Respiratory Tract Infections and Asthma " Kiril is a 51-year-old millwright "

Case study ( 4511 views as of December 10, 2023 )

Kiril is a 51-year-old millwright, who was off work for two days last week with a bad cold. He almost never misses work, so to be off for two days it was more than a "sniffle". He had one night with fever, sweats and a body ache, followed by runny nose, sore throat, and a dry, non-productive cough. He felt better after two days off work, but the cough has persisted and he feels a bit short of breath when he goes up stairs, and he endurance for his regular work tasks is still down. He feels exhausted at the end of the day.

Kiril's story is consistent with a respiratory infection that has not completely resolved. Kiril should see his primary care provider and may visit an emergency department to rule out pneumonia or other more serious cause of shortness of breath and cough. However, persistent cough, shortness of breath and wheeze following a viral respiratory infection is not uncommon. He may be referred to a respiratory disease specialist for further work-up and risk stratification.

Some patients benefit from inhalers and even oral steroids for a period of time to settle down the inflammation in their lungs. Kiril may need to modify his work duties until his health improves over the next days or weeks.


Conversation based on: Respiratory Tract Infections and Asthma " Kiril is a 51-year-old millwright "

Respiratory Tract Infections and Asthma " Kiril is a 51-year-old millwright "

  • Asthma is indeed a common respiratory disease that can have various presentations. The symptoms of asthma can include a persistent cough following a cold or fever, wheezing, chest tightness, and shortness of breath. If you experience symptoms of asthma, it is recommended to start by consulting with your family physician. They can assess your condition, provide appropriate treatment options, and monitor your progress. In many cases, asthma can be effectively managed by a family physician. However, if your asthma symptoms are severe or not well-controlled with initial treatments, your family physician may refer you to a respiratory specialist or pulmonologist. These specialists have advanced training and expertise in managing respiratory conditions like asthma and can provide specialized care and treatment options tailored to your specific needs. It's important to work closely with your healthcare provider to effectively manage your asthma and ensure proper control of symptoms for optimal respiratory health.
  • Airway remodeling, which refers to changes to the structure of the airways, occurs in asthma and is linked to reduced lung function and a greater use of asthma medications. Collagen, in particular, is an important component of the airway structure that accumulates more in asthmatic airways compared to the airways of healthy individuals.
  • It sounds as though Kiril's immune system is not working at 100%. Both his asthma and respiratory tract infection could be manifestations of an immune system that has not been maintained, so I would be interested to know what his current diet is like. It could be that his balance of intestinal flora (pre- and probiotics) is not being supported; having this balance is an important consideration for infection recovery, since these bacteria play an important role in defending the body from germs that aren't initially filtered out. In addition to seeing his primary health care provider, Kiril would benefit from seeing a Registered Dietitian to identify aspects of his diet that could be making it difficult for him to recover from his infection/manage his asthma.
  • I wonder if Kiril's work environment is affecting his asthma symptoms. As a millwright, he must be exposed to lots of airborne sawdust particles that could irritate his lungs.
    • That's a very good point Michelle Kaarto. I would imagine that there would be more than just sawdust in the air of his work place. Chemicals used to seal wood can also aggravate the respiratory tract
  • I am an allergy sufferer as well and am prone to coughs that don't resolve. I was told this is called a post viral cough and have been put on inhaled steroids (a puffer) for this. This has always been an effective treatment but it does take time to resolve completely.
    • Both of my daughter's suffer from viral induced asthma as well. In the case of my youngest hers is worsened by the fact that she also suffers from bad seasonal allergies
    • My youngest suffered from constant viral-induced asthma during the winter months for the first few years of her life. If was diagnosed as such and we were given 2 different inhalers to help manage her symptoms (ventolin and flovent). She was also followed by a paediatric asthma clinic to monitor her symptoms. After a few years, she has all but grown out of her need for puffers. I find she still gets a lingering cough after a cold, but it certainly isn't as bad as it was during that spell.
  • My daughter has had a number of respiratory infections like this. I was told that because she suffers from hayfever she is more prone to them.
    • It was explained to me that having seasonal allergies leaves your lungs weaker and easily irritated. That is why people with hayfever are more prone to chronic coughs.
    • I'd like to hear more about the connection between allergies like hay fever, and chronic coughs. Is it a result of excess mucus or congestion in the sinuses from allergies that cause the coughs, like a post-nasal drip?
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