Doctors Lounge - Chest Answers
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Forum Name: Chest symptoms
|mmsc - Fri Jan 04, 2008 4:57 pm||
Seven months ago I went to the hospital where xrays showed an upper respiratory infection. I was given antibiotics then sent home.
Five months ago just after turning thirty, I ended up sick in the hospital with a "hole" in my lung and the doctors thinking I had TB or worse. Turns out I don't have TB and the biopsy of the spot was negative for cancerous cells. Unfortunately they still don't know what it is. I've had many CT scans and most tests imaginable since then. The inital CT scan showed Mild Bullous Emphysema so the doctors told me to stop smoking which I did. Most recently, the pulmanologist thinks it's some sort of fungal infection although every specific test returns negative including Cocci and histo (as I live in the midwest but visited the west coast just before getting sick).
I was given two kinds of antibiotics in the hospital, followed up with six weeks of another kind after getting out and then became ill again with another lung infection and did two more weeks of antibiotics. I was fairly well for about four weeks and slowly sick again and am now on antibiotics again.
I've only had two breathing treatments throughout the ordeal and don't use inhalers. Fact is, I'm not short of breath nor have trouble breathing so they don't feel I need it. I've also gained 13 pounds since quitting smoking so I'm actually healthier in that regard. The problem is that, I've yet to stay uncongested for long. I constantly relapse back to the same symptoms and can yet again feel the spot in my lung which shows up on CT scans as what the doctor explained to be scar tissue surrounding a node. (It feels like theres a sticker on my back). The fever returns, the burning and tingling in the lungs return, the stabbing chest pains return, my underarms ache and oddly, my right knee will ache though I've never injured it. I'm worried that they are missing something or that there might be something more I can do. I'm also worried that since I'm allergic to pennicillins, the antibiotics won't always work.
Is there anything else it might be? Is there anything else I can do?
|Dr. A. Madia - Wed Mar 12, 2008 12:08 pm||
The differential diagnosis of your lung picture is:
Atypical pneumonia-[caused by unusual bacteria]
The list goes on but this is the compact list that usually gives one the answer.
carcinoma is ruled out as per your story.
TB one cant be sure because a negative TB report doesn't rule out Tuberculosis. So if the general clinical picture suggests, this avenue should be pursued. One point against TB is your 13 lb weight gain.
Lung abcess, fungus, atypical and bacteroids can be diagnosed with a brochoscopy, lavage, and serology from blood.
Finally since you have been a smoker, and your chest CT did show emphysema this could be Chronic Obstructive Pulmonary Disease [COPD] with refractory lower respiratory infection.
There are several powerful antibiotics now available to replace penicillin and resistance to penicillin need not be a cause of any worry.
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