Question for "Infectious Disease Specialist" or "Respiratory Specialist"

Symptoms:
----------

- Hidden Infection detected via High CRP blood result - Root cause not known despite extensive investigations
- Ongoing Cough - 6-7 months
- Moderate amounts of Yellow Sputum
- Low grade Fever
- Chills
- Muscle aches
- Chest Discomfort.


History:
--------

My name is Gurmohan Singh and I'm a 37 year old male living in Melbourne Australia. I'm a Non Smoker and a very socal drinker (once or twice in a month). I've been a fit person until I returned from India last year in Feb 2014.

I initially developed a cough bac in April/May 2014. It was qute a severe cough at the time with production of yellow sputum. I improved briefly with antibiotic therapy.

On 2nd June, Serology had suggested PERTUSSIS (Whooping Cough) Infection. Treatment included Antibiotics - Clarithromycin

On 31st July, I ended up in Hospital for 6 days. Sputum culture had grown PSEUDOMONAS Pheumonia. I was treated with intravenous antibiotics for 6 days whilst in hospital and subsequently discharged completing 14 days of treatiment with

Ciproxin 750 mg along with Clarithromycin. My symtoms then improved with resolution of Cough for a week or so.

Unfortunately my cough reoccured and has persisted since then. I had futher addmission into hospital and was treated with intravenous antibiotics with a 14 day course.

My ongoing cough has an productive of moderate amounts of yellow sputum. There has been no Haemoptysis. The cough is worse first thing in the morning and evening. I wake up with cough most nights. At the time (August/September 2014) I

felt severe discomfort in Chest associated with Coughing. Some of the treatments at the time included Symbicort 2 puffs daily despite No Asthama as the Lung Function test was normal. I was also given Nasal steroid spray.

In November 2014, I was then investigated by another Respiratory Specialist who mentioned that his examination showed that I was not clubbed or cyanosed and had no cervical lymphadenopathy.

I've had extensive investigations by various local Docotors and Specialists however to date the root cause of my problem (Hidden Infection) is not known.

Tests included - Sputum Tests, Chest X Ray, CT Scans of Chest, CT Scan of Sinuses, CT Scan & MRI of Brain, Thyroid Function, Lung Function, Blood Culture, Malaria, Quantiferon TB Gold, Bronchoscopy, Abdominal Ultrasound, Barrium Swallow,

Holter Monitor, Heart Stress Echo and TTE, 24 Hours BP Monitor, HIV Serology, Auto Immune etc... and all of these test came back as NEGATIVE

Detailed history of Tests which have been performed so far:


- Bordetella Pertussis Serology (Serum) Detected
- Bordetella Pertussis IS481 Gene Assay Not Detected
- X-Ray Chest Clear Lungs, no pleural effusion. Normal Heart size
- Quantiferon - TB Gold Latent M TB Infection UNLIKELY
- Respiratiory Microbiology - SPUTUM A few ploymorphs. No bacteria seen
- Respiratiory Microbiology - SPUTUM Heavy growth of Pseudomonas Fluorescens.
- Erythrocyte Seimentation Rate (Blood) Normal
- Bordetella Pertussis Serology (Serum) Detected
- Bordetella Pertussis IgG (EIA) Positive
- Iron Studies Normal
- Thyroid Function Test Normal
- Serum/Plasma Biochemistry Normal
- Glucose Serum Specimen Normal
- Mycoplasma Pneumoniae Antibiodies (Serum) Normal
- Chlamydia Group AG - Referred Work Normal
- Serum Immunoglobulin E Normal
- Respiratory Function Analysis (Lung Function Test) Normal
- Serum 25 - Hydroxy Vitamin D Severe Vitamin D deficiency
- Vitamin B12 and Folate Normal
- Serum Viramin C Normal
- Cumulative Serum Vitamin A Normal
- CT Scan of Chest (Done twice) Normal
- CT Brain Normal
- CT Sinuses Normal
- Ambulatory Blood Pressure Report "Borderline Diastolic hypertension during walking hours (128/84)
Normotensive during sleep (112/69)"
- Serum Glucose Normal
- HIV Antibody/Antigen Combo (Serum) Negative
- Blood Haemoglobin A l c Diabetic control appears normal.
- Serum C-Reactive Protein (CRP) 11 mg/L
- Thyroid Function Test (Serum) Normal Thyroid Function
- Autoantibiodies - Extractable Nuclear Antigens (Serum)Negative
- Anti-dsDNA Serology (Serum) Normal
- Antinuclear Antibodies (Serum) Negative
- MRI Brain Normal
- Microbiological Examination of Sputum (Mucopurulent) Normal
- Blood Culture Normal - No growth at 24 Hours
- Cytology of Sputum - Specimen#1 Negative for Malignancy
- Cytology of Sputum - Specimen#2 Negative for Malignancy
- Urine Microscopy Culture - No Growth
- NOW ICT Malaria Test (Blood) Negative
- Microbiological Examination of Sputum (Purulent) Normal
- Fibreoptic Bronchoscopy Report Normal
- Upper Abdominal Ultrasound Normal
- Serum C-Reactive Protein (CRP) 104 mg/L
- Microbiological Examination of Sputum (Purulent) Normal
- Urine Microscopy Normal
- Examination for Mycobacteria Specimen # 1 No acid fast bacilli seen
- Quantiferon - TB Gold Latent M TB Infection UNLIKELY
- Serum C-Reactive Protein (CRP) 93 mg/L
- Serum C-Reactive Protein (CRP) 132 mg/L
- Thyroid Function Test Normal
- Serum/Plasma Biochemistry Normal
- NOW ICT Malaria Test (Blood) Negative
- Barrium Swallow test Normal
- HIV Serology Negative
- Auto Immune Serology Negative
- Holter ECG Report Summary Normal
- Holter Monitor Report Normal
- Heart ECO Stress "Negative test for Myocardial Ischaemia. No Regional Wall Motion Abnormality on Stress Echo
Ecg - Sinus rhythm
Echo - Normal size left ventride with normal systolic function"



At the time of writing this today, i.e. 13/01/2015, I still have same symtomps which are Cough, Moderate Yellow Sputum (a couple of times with streak of blood), Chest discomfort, Low grade fever, Random Chills, Difficulty breathing.

Whilst I hope that I've been trough a lot of tests and that my Doctors have given up hopes on me, I strongly believe that there is someone out there who will be able to diaganose my Hidden Infection and perhaps save my life.

I look foward to any suggestions, tests which may have been left out, or any opinions.

Thank you.

Kind Regards,
Gurmohan