lingering fever, chills, rigors, dyspnea after pneumonia

[fritz]

49-year old male. No previous health problems. After exposure to friends who had been ill for 4 weeks, I experienced a fever, sore throat, body aches, and headache eight weeks ago. Four weeks later I was diagnosed with pneumonia. Z-pack helped but didn't cure. Follow-up chest x-ray was clear. Sputum culture clear. Next prescribed Bactrim: caused severe allergic reaction at end of dosage. Three days ago had a post-check with the physician who could not hear anything further in my lungs. Same night I continued running fever >101. Began Levaquin yesterday. Ran fever of 102.1 at night. I seem to be relatively functional throughout day (although dyspnea and productive cough remain and energy level is quite low), but continue to run a nightly fever with chills, rigors, and uncontrollable coughing fits for a few hours late each evening. Chest only hurts when coughing. My wife also has been sick for the past six weeks which started the same way but has not progressed to pneumonia. She continues to struggle with moist cough and energy level. (Proximity to me is likely a factor.) I can understand the dyspnea & cough lingering, but cannot understand why I continue to run nightly fevers. Should other tests be performed to lend insight?

[John Kenyon, CNA]

Hello -

Since you've had a clear chest x-ray fairly recently but continue to have these symptoms and your wife is also having similar problems, you likely have a more stubborn form of bacterial or perhaps fungal pneumonia (or perhaps relapsing bronchitis which could cause pneumonia to start back up again). You're currently on a pretty strong antibiotic and hopefully your wife is being treated as well.

Have you been cultured to determine what, exactly, is causing the infection? This may be up for grabs, diagnosis-wise,and could warrant a change in medical therapy to knock this thing out once and for all. This would be my one suggestion, except that I can hardly imagine it wasn't already done. If not, though, that would be the one thing I'd ask to be added: blood cultures and sputum cultures. Perhaps even if you did have this done before it should be repeated, since there may have been an opportunistic bug that's moved in as often happens after a serious pulmonary infection.

I hope this is helpful. Best of luck to you both, and please follow up here as needed.

[fritz]

I asked our doctor about ordering blood work, but she said she wouldn't know what to look for, so she has referred me to an infectious disease specialist. In the meantime, my fever has gone away and I'm beginning to feel slightly better. Since the appointment with the specialist is not for another week and a half, I wonder if it will be necessary, but am thankful to finally feel as though I may be recovering.