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Sunday, March 9, 2014
Difficulty in diagnosing lung infection
My mother is 80 years old, has atrial fibrillation (but has had an av node ablation and a pacemaker), and has congestive heart failure. For the past 5 months, she has suffered (off & on) from a number of symptoms that have primarily been treated in isolation, but now I`m wondering if they could possibly be part of a larger, more complicated illness: she has had chills & fever (as high as 103); urgency and diarrhea; dry cough; loss of appetite; weight loss; weakness/fatigue; and problems with balance. She has been in & out of the hospital; once she was diagnosed with pneumonia; two other visits, she was diagnosed only with an "infection." Now in her third hospital visit, her doctors see a "spot" on her lungs (but won`t confirm pneumonia) and can only say she has some type of infection, perhaps viral. Any suggestions for our next step or what type of specialist we can consult? Is there any chance it could be Legionnaire`s disease? I apologize for the length of this and would greatly appreciate any help you can offer.
You present a complex problem as you know. If this has not been done, a specialist in Infectious Diseases or Pulmonary Medicine would be reasonable. Both are subspecialists in Internal Medicine. They should be able to provide next steps based on her specific case.
Gary Roselle, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati