Question:
Six years ago I was diagnosed with bronchitis and took three different
sets of antibiotics over the course of a month. The cough didn't go
away or even ease up. I was finally diagnosed with asthma. Once I
started use beclovent (a prophylactic, not rescue, inhaler) the cough
went away.
It can't hurt to ask a doctor about it.
Any help?
Answer:
No one is actually "born" with asthma. And she
describes the sound more as a bark than a cough, which suggests an
upper airway abnormality or obstruction.
I suggested he might need laryngoscopy because, from what she
describes, I would be suspicious for conditions such as laryngeal web,
laryngeal papillomatosis, laryngeal hemangiomatosis, or perhaps
laryngomalacia (although this latter condition should be outgrown by
now). While she does not say whether the child has stridor,
hoarseness, or feeding difficulties, these diagnoses are still
possible and can be easily excluded by laryngoscopy.
This is a very compelling and, unfortunately, not uncommon situation.
Asthma is frequently mistaken for "bronchitis" and treated
inappropriately with antibiotics rather than bronchodilators and
anti-inflammatories. And certainly some people have "cough variant"
asthma. But, again, a barky cough since birth in a child is a
completely different scenario than an adult with new-onset cough,
which was probably more productive and wheezy than barky. The former
sounds much, much more like an anatomic abnormality rather than
asthma.
Of course. We can only speculate. A physician who could obtain a more
thorough history and examine the patient would hopefully have a better
idea of what's going on than we do.
