25F repeated severe respiratory infections starting suddenly 4-6 years ago and getting worse, abnormal pulmonary function test, no idea what’s causing it

25F, 135lbs, 5’5”, no smoking (ever), no drugs, very infrequent drinking (<1 drink/month), UTD on all vaccinations, only medication is 300mg Wellbutrin daily and occasionally 5mg melatonin gummies.

Medical history that I don’t think is super relevant (relevant stuff is later), but including anyways: PTSD, depression, anxiety, chronic vitamin D deficiency, slightly high cholesterol, partially torn rotator cuff, torn labrum in hip, mild nerve damage in one finger, poorly healed stress fracture in shin, concussion at 16, BBL in 2024, allergic to mosquito bites. I’m a vet tech and have 2 dogs and 2 cats. Vaccinated against rabies.

Important: no history of asthma. I have never smoked or vaped even once in my life, or been around smokers

I will be discussing this further with my primary care doctor, but it’s so weird I wanted to see if anyone else might have some ideas.

Starting in early 2022, I have gotten multiple severe respiratory infections every year, and I’m only getting worse. I’ve had COVID (twice), strep, hMPV, coronavirus, bronchitis, pneumonia, you name it. Each illness lasts a minimum of 2 weeks, with some lasting up to 6 weeks. Even if I know I caught the same bug as someone else, it will be SIGNIFICANTLY more severe and last much longer for me. I’m a professional cosplayer so I go to conventions with a lot of people regularly, and I get sick after almost every single one. I also get sick when I’m just at home too (due to my anxiety I very rarely leave the house, so not a ton of face to face interaction with people), so it’s not completely related to the conventions. I’m currently on my 6th or 7th illness this year. These illnesses are so severe that I basically can’t get off the couch, and I’ve had multiple ER visits because of them. Typically I’ll be prescribed an inhaler (Combivent), a nasal spray (fluticasone propionate), benzonatate, guaifenesin, and maybe cough syrup. For my most severe one this year (started as hMPV and coronavirus and turned into pneumonia), I was also given a nebulizer with medication, cetirizine, and an antibiotic.

After my recent bout of pneumonia, my doctor ordered a pulmonary function test and the results were abnormal (unfortunately I don’t have the exact numbers, or I’d happily share them). This was followed by a chest CT for a lung cancer screening. Here are the results of the CT:

“Unremarkable noncontrast CT chest.
Left lower lobe focal curvilinear
attenuation consistent with scarring unchanged from CT scan images dated September 30, 2024.”

I was never told I had any scarring before this, so I don’t have any more information on the 2024 CT (it was an abdominal CT, due to my IUD trying to exit stage left)

I can only think of 2 possible things in my history that would be relevant:
- In 2019 while in basic training for the army, I got a severe respiratory infection that lasted from mid September to late January with no breaks. It was so bad I would double over coughing uncontrollably frequently, and at one point I coughed up blood after physical training. I was prescribed sudafed and mucinex, and a chest xray showed no pneumonia. After I got home from basic training in May 2020 (army reserves, not active duty), I was extremely strict with quarantine/masks and didn’t really go out a lot until early 2022, which is when I started getting sick all the time. I think this is probably the most relevant thing, but I’m not qualified to say for sure.
- The first episode I can remember was early 2020, where I had COVID and strep at the same time. I was VERY sick for a full 2 weeks, and it was miserable. I had all of my COVID vaccines/whatever boosters were available at that time. Starting with this episode, I’ve had a minimum of 3 a year.

Before this, to my knowledge, I was perfectly healthy. I got sick a normal amount as a kid, and would typically recover quickly. But now it’s like my immune system just can’t fight anything. I go to a concert, I get sick. I hang out with friends, I get sick. I stay home and don’t go out at all, I still get freaking sick. Aside from this I’m a reasonably healthy person, and it’s starting to really negatively impact my life. I lost my job because I was sick for so long earlier this year. I have to plan to lie in bed for 2 weeks after every convention just in case. It sucks.

I get my healthcare through the VA so cost is not a concern, and at this point I’m willing to try anything. Are these any tests I could request to rule things out? Things to bring up? What could be going on with me?

Thank you so much for your time, and I apologize for the wall of text 😅