Avatar universal

Xray, CT says lungs are "fine". Why can't I breathe and why do I have a fever?

I felt run down and have had a fever since Christmas.  Fever wasn't super high, just enough to feel, 99-101F (I usually run a bit cold, 97ish), daily, very tired, and so I wrote it off as a holiday-stress cold, gave it a few days to clear up, tried to rest and drink lots of water.  It didn't.  Figured it had become a sinus infection, realized I was extra tired, kinda winded trying to do simple things, and I am very prone to those having chronic allergies since childhood, so I went to the local stat clinic.  I was given a steroid, some antibiotics, which usually takes care of it for me.  Nope.  7 days later, still feel the same.

Did a walk in with my GP - trying to do all this around working full time means it was almost a full month from the onset of symptoms, about Christmas, to getting in to my GP.  Feeling like I could not breathe well, plus some aches in my chest had me figure I'd picked up some strain of pneumonia, even though no cough or phlegm was present.  A little post nasal drip, but as an allergy sufferer living in South Texas, this is a daily thing.  

They see that my throat is red, not sore but red, ears infected, lymph nodes swollen, and tell me to get some bloodwork and a chest x-ray.  

I told them my father in law has COPD, and often ends up with pneumonia, but often does not fully finish his antibiotics - he can't leave the house for his injections in poor weather, is immobile, and his wife can't help him, and no one does house calls.  They live pretty far away so we can only go visit when there's time to stay a few nights to make it worth the drive.  We saw them at Thanksgiving AND at Christmas, and he said he was sick both times.  So, he "might" be harboring some resistant strain of who knows what and being the person with allergies and a history of getting pneumonia, sinus infections and bronchitis, I thought I might be more susceptible than my husband.  

I felt so horrible I actually passed out during the blood draw.  My x-ray came back "lungs okay".  My bloodwork came back great, save showing I had been exposed at some point in my life to pneumonia... duh.  I've had it about 4-5 times, once as an infant.  So, inconclusive.  Fever is still here, going into the 2nd month of it, chest pain comes and goes, breathing is just strained at times, even sitting still right now.  It's not a sharp pain.  It feels like an ache from long over use, like I've been doing 100 pushups, or moving heavy furniture.  I've not.  I've been lying on the couch, lying in bed, or struggling to sit up and be productive at work.

Tested for tuberculosis.  Negative.  Chest Cat Scan - "airways and lungs unremarkable."  Everything was unremarkable save they found a 5mm nodule in the lower right lung I now need to watch to be sure it's not growing.  New, more intensive blood work is in progress - I almost passed out but was ready for it this time and warned the techs.  They kept me conscious.  

X-rays and cat scans should have caught pneumonia, pleurisy, structural lung issues, yes?  My blood counts are well within normal ranges.  I can't even tell if they register an infection.  I've been on 5 antibiotics since January 12 and maybe seen a temporary dent in the fever for about half a day, staying under 99.6F, but it still heads right up to sit at 100F.  I have been resting.  I can't do much else, I have no energy.  My house is a wreck, I can't keep up with cleaning.  I am missing work through appointments and just being unable to make it.  I have no idea what this can be, now, and waiting till the end of the week for what might be more inconclusive blood work is kinda scaring me.  I can't walk or move too much or I get winded and tired.  I'm not in great shape, but walking 3-8 miles a day is not usually out of my ability.  Now it is.  Ideas?  Things I can ask my GP?
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Avatar universal
What your chest ct with contrast?
Helpful - 0
They did both With Contrast and Without.  They noted a 5mm nodule in the lower right lung.  Here's the wording from the report:

TECHNIQUE: Axial images of the chest were obtained from the lung apices through the
lung bases prior to and following 80 cc Isovue-300 intravenous contrast.

Lungs and airways: There is a 5 mm subpleural nodule identified in the right lower lung on
axial image 104. The remaining airways and the lungs are otherwise unremarkable.

Thoracic inlet: The thoracic inlet is unremarkable.

Mediastinum and Hilum: There is no significant mediastinal or hilar lymphadenopathy.

Heart and great vessels: The heart and great vessels are unremarkable.

Soft tissues: Normal.

Abdomen: Limited noncontrast views of the upper abdomen show no abnormality within the visualized liver, spleen or kidneys. The adrenal glands are normal.

Bones: The visualized bony thorax is within normal limits.
Did they do a ddimer by chance? Its a blood test
I'm not sure, I am waiting for the results from Mondays draw, they were doing a culture, and several others.  
Avatar universal
I've been off the antibiotics since Tuesday morning.  I am still running fever, 99.6-100.2, still feeling like breathing is difficult at times.  Not as bad as it was, but I am also moving around a LOT less than normal, and taking my time when talking now.  It feels like I forget how to breathe at times, and am trying to make up for it.  Chest pain is not constant, not sharp, just achy if I breathe too fast, too deep, too much.  I end up panting a bit just taking the trash outside to the bin.  

Logged onto the lab website with my bloodwork results from the 24th of January, everything is so inconclusive.  For a person with a constant fever who can't breathe, I'm in great health.  Results confirm that at some point in my life I've made IGG antibodies versus pneumonia, but I've had is many times... I'm not making new antibodies, but it also says that is not conclusive.  White blood cell counts are in the middle of the range, everything is in the middle of a range.  CT is "unremarkable" save the tiny nodule.  Xray showed "okay".  I had been expecting to be told it was maybe pleurisy since I have no cough, but nothing is showing up.  I am still waiting for the blood tests started Monday this week to come back.  I am just tired both physically and mentally.  The biggest improvement so far seems to be a minor up-tick in energy because my body is not processing multiple antibiotics today.   My husband is upset, getting frustrated, wants answers.  
Helpful - 0
So, weird.  GP's office calls, says I have a salmonella infection based on my test results.  They called in one more antibiotic, the last type to try.  But I'm not feeling ill to my stomach... and that does not explain the chest distress.  Sigh.  It might explain the fever, but really, why can't I breathe?  Have I just had a fever so long my lungs are tired, or chest inflamed just enough to not show on Xray or CT but for me to feel?  
Avatar universal
Has anyone recommended a vq?
Helpful - 0
what is a "vq"?  
I looked it up - no, no one has done that, yet.  
Avatar universal
Ventilation/ perfusion scan... can give some info!
Helpful - 0
15695260 tn?1549593113
Welcome to MedHelp's forums.  We look forward to your results from the blood draw earlier this week.  I guess it is good news and bad news that thus far nothing is pointing to a definite issue.  But a diagnosis so you can understand what is going on and what options you have about treating it would be nice.  I understand the frustration with that.  Let us know those results and we'll go from there.
Helpful - 0
They called, said the culture showed salmonella?  Put me on ciprofloaxan, last antibiotic they can try.  Fever still here, hitting just at 100, 100.8.  Seems like they are stumped.  White blood count in normal range, what other than cancer or infection causes fever?
Please, I am tired of this, it’s messing up a lot in my life, work and home are suffering.  I think my GP is trying, but my husband is upset they’ve not identified it yet.  He’s tired of me being sick, it caused canceled planes, missed family events already.  I need to get better, and I need to know what’s wrong first.
15695260 tn?1549593113
I am really sorry you still have no answers.   With the absence of gastric side effects, I can see how a diagnosis of food poisoning by salmonella is confusing but you did test positive for it so eliminating that through treatment will be helpful.  You can get systemic salmonella poisoning which can cause issues with heart and blood vessels which would raise your temperature. https://www.webmd.com/food-recipes/food-poisoning/what-is-salmonella#1.

What types of specialists are you now seeing?  Pulmonologist or infectious disease?
Helpful - 0
I live in a tiny rural town, at this time all I’ve seen is my general practitioner.  To get to a specialist I need to be able to go a 90 mile round trip to the closest large city, but can’t spare time off work for this.
That does make it difficult.  Sometimes though, seeing a physician with a specialty who has a greater scope of patients suffering the similar issues can be very valuable.  If your doctor is grasping at straws, they well be missing something although I'm sure they are trying their best.  If you are not well after this round of antibiotics, I would ask your physician what type of specialist would be best to see.  While it is hard to miss work, this situation is greatly impacting your life.  Your time given to proper diagnosis and treatment may ultimately cause you to be more productive at work in the long run. Only you can judge if that is worth it but if things spiral anymore in a negative way, this may be necessary for you to take the time to see the proper specialist who may have a better grasp of what is going on.  We will hope the salmonella diagnosis is the last you'll need and the antibiotics you've been given treat your symptoms effectively. Is there a hospital in your area albeit small?  There may be people for your doctor to confer with?
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