Severe asthma. Our patient's story
NewsA 36-year-old patient applied to the Pulmonology department of MCSC. He complained of constant shortness of breath – it was hard to climb even to the second floor, every day there are attacks of suffocation — 6-8 times. At night, breathing problems occur 2-3 times a week. He also has a paroxysmal cough, with a little thick sputum coming off, and sometimes there is heartburn.
At the age of 6, he was diagnosed with bronchial asthma. The condition was worsened by the fact that the body reacted to many allergens.
- This includes household dust, hair of various animals, pollen, as well as a number of products (eggs, milk, various types of meat, fish, cereals, citrus fruits, etc.). In addition, he often suffered from allergic rhinosinusitis.
Before the age of 18, the patient was hospitalized several times due to exacerbations of the disease.
From that time on, he began taking medication to control asthma, but not regularly, but only when there were symptoms. At the end of 2022, he was given a chest X—ray - he did not show any pathologies.
However, at the beginning of 2023, the condition became worse. Drugs were needed again, and some had to be taken every day, but something almost didn't help - choking attacks happened 2-3 times a day, at night problems arose twice a week.
- Examination of lung function showed serious violations: it was difficult for air to pass through the respiratory tract.
Therefore, in March 2023, the man decided to apply to the pulmonology department of the MCSC named after A. S. Loginov.
- He was prescribed stronger anti-inflammatory therapy, as well as a special drug for the treatment of asthma.
- At the same time, the esophagus and stomach were examined: inflammation of the esophagus (esophagitis) and increased pressure in the lower esophageal sphincter were found. Diagnosis: gastroesophageal reflux disease " (GERD) — the contents of the stomach are thrown into the esophagus and irritate it.
After discharge, the patient began to use another inhaler (a combination of drugs). But after 3 weeks, he began to need more inhalations again. He attributed this to the flowering of plants and the weather (especially with high humidity).
In July 2023, he was again admitted to pulmonology due to the fact that shortness of breath and cough increased, and the need for inhalers for emergency care increased.
To better understand the situation, the patient underwent computed tomography of the chest and bronchoscopy. A substance (galactomannan) was found in the bronchial flushing, which indicates the presence of mold fungi — this is how invasive pulmonary aspergillosis (fungal lung disease) was detected.
Also, our doctors re-examined the esophagus: they checked how well the medicine that reduces acidity works. It turned out that therapy helps.
The patient was prescribed an antifungal drug — he took it for 3 months. At the same time, asthma treatment was continued: a three-component inhaler (once a day) and a special remedy for the night were used.
Doctors found out that several factors influenced the severe course of asthma at once: GERD with esophagitis, fungal infection in the lungs, as well as damage to the small respiratory tract.
- When the therapy was adjusted and all these problems were treated at the same time, the patient's condition improved markedly: seizures became less frequent, he tolerated physical exertion more easily, and the quality of life became much better.
The history of our patient shows how important it is to approach treatment comprehensively: carefully examine the patient, identify all the factors that worsen the disease, and select therapy taking into account all the problems found.
