Cough and Phlegm: When to See a Pulmonologist

Q: Cough and Phlegm: When to See a Pulmonologist

Hello： Common symptoms of pulmonary tuberculosis include a cough lasting more than two weeks, fever, fatigue, and weight loss, especially if there has been contact with a family member who has tuberculosis. <br>It is recommended to have a chest X-ray if the cough persists for mor

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Hello Doctor, I have been experiencing a lot of nasal discharge, some phlegm, and a slight sore throat, with minimal coughing except for occasional attempts to clear my throat.
I visited a general clinic and was prescribed medication; the doctor mentioned that I have a mild cold.
However, after researching online, I found that tuberculosis can also present with symptoms like coughing and phlegm, which has made me a bit worried.
I would like to ask if the cough associated with tuberculosis is usually very severe? The phlegm I have feels clear and watery, almost like an increase in saliva, and sometimes it feels like nasal mucus is running down into my throat.
About six months ago, I had a chest X-ray because I suddenly experienced chest pain after a massage, but the doctor said there were no signs of pneumothorax or any other significant issues.
Should I see a pulmonologist for further evaluation, or am I just being overly anxious? Should I continue taking the medication and see the doctor again in a couple of days? Thank you for your response.

Min Min, 20~29 year old female. Ask Date: 2020/07/29

Dr. Yang Wenda reply Pulmonology

Hello: Common symptoms of pulmonary tuberculosis include a cough lasting more than two weeks, fever, fatigue, and weight loss, especially if there has been contact with a family member who has tuberculosis.
It is recommended to have a chest X-ray if the cough persists for more than two weeks.

Reply Date: 2020/07/29

More Info

When it comes to understanding cough and phlegm, particularly in the context of potential lung issues such as tuberculosis (TB), it is essential to recognize the symptoms and when to seek further medical evaluation from a pulmonologist.
Coughing and the production of phlegm can be symptoms of various respiratory conditions, ranging from benign viral infections to more serious diseases like pneumonia or tuberculosis. In your case, you mentioned experiencing a runny nose, throat discomfort, and occasional cough, which your doctor attributed to a common cold. However, your concerns about tuberculosis are valid, especially given the overlap in symptoms.

Tuberculosis typically presents with a persistent cough that lasts more than three weeks, often accompanied by other symptoms such as weight loss, night sweats, fever, and fatigue. The cough associated with TB can be severe and may produce sputum that is discolored or even blood-tinged in advanced cases. In contrast, the clear or white phlegm you describe may suggest a less severe condition, such as a viral upper respiratory infection or post-nasal drip, where mucus from the nasal passages drips down the throat, leading to throat irritation and cough.

Given that you had a chest X-ray six months ago that showed no signs of pneumothorax or other significant issues, and considering your symptoms have not escalated to include the hallmark signs of TB, it may not be immediately necessary to see a pulmonologist. However, if your symptoms persist, worsen, or if you develop new symptoms such as significant weight loss, prolonged fever, or night sweats, it would be prudent to seek further evaluation.

In the meantime, continuing with the medications prescribed by your doctor is a reasonable approach. If you notice no improvement or if your symptoms worsen, returning to your healthcare provider for a follow-up is advisable. They may consider further diagnostic tests, such as a repeat chest X-ray or even a CT scan, depending on your clinical presentation.

In summary, while your symptoms could be concerning, they are more consistent with a mild upper respiratory infection rather than tuberculosis at this stage. Keep monitoring your symptoms, and if you have any doubts or if they change, do not hesitate to consult your healthcare provider or a pulmonologist for further evaluation. It's always better to err on the side of caution when it comes to respiratory health.

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