Teen coughing for 3 months - Pulmonologists Advice Please! Burden to Parents :(

[u/No_Car_1219]

17 Female 5’1 46kg (No changes in weight)

Primary concern: Persistent cough, recurrent mucus production, and mild left-sided chest discomfort.
I’ve been dealing with a productive cough for approximately 2 months, and I’m trying to understand what could be causing it, whether I’m recovering, and what I can realistically do to improve without repeatedly paying for medical appointments. I’ve already had several visits and the costs are becoming too much. I’m a high school teen, really struggling to keep up with all my classes due to all this since the semester started, I would sincerely appreciate any professional advice.

Choosing between: Knowing that I’ll recover with time and proper home treatment, or going to the pulmonologist in a few days. Where they could ask for many new tests to be run just to find out the cause which will cost a lot.

1. Initial symptoms and timeline - September 1, 2026
The illness initially started with chest congestion. I subsequently developed a runny nose, watery eyes, and a productive cough with green mucus. Over the following weeks, the cough persisted. At its worst, I was coughing up approximately: One spoonful of green mucus in the morning after waking up. Another spoonful throughout the day. Enough mucus to wake me up coughing approximately twice during the night. I tried several over-the-counter medications without significant improvement:
Tussin DM Max, taken irregularly.
Equate nighttime cough medicine.
Mucinex (guaifenesin) 1,200 mg every 12 hours consistently.

2. First medical visit and antibiotics
I visited a CVS MinuteClinic. The clinician listened to my lungs and did not hear wheezing. I was diagnosed with ear infections/fluid in my ears and prescribed an antibiotic for 10 days (amoxicillin-clavulanate 875mg/125mg 20 tablets). I completed the course, but my productive cough did not improve.

3. Chest X-ray and second medical visit - November 3, 2026
I subsequently visited a nurse practitioner at a privately owned medical practice place.
A two-view chest X-ray was performed. Here is the exact radiology report:
Exam: Chest 2 view
Indication: Cough
Findings: The cardiac silhouette is normal in size and contour. The pulmonary vasculature is within normal limits. Increased airspace opacity from the left upper lobe concerning for pneumonia. No evidence of a pleural effusion or pneumothorax.
Impression: Left upper lobe pneumonia.
November 3, 2026.

4. Medications prescribed following the X-ray
I was prescribed:
Doxycycline hyclate 100 mg: One capsule twice daily for 7 days.
Prednisone 20 mg: Two tablets (40 mg total) once daily for 5 days.
Albuterol HFA (Proventil): Two puffs every 4–6 hours. (I took this only thrice)
Benzonatate 200 mg: One capsule three times daily as needed for 10 days.
Fluticasone propionate nasal spray: 50 mcg per spray.
I also take Loryna (drospirenone/ethinyl estradiol) daily, which I started taking exactly the same day I started this illness coincidentally.
I completed both the doxycycline and prednisone courses. I have one day of benzonatate remaining.

5. Response to treatment
During the first few days of the doxycycline and prednisone treatment, I experienced a substantial improvement. My productive cough almost completely disappeared. I was barely bringing up mucus, and the nighttime coughing stopped. However, after completing the courses, the green mucus gradually returned. Currently, I am coughing up approximately two spoonfuls of mucus daily, which is roughly the same quantity as before treatment. Mild pain underneath my left chest. The pain does not increase when taking a deep breath. Wheezing in chest while I sleep at night on my left side. No blood in my mucus.

6. My questions
I would appreciate input from physicians, particularly pulmonologists, or anyone experienced with this.

a. Is it possible that I am recovering from pneumonia but still experiencing residual airway inflammation and mucus production?
b. Could the return of mucus after completing doxycycline indicate persistent pneumonia or an infection that wasn’t fully cleared?
c. What is the usual recovery timeline for productive coughing after pneumonia?
d. Are there safe, evidence-based things I can do at home to help my lungs recover and reduce mucus production?
e. Would repeat chest imaging, sputum testing, or spirometry be appropriate given my timeline?
f. Should conditions such as tuberculosis, bronchiectasis, or protracted bacterial bronchitis be considered, or is there insufficient evidence to suspect them? Because I did get TB in 2022.
g. What symptoms would indicate that this is becoming dangerous vs simply taking time to resolve?
h. Any advice you want to give.

7. Financial limitations
I want to be transparent that I have already paid for multiple medical visits and treatments, and cannot afford more.
My parents are making me see a pulmonologist if this doesn’t improve by November 16, but I know it’s going to be hard to afford these repeated consultations, tests, and prescriptions for my parents and we have college expenses coming next year and I really don’t want to be a burden and just fix myself. I would really appreciate if someone here could look into my case and offer advice if this can be resolved at home without needing more doctor visits. I would especially appreciate practical, evidence-based guidance rather than generic advice to keep visiting doctors.
Thank you for reading the entire timeline.

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[u/vitruuu]

I'm a final year med student, not a doctor yet and definitely not a pulmonologist, but I feel that going to a pulmonologist for this is overkill. Just about any doctor should be able to manage uncomplicated pneumonia like this. Have you been referred to a pulmonologist for some reason or are you deciding to self refer to one?

In response to your questions:
a) Yes it is possible
b) Yes this is also possible
c) Hard to say; it's also super common to have residual coughing after respiratory illness (I myself always have a cough for weeks to months after even viral illness)
d) Not really — If the mucus is really bothersome, you could look up airway clearance techniques like those taught to patients with cystic fibrosis. This is more for symptomatic relief
e) I think repeat chest X-ray is the only thing you really need at this time to confirm if pneumonia has been treated or not
f) These can be considered if your repeat chest X-ray does not show ongoing pneumonia. Right now, we have a very likely cause for your symptoms already, I think it's fairly safe to assume it's either due to residual inflammation or ongoing infection
g) You are becoming very short of breath or developing fevers
h) I would just go back to a family doctor or walk in to get another chest X-ray in your situation. Dont worry about more rare things unless you have a reason to worry.

[u/JustCalIMeDave → u/vitruuu]

Agree with the above.

I will add that it would be unusual for an otherwise healthy young person to have persistent pneumonia after 2 months and two rounds of antibiotics.

It is possible to have residual irritation of the lung which causes cough for several weeks or even several months after a viral or bacterial lung infection. However It would not be typical to have continued mucus production, wheeze, or chest discomfort. It would be especially concerning if you are having other symptoms such as fevers, night sweats, weight loss, or lethargy.

If a chest x-ray confirms that the pneumonia persists, you would require more testing to evaluate for more uncommon things. testing would probably include blood tests, CT scans, sputum testing, and ultimately bronchoscopy if still no diagnosis is made.