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Chest or trachea infection?

This maybe a very daft question but I have been struggling with what I think has been a chest infection for the last 11 weeks. Diagnosed with asthma 30 years ago. I have had lots of medication and produced lots of mucus but still have it! The front of my chest is sore and the base of my throat but my ribs are ok. Never really had a fever only at the very begining. The cough gets worse during the day when I have been talking and I am hoarse by the end of the day. I am also breathless and very aware of my breathing. I am on Fostair 100/6 2 puffs twice a day taken with a spacer. I have had 2 lots of oral steriods. The antibiotics helped but I feel the majority of my symptoms occur before my lungs if that makes sense i.e. in my throat or trachea and I find it difficult to explain to the GP. My peak flow has never really dropped although the symptoms have all been very like asthma and this is what the docs think it is. Nothing is helping and docs always say I have a clear chest. Has anybody had similar sypmtoms as I am truely mystified and fed up of feeling rubbish. Thanks

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Yes I recognise your symptoms, I'm a lifelong asthmatic and looking back I've had chest infections that have lasted for months, at the time I didn't really understand that it was an infection just struggled on and put it down to asthma.

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Hi! I’m Lori, from the US. I have your symptoms, I have been told a few different things over the years, 1 that I have upper respiratory asthma, and someone actually called it throat asthma, but along those lines. Sometimes even with severe symptoms, years ago, they can’t hear the wheezing in my lungs (in the back) but I’ve asked many of my Drs to listen above my heart area, a little. They’ve heard it there several times. I’ve felt breathless to, but I have, a type of, heart palpitations. And sometimes it’s that. Or anxiety. It’s all difficult to know which is which sometimes. Nothing very definitive here. Just what I experience. Hope this helps, in some way.

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Your symptoms (and the two previous replies) sound similar to mine. I have what I call recurrent chest infections for maybe 7-8 years. Some doctors have been happy to give me antibiotics more or less on request, others don't think I should have them as a matter of course. When I've taken them they've not always resolved the problem.

As a general rule when I see the doctors my chest is clear and peak flow high so I also suspect my issues are in the upper part of the lungs/lower part of the throat.

The key symptom is a tight chest (which my ventolin inhaler can't help) combined with fatigue . While it lasts I feel like a convalescent.

I had an tiny point itch in my chest about two weeks ago and that developed into what I'd call an unproductive cough - ie which convulses you but never quite or never adequately reaches the itch. It's loosened up in the last two days.

Because I was getting conflicting advice from the doctors in my surgery I went privately to a consultant at the Royal Brompton Hosp in London who, over the last year has done various tests, incl CT scan and one to monitor nitrogen (?) levels . The latter evidenced that I was asthmatic, the scan showed everything normal. He has me on two puffs Fostair per day.

Since the onset of the cough I've doubled the Fostair and also noted my peak flows which are down approx 100 from my normal levels.

I told the consultant i was unwell at the beginning of this week, dropped in a sputum sample and am going to see him this afternoon. If i had to guess I'd say there won't be much to report from this...but if anything interesting comes up I'll post it!

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...so the sputum sample showed no infection and the nitrogen levels when tested again on friday were in normal range so interestingly no asthma. Doc advised I continue with the upped Fostair doseage for now , did a blood test for infection (results not in yet) and is setting up rhinoscopy shortly (? ie camera up my nose, ouch, to look for infection down throat...) Couple of other points, Doc helpfully confirmed he doesn't know what's wrong yet and that Fostair on my doseage is safe to keep using for 'decades'.

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That's an interesting set of results.So no asthma on this occasion or no asthma full stop? My guess is that I don't have an infection (at least not at the moment) and that the cough etc is coming from my throat.

What Fostair doseage are you on 100/6 or 200/6, I'm on 100/6 MART which means I can use it up to 6 times a day as a reliever. Hope you get some answers soon.

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I have asthma and often have normal exhaled nitric oxide (FENO) even when very symptomatic. I see a specialist team and they use that to decide whether pred will help ie is there specific inflammation. I got quite confused at first but they said still asthma if it is normal or at least bronchospasm but different cause ie not inflammation responsive to steroids.

Otherwise.I absolutely cannot tell the difference between attacks with and without raised FENO. I have had raised FENO and been able to go back to work and normal FENO and ended up in resus being treated for a severe attack. A and E very much do not care what FENO is and basically told me my cons could play with it in clinic and meanwhile they would treat me for.asthma.

Oh and I am on Fostair Nexthaler 200/6 and some other things.

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interesting re. FENO . What is pred?

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Sorry too used to being lazy! Pred is oral steroids, prednisolone/prednisone.

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Sounds a bit like reflux (Gastro-oesophageal reflux disease) to me.

asthma.org.uk/advice/manage...

I am a life long asthmatic and ended up with Barrett's Oesophagus due to prednisolone causing silent reflux.

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I have sometimes had symptoms that probably were linked to asthma but felt higher up. It has been pointed out to me by more than one professional that our breathing organs go from the bottom of the lungs to the tip of your nose. So inflammations can spread out of distinctly lung area, I suppose.

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Thank you all so much for replying. It is nice to know that other people have similar symptoms and I am not on my own. The GP has tried me on a months trial of lanomprazole which I am just coming to the end of and I am not sure if it has helped or not as I wasn't aware I was suffering from reflux, although I know it can be 'silent'. It doesn't seem to have made much of a difference to my asthma symptoms but i think I may have to give it a bit longer.

Asthma is such an induvidual condition and we all present with different variations of similar symptoms it's no wonder the doctors find it difficult to give advice and treatment. I think I will push for a CT scan and more specialised tests as I have had all the other usual tests ECG, echocardiogram,blood tests and 2 chest xrays which have all been normal. I really just need to know what is going on as I have never had such a long exacerbation/infection and like everyone on here just want to feel in control and able to get on with my life.

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