Conversation: The conversation between human and AI assistant.
[|Human|] yes, my son , who is severe to profound disabled and has an intractable seizure disorder has experienced a productive cough unlike what he has ever had. Considering everything he has always been very healthy. I May 2014 he had this cough and he went through bouts of being very active and then not-so-much. I took him to his doctor and was concerned about pneumonia, as he had that Dec 2nd 2012. The chest x-ray, an upright, was normal, but then June 7th 2014, he was very lethargic and it scared me and I took him to the ER and they did a semi upright chest x-ray and did blood work. I was basically left with the question, what do you want us to do, My response was, I wanted antibiotics, which they gave me. He took them for the 10 days and we went back to his doc and had another set of upright chest x-rays and confirmed a left upper lobe infiltrate and when compared to the one done in the ER and the previous one it confirmed that he had an infiltrate left upper lung. I saw it and being a retired ultrasound/x-ray tech I know how to read x-rays, etc. Another round of a more potent antibiotic and another set of x-rays 2 weeks later and still not cleared. Another 2 weeks without antibiotics and he is still not cleared. They are now looking at a pulmonologist for further study. My son also has a vagal nerve stimulator in his left upper section of his chest and it has been there since he was 8 or 9 and he is 21 1/2 years old. He is to have surgery to replace the battery and this can not be done until his lung is cleared. The device helps with his seizures. He is otherwise doing fine, healthy and active with no fever. He has has a lot of coughing in the beginning and now it is just slight and not every day. I do hear the sound of phlegm. He is disabled and can not talk. Thank-you for your advice This has been going on since May 2014
[|AI|]  Thanks for your question on Chat Doctor. I can understand your situation and problem. Thanks for the detailed history. In my opinion you should consult pulmonologist and get done1. CT thorax2. Bronchoscopy and BAD (Bronchoalveolar lavage) analysis to rule out tuberculosis, fungal infection and other chronic infection. CT thorax is better than chest x-ray in diagnosis of pneumonia. BAL is superior to sputum report in isolating causative organism. And upper zone chronic infection is commonly seen in tuberculosis. So better to consult pulmonologist and discuss all these. First diagnose properly and then start treatment accordingly.