I had a 38 yrs old pt who came with persistent cough for 1 week. Th e cough is so severe alternating dry with sputum. T he cough is so intense that from 8 the day of coughing he hoes into syncope for 2-3 seconds. On one occasion during the episode he fell down and broke his rt fibula. On the 10th day he developed widespread severe subconjunctival haemorrhage in both eyes.
He was admitted in the ICU and was managed conservatively for the # but for his cough managed with antibiotics Iv ceftriaxone/and clarithromycin/pantoprazole /hydrocortisone Iv bid. All work up was normal-mri/eeg/ecg/ctsinus, wbc-20,000, crp-8.7, e nt- follicular tonsillitis. Pt was already taking perinopril/thyroxine/escitolopram. After 3weeks pt has reduced frequency of cough but no syncope. Pls comment on the cough syncope management and prophylaxis.
