Which Medical Specialty Should I Consult for Persistent Cough?

Which department should I register for?

Hello, doctor.
Since I caught a cold during the New Year, I have been coughing continuously for almost a month now.
I have seen three doctors, one of whom said it was due to enterovirus and allergies.
Last week, I went to Mackay Memorial Hospital to see an ENT specialist, who diagnosed me with post-nasal drip and sinusitis.
The doctor prescribed me cough suppressants, antibiotics, and antihistamines.
However, after taking the medication for almost a week, I still feel no improvement in my cough.
(I usually do not experience frequent sneezing or runny nose, and there are no wheezing sounds when I breathe.) I plan to see a doctor again this week, but I am unsure if I should consult a different specialty.
Could you please give me some advice?

duo, 20~29 year old female. Ask Date: 2005/03/09

Dr. Lin Mingxing reply Family Medicine

Dear Dual,
Based on your symptoms, subacute bronchitis is quite likely.
Viral upper respiratory infections typically cause spasms within a few days if they are caused by common viruses.
However, some viruses (such as the influenza virus) can sometimes invade deeper respiratory tissues and alter the immune system's defense mechanisms, leading to secondary infections that may persist for several weeks or even one to two months, potentially triggering conditions such as pneumonia or sinusitis.

I recommend focusing on strengthening your overall health (through diet, exercise, sleep, etc.), and it is also crucial to actively prevent secondary viral or bacterial infections.
Wishing you good health and all the best!
Sincerely,
Dr.
Lin Ming-Hsing
Director, Department of Family Medicine
Tainan Hospital, Department of Health, Executive Yuan

Reply Date: 2005/03/09

More Info

When dealing with a persistent cough that has lasted for nearly a month, it is essential to consider the underlying causes and the appropriate medical specialties to consult. Given your history of a cold followed by a persistent cough, it is possible that your symptoms are related to post-nasal drip, sinusitis, or even a lingering viral infection.
Based on the information you provided, you have already seen three doctors, including an ENT specialist who diagnosed you with post-nasal drip and sinusitis. You were prescribed cough suppressants, antibiotics, and antihistamines, but your cough has not improved significantly. This situation can be frustrating, especially when you are not experiencing other symptoms like sneezing or wheezing.

In your case, it may be beneficial to consult a pulmonologist, a specialist in respiratory conditions. A pulmonologist can perform a thorough evaluation of your lungs and airways, which may include imaging studies such as a chest X-ray or CT scan, pulmonary function tests, and possibly a bronchoscopy if necessary. These tests can help rule out any underlying lung conditions such as bronchitis, asthma, or even more serious issues like chronic obstructive pulmonary disease (COPD) or lung infections.

Additionally, since you mentioned that you do not typically experience sneezing or nasal congestion, it might be worth exploring whether there is an allergic component to your symptoms. An allergist can perform tests to determine if you have any allergies that could be contributing to your cough. Allergies can cause inflammation in the airways and lead to chronic cough, even in the absence of typical allergic symptoms like sneezing or runny nose.

Furthermore, if your cough is accompanied by any other concerning symptoms such as chest pain, difficulty breathing, or coughing up blood, it is crucial to seek immediate medical attention. These symptoms could indicate a more serious condition that requires prompt evaluation and treatment.

In summary, for your persistent cough, I recommend considering a consultation with a pulmonologist to assess your respiratory health comprehensively. If allergies are suspected, an allergist may also provide valuable insights. It is essential to communicate your ongoing symptoms clearly to your healthcare providers, as this will help them determine the best course of action for your treatment. Remember to advocate for yourself and seek further evaluations if you feel your concerns are not being adequately addressed. Your health and well-being are paramount, and persistent symptoms warrant thorough investigation.

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