### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have been diagnosed with asthma, recently with bronchiectasis , and I also have chronic pneumonia . I still currently get sick very frequently and my doctor and I can not find the solution to my treatment. In the past year I have had two CT scans, a bronchoscopy (which showed I was growing strep-pneumonia) and last week an open lung biopsy (which I was told only showed inflammation on the pathology results, and currently still growing cultures). I usually take either bactrim or levaquinn with prednisone for a period of time to treat my pneumonia but as soon as I get back off of it I get e pneumonia right back. Can you please suggest any further treatments or any further disease possibilities or autoimmune diseases. My dr thought it may be autoimmune but nothing showed up on the biopsy.

### output:

Hi, You seem to have been diagnosed as a case of asthma with bronchiectasis with on and off pneumonia episodes. A diagnosis of APA (Allergic Bronchi Pulmonary Aspergilli) can be considered in such a scenario. Do get your total serum IGE levels, Serum Egg and IGE specific for aspergillus, sputum fungus examination. If it is detected then oral steroid therapy will have to be started to which your condition should respond. Regrading the autoimmune profile, if your physician is suspecting then collagen vascular diseases are a possibility for which you may undergo an extranuclear antigen profile. For episodes of pneumonia antibiotics will have to be taken as per culture sensitive reports of the organisms isolated from the sputum/ bronchoscopy samples. Also, you may consider yearly flu shots and 5 yearly pneumococcal vaccination for prevention of repeated infections. Regards 