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Chronic cough fiver body pains
Dear Doctor
I have been experiencing a persistent dry cough and breathing difficulty for the past 8–10 years. I also have headaches, body pain, and unexplained fever.
I have undergone the following tests:
Chest X-ray: Normal.
HRCT Chest: Normal.
PFT: Slightly low.
ESR: 40.
CRP: Positive.
ANA, RA Factor, and Anti-CCP: Normal.
Other blood tests: Normal.
Despite these investigations, the cause of my symptoms remains unclear, and my problems continue.
I would like to investigate whether there is any hidden inflammation, infection, or other disease in my body.
Kindly review my reports and advise whether a Whole Body FDG PET-CT scan is use d.
Thank you ,
Answers (29)
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Would recommend to do sputum AFB and CBNAAT. PET CT isn't advised
Next Steps
Would like to evaluate with detailed history. I'd be happy to assist you on further treatment plan. For personalised medical guidance and a detailed assessment of your concerns, kindly book an online consultation with me through the Practo app!
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CRP RAISED ITS HIDDEN INFLAMMATION.
STEAM INHALATION WITH VICKS OR EUCALYPTUS OIL TWO TIMES BEFORE MEALS.
MONTEK LC ONE AT NIGHT AFTER DINNER FOR 5 DAYS.
AZEE500 ONE PER DAY AFTER FOOD FOR FIVE TO SEVEN DAYS.
ZERODOL SP THREE TIMES A DAY AFTER FOOD FOR 3TO5 DAYS.
CHERICOF SYR 5ML TWICE N 10ML AT NIGHT. DUOLINE N BUDECORT RESPULE TWO TIMES FOR 3TO5 DAYS.
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Hello, persistent cough and breathing difficulty for 8–10 years, along with unexplained fever, body pain, ESR of 40 and positive CRP, need further evaluation by a pulmonologist or internal medicine specialist.
A normal chest X-ray and HRCT are reassuring, but they do not rule out every cause. Depending on your history and examination, your doctor may consider asthma or airway disease, tuberculosis or other infections, and other causes of chronic inflammation. Your slightly low PFT results should also be reviewed.
A whole-body FDG PET-CT is not usually the first test for these symptoms. It may be considered if a detailed evaluation does not identify the cause and there is a specific concern about hidden infection, inflammation or cancer. Your specialist should decide whether its potential benefits justify the cost, radiation exposure and possibility of false-positive findings.
Please bring all previous reports and discuss whether repeat spirometry with bronchodilator testing, sputum tests, or targeted blood investigations are appropriate.
Important safety advice: If you currently have significant breathing difficulty, chest pain, coughing up blood, or high persistent fever, seek urgent medical care rather than waiting for further investigations. Avoid starting antibiotics or steroids without medical supervision.
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Hello,
I understand your concern. Persistent dry cough and breathing difficulty for 8â10 years, along with fever, headaches, and body pain, require further evaluation.
Normal chest X-ray and HRCT findings are reassuring but do not exclude conditions such as asthma, cough-variant asthma, upper airway cough syndrome, or gastroesophageal reflux (GERD).
An ESR of 40 and positive CRP suggest inflammation but are nonspecific and cannot independently confirm infection or autoimmune disease.
A whole-body FDG PET-CT is not recommended as a routine first-line investigation in this situation. It may be considered only if further clinical assessment raises suspicion of a specific condition requiring advanced imaging.
Next Steps
Consult a pulmonologist and internal medicine specialist for a detailed clinical assessment. Review your pulmonary function test results, including bronchodilator reversibility. FeNO testing or bronchial challenge testing may help evaluate asthma. Consider repeat CBC, quantitative CRP, ESR, and targeted infection screening, including tuberculosis testing if clinically indicated. Evaluate other possible causes, including allergies, GERD, environmental exposures, and sleep-related breathing disorders. If fever remains unexplained, further investigations should be guided by examination findings rather than proceeding directly to PET-CT.
Health Tips
Avoid smoking, dust, pollution, and other respiratory irritants. Maintain adequate hydration and keep a record of fever episodes and associated symptoms. Seek medical attention if you develop worsening breathlessness, chest pain, coughing up blood, low oxygen levels, or persistent high fever. A systematic investigation is more likely to identify the underlying cause than an immediate whole-body scan. Wishing you good health and a speedy recovery.
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A normal chest X-ray, HRCT and autoimmune panel, but a raised ESR and positive CRP, means there's some ongoing inflammation that hasn't been pinned down yet, even though the common causes have been ruled out. A PET-CT is a significant scan usually reserved for specific situations, so it isn't something to decide without a specialist reviewing your full case first.
Next Steps
Please see a rheumatologist or physician, who can review your reports together and decide whether a PET-CT or a different, more targeted test fits your case better. Carry all your reports to that visit.
Health Tips
Symptoms lasting 8 to 10 years need proper follow-through, so please don't let this go untreated further.
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