Med-Hive Series || Not Every Cough is a Bluff

I was trying to figure something out, how will my umbrella spoil just at the time when the rain decided to show its self. My mistake though, I had thought a could control the winds, I opened on a moving motorcycle. A moment a silence passed in my mind as I accepted the folly, and then there was that thought, a familiar one, Now was not the time for the thought but it came through with lightning speed, I couldn't stop it.. I almost even open my mouth to say it out loud "I wish I had a car".. Oh shut up you You don't need one yet, you don't.

I had managed to get to the hospital somehow not so wet but I made my way straight to the call room to change to my scrubs. Thank God we have this pics of spare clothing. I would probably have seen patients we're and not only that.. caught a cold too. It didnt happen.

It was an afternoon shift and I had hoped it would be calm, everyone was calm too and no sudden emergencies, please God, God must have been like.. "Why is it called emergency again..."
A few minutes passed and I heard a knock on the door, ..come in'.. And have your seat." I said, to my first patient.


An elderly woman walked in, I somehow liked her because the wore her facemask properly. With the decline in mention of COVID 19 in the news a few people dont want to wear the mask again. Especially where I stay. I wonder if they even believed the whole thing. But my patient definitely does. She wasn't a careless person and most likely very literate. We went on to discuss about her complaint

She had been coughing on and off for the past 3 months and have been using cough syrup, for the symptom.
She had associated weight loss, and a history of sweating excessively at night without much heat, she had at a point produced sputum with the cough, but recently has a fever.

I went on to investigate with some series of test, to first rule out the first culprit in my head, Tuberculosis.
She eventually had TB and was commenced on necessary treatment course.

Tuberculosis is a disease of mostly associated with poverty, co infection with HIV in the under developed and developing countries of the world. It has led to million of deaths, all over, but the burden is still a bit more in these countries with less acceptance of the BCG vaccination, and illiteracy.
It is usually transmitted via airborne droplets and causes a causes a chronic inflammation of the lung tissues, it can also spread to other body parts through blood circulation affecting the brain, stomach and intestines, liver and even the bones especially the vertebra cause "pots disease".

But the problem here wasn't treatment either, treatment is available, easy to administer a free to the best of my knowledge. The issue is the subtle nature of the cough, and the poor health seeking behavior of the populace. Most of those who even attempt to seek help go to the wrong set of people an get wrongly treated.


Most cough syrup contains expectorants and sadly cough suppressants which suppresses cough as the name already implies.
Now, cough is not the enemy here, the cough is only a physiological reflex to help push foreign particles or secreted mucus out of the airway when irritated. So suppressing that could be detrimental if the accumulation continues, airway block and infections ensues and there we have more on our hands to deal it. It is best to know what is causing the cough as taking a syrup containing dextromethorphan (the suppressant agent, will block this physiological cough reflex).

That Cough may not be ordinary, please check it, not everyone is vaccinated, but despite that, not everyone is immunized.

If you could probe a little further you ll find that

  1. Chronic cough of greater than 2 weeks
  2. Weight loss
  3. Drenching Night sweat
  4. Abdominal fullness or early satiety
  5. Fever and other salient constitutional symptom.

On complicated cases, cough can be either dry, productive of sputum or even blood stained sputum. With spread to other body parts as earlier mentioned and those symptoms may vary based on the spread.

A chest X-ray will help a lot in its diagnosis however and Gene Xpert laboratory test will give a more specific information of the presence or absence of the disease.

Other cause of productive cough must also be ruled out, allergy, upper respiratory tract infection, asthma, bronchopneumonia, bronchiectasis and
Liver abscess.😊.

So when next you have a cough,you know better than not not see your doctor.


This is Med-Hive, A new series of medical case stories and short explanations on the case, symptoms and slight clinical insight.
This does not aim at giving any medical advice as your doctor would do that after proper review involving history taking, physical examination and necessary investigations. However, a healthy society can only thrive with healthy information's like this.
I will also love to entertain your questions in the comment section.
Thanks for Reading.

Previous Releases are Here

Med_Hive Series || Doctor Talk: Menstrual Pain and Peptic Ulcers

Image Credits
Image 1:Towfiqu barbhuiya
Image 2:Towfiqu barbhuiya
Image source 3: National Cancer institute


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