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Cough with GREEN MUCUS, runny nose and fever.

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Hello. My boyfriend lives in Brooklyn, NY, and doesn't have health insurance (or much $). Unfortunately, unlike me, he hasn't had many positive experiences with doctors, so I'm resorting to this in lieu of convincing him to make an actual visit to a specialist.

He experiences frequent colds - at least 4 a year - that always result in a lingering chest infection. Each time, he has a cough (which is mostly clear or rarely, light green mucus - never too dark) for 2 weeks or even more, with accompanying fatigue and occasional fever. The coughing keeps him up at night and most often results in headaches and fatigue. Sometimes, cough syrup with dexomethorphan helps (he takes it very rarely). Runny nose with mostly clear mucus (for one or two weeks on end).

Right now, it's week 2 of this "cold." He's had fever several times, and has been coughing every night and having a runny nose (but again, mostly clear mucus in both).

Possible factors/reasons: the apartment he lives in is old and a bit musty. There could be some air pollutant that aggravates his symptoms? (However, I spend a lot of time here and so have others and no one has had similar symptoms). Another: he says he has a deviated septum, but it's self-diagnosed.

- What could this be?
- Is it essential to see a doctor? If so, how can we find a decent one who charges on a sliding scale? (This is essential) Any recommendations in Brooklyn or anywhere else in NYC would be so appreciated.

Thank you so much in advance.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 27 Doctors Online

Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.

From your history it seems like your boyfriend suffers from recurrent allergic attacks. What starts off as an allergy progresses to an chest infection due to the development of mucus in the respiratory tract, which invariably makes it easier for infections to develop.

His apartment being old and musty could be the source of an allergen. Especially musty areas are prone for allergies and fungal infections. The fact that other people don't develop the same symptoms shows that they are not allergy prone.
There is one more important part in your history. The fact that he has green mucus sometimes apart from the allergies,can also indicate sinusitis. Recurrent sinus infections make a person prone for recurrent cold and that can further lead to chest infection. In that case,DNS is a common cause for sinusitis and your boyfriend's analysis may be right. I will suggest you get an ENT consult, because if it is due to sinuses then the primary cause has to be treated.
I will advise you the following medicines :

1) Tab. Montelukast+Levocetrizine ( combination ) one tablet once at bed time for 5 days.
2) Tab. Augmentin 650 mg twice daily for 5 days. ( very good for chest infections )
3) You can give Dextromethorpan whenever he has excess cough and it should be helpful.
4) Steam inhalation ( drain the sinuses )
5) Tab. Neurobion Forte one tablet once at bed time for 10 days.

Only Augmentin being an antibiotic will need a prescription. Others are OTC drugs.
I am sorry I won't be able to recommend someone in Brooklyn as I am not from there. I sincerely apologize for that. However a good ENT specialist will be helpful for the sinus problem and he can rule out DNS too.

Hope this was helpful,
Regards.


Patient replied :

Thank you so much!
Unfortunately, montelukast and levocetrizine are dispensed by prescription only in the US (what a pity). Is there any comparable medication?
And neurobion forte is a vitamin B complex supplement, correct -- would any vit B comlex do then?


Hello,
Thanks for you reply.
Montelukast+ Levocetrizine combination will work best for him,
If it is not possible for you to get the prescription drug, then a nasal decongestant like Xylometazoline can be useful. But i guess you have to get a prescription for augmentin anyway, so you can get M+L at that time too. Montelukast works really well in chest infections, especially by reducing the mucus and relieving the bronchospasm.
And yes definitely any b complex would do. I recommend b complex along with antibiotics, because being an anti-bacterial drug it can also kill the useful bacteria in the gut, that is responsible for vitamin absorption in humans.
Regards.


Patient replied :

Hello,
Thanks for your reply.
Montelukast+ Levocetrizine combination will work best for him,
If it is not possible for you to get the prescription drug, then a nasal decongestant like Xylometazoline can be useful. But i guess you have to get a prescription for augmentin anyway, so you can get M+L at that time too. Montelukast works really well in chest infections, especially by reducing the mucus and relieving the bronchospasm.
And yes definitely any b complex would do. I recommend b complex along with antibiotics, because being an anti-bacterial drug it can also kill the useful bacteria in the gut, that is responsible for vitamin absorption in humans.
Regards.



Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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