Pampered diagnosis !

Pampered diagnosis ! 
A young lady with dreams of bright future as a model had cough since six months. she had dry cough most of the time. Her throat would itch so severe that she would feel like scratching the inside of throat. The unpleasant sensation was a constant  trouble for her. As the time passed she got habituated with her cough. 

She was a conscious educated  person regarding her health. So, she took medical advice from a reputed doctor for her problem. She was assured of the benign nature of her cough. She also had some noisy breathing along with cough. Cough and noisy breathing came together like twin brothers. Any doctor with an average IQ would suspect  her  having bronchial asthma. 

She was given asthalin  puffs through inhalers. In addition to the asthalin, she was prescribed steroid based puffs. However her symptoms never subsided completely. She never had these symptoms in the past. Her abdomen was fine and had no urinary complaints as well. She had frequent visits with different doctors as her symptoms never went away. She had diagnosis of having asthma on each visit.The medications also didn't get luxury of change. It is usually seen that  the diagnosis made at first time follows as legacy in each visit because of ease of copying the same diagnosis. 

After these six months of her irritating cough, she had fever for 7 days. In the current scenario, he was admitted for the test of covid 19. When she was negative for covid 19 , she was transferred to general bed. On reviewing her history,  she had noticed gradual decrease in weight since four months. She was never asked the leading question about her weight. Noone recorded her weight in outpatient visits. She was more than happy with her weight loss. It had been difficult for her to be slim and glamorous. However, she never put any physical effort to decrease her weight. 

Her chest x-ray was normal. Her fever subsided in a few days. Her cough was still persistent and had some sputum production as well. It wasn't surprising that her sputum examination  revealed rod shaped pink bacilli consistent with mycobacterium tuberculosis. What was the  key symptom that received least care from herself and the doctors  ? What possibly  made Tuberculosis come to play ? 


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