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Asthma

Post-pneumonia Asthma and Pleural Pain

07/06/2007

Question:

I am a 51-year old male. In February, I had pneumonia with pleurisy. This left me with what my internist called a post-infection asthmatic response. I did not previously have asthma although I have always had allergies. It is now early July and I still have some intermittent pleural pain that I notice after moving in certain ways. A CAT scan was clear. I am using Advair 250/50 (reduced from 500/50 after 2 months), Singulair (10 mg), Nasalcrom, Flonase, and Allegra.

Is the pleural pain a cause or effect of the asthma? How long does it usually take to get rid of the pleural pain and post-infection asthma? Would any physical therapy help? What about nebulized glutathione or n-acetyl cysteine? Is use of baby aspirin contraindicated with asthma?

Answer:

Asthma exacerbations are often caused by infections particularly viral infections. However whether infections actually cause a person to develop asthma is still controversial. Pleuritic pain can be caused by many different issues but is not typically associated with asthma or asthma exacerbations. Nebulized glutathione and n-acetyl cysteine are not indicated treatments for asthma. Some people with asthma have exacerbations when taking aspirin or non steroidal pain relievers. If you have never had any asthma symptoms after taking these medications then taking a baby aspirin would also not cause an issue. If you are uncertain then seeing an allergist for evaluation for aspirin allergy might be useful.

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Response by:

John G Mastronarde, MD John G Mastronarde, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University