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I had COVID in 2020. After that, I started having breathing problems. I go to a government hospital regularly.
My IgE is very high – around 7000 IU/mL. Before COVID, I never had any breathing issues.
My PFT results have been decreasing over time, from 110% to now 85%.
Recently, I tested myself privately for ABPA (Allergic Bronchopulmonary Aspergillosis), and the result was 4.68 kU/L (positive according to the lab), but the pulmonologist did not recommend antifungal treatment.
He only gave LABA + Budesonide inhalers.
Now, I am planning to consult an MD Internal Medicine doctor or a DM Infectious Disease super specialist.
Which one should I meet – MD Internal Medicine or DM Super Specialist in Infection?
Do they understand PFT reports well?
In your opinion, should I start antifungal treatment for ABPA?
I am looking for multiple expert opinions. Please guide me.
Answers (25)
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Hi,
A few things which you need to understand
You don't diagnose ABPA with a single report. It's based on a clinical criteria. So if the pulmonologist did not start it, it's because you didn't fit into the criteria. Don't overthink it.
PFT has multiple components and nobody can understand what has decreased from 110 to 85 percent if you don't provide the entire report
Looking for multiple expert opinions leads to anxiety and unnecessary confusion. Kindly visit a physician and get a clear workup done. Ask all your queries there. Don't pop in an antifungal drug because of what the lab report says. If medicine was that simple, any fool can be good at it right?
Take care
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I can help you, and understand PFT very well
You could be having small airways obstruction, which is now increasing .Please share details of your problem- since when do you have breathlessness, is it increasing progressively, do you feel tired soon ?
Share your results of complete blood picture, X ray chest, C.T. scan of chest if done, P.F.T.
Next Steps
After knowing above details, I can guide you. you can connect with me .
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Long Covid symptoms involving the lungs with diminished lung capacity, should definitely consult a pulmonologist for appropriate management.
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Connect
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You have long COVID Syndrome.
Please make an appointment in my clinic for further assessment and management
Next Steps
Please make an appointment in my Doctors hub clinic in Gurugram or Dwarka or a video consultation in Your Pain Clinic Mayapuri. Best wishes
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DM pulmonary medicine
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Hello,
Take balanced diet.
For prescription please pay and consult or contact me at WhatsApp at +9195950eight7399.
Thanks.
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Need few more details
Kindly connect.
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Good afternoon..
You can consult MD medicine doctor in respiratory medicine chest TB specialist.../pulmonologist
Or Even a experienced senior MD medicine doctor
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Send me your reports
860558563 five
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Yes both can guide u. U prefer MD physician.
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Dr. Manoj Kumar
General Physician
9 yrs exp
Dehradun
Need few more details
Kindly consult
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Dr. Marini Vanitha
General Physician
12 yrs exp
Kakinada
Pulmonologist.
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Dr. Kaviya Karthikeyan
General Physician
5 yrs exp
Dindigul
Greetings of the day..
I am a MD in microbiology..
I can help you better in this aspect..
I have experience in diagnosing/ treating the condition you speak about..
Connect with me on practo..
I need detailed history
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Dr. Amit Joshi
General Physician
12 yrs exp
Jodhpur
Regards, you can visit and chest physician and then further for infectious disease doctor you can take both of the doctors opinion. Recommendation regards.
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Dr. Himani Gupta
Ear-Nose-Throat (ENT) Specialist
8 yrs exp
Guwahati
Show to Pulmonologist without any doubt!!!
Also get done S. Galactomannan
And HRCT chest if not done yet!!
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Dr. Jyoti Singh
General Physician
7 yrs exp
Meerut
MD medicine and MD respiratory medicine both are fine
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Dr. Daisy Rure
Psychiatrist
7 yrs exp
Khandwa
Respiratory medicine with good experience
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Dr. Sachin Bhiwaji Sanap
General Practitioner
7 yrs exp
Hingoli
need more information
kindly consult
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Dr. Bilal Ahmad Bhat
General Physician
13 yrs exp
Srinagar
Visit someone with DM in Pulmonary Medicine
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Dr. Sunil Nagar
General Physician
17 yrs exp
Rewa
Adv. Pulmonary medicine opinion
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Yes start antifungal.
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Dr. Faizan Khan
General Physician
3 yrs exp
Bhopal
Refer to a Good Pulmonologist - I’m myself An Internal Medicine physician and can treat you but if you want a second opinion respiratory physicians deal with ABPA Often
ABPA is a hypersensitivity reaction to Aspergillus fumigatus in the lungs, mostly affecting patients with asthma or cystic fibrosis and here in your case COVID infection might be the cause of your condition (did u take steroids at that time).
It causes recurrent wheezing, pulmonary infiltrates, and bronchiectasis so you should get examined and auscultation is must with Chest X ray and a HRCT of thorax because your PFTs are in worsening trend and also get your sputum examined and culture sensitivity from a Good lab
There are some Criteria to diagnose your condition if ABPA
Check if these match
First - Essential Criteria:
1. Asthma or cystic fibrosis or Covid like ailment
2. Positive skin prick test for Aspergillus fumigatus or elevated specific IgE against it
3. Elevated total serum IgE > 1000 IU/mL
Second is the - Supporting Features (Need at least 2–3)
Serum IgG against A. fumigatus - Elevated
Eosinophilia - check in CBC For AEC (absolute eosinophil count >500 cells/µL)
Radiology (CXR/HRCT)- showing Transient infiltrates, central bronchiectasis
Precipitating antibodies- Positive for Aspergillus precipitins
Mucus plugs - Seen in sputum or bronchoscopy
Treatment - First line management is Corticosteroids in tapering doses
Consult me personally for the dose and the regimen for treatment because I’ll be taking follow up for the treatment if we start
Also we’ll add Tab Itraconazol for adequate duration if the tests come positive and HRCT is suggestive
Mucolytics can also be used but should consult a specialist as your lungs are deteriorating with time since were not treating you properly
Whatever you want to do just do it fast
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Dr. Gaurav Jaiswal
General Physician
6 yrs exp
Jhansi
Respiratory medicine
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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