (associated with TB), and may indicate findings that are suggestive of prior TB (inactive) but an assessment can not be accurately made by one chest xray alone. Generally speaking, regarding this matter, sputum smears (AFB) are completed for identification of active rather than latent disease. If the nodules (fibrotic opacities) are calcified, and have not changed, it would be less concerning. However, if calcifications were not stated or areas have changed, taking into consideration that he is feeling unwell, in my opinion, further follow up would be indicated with some diagnostic studies, ie., serial AFB's, and CT Scan.
Sincerely,
Theresa Jones, RN
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