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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes High Fever Along With Severe Chest Pain And Cough?

My son(Age-22 yrs) Started as high grade fever 104 and treated accodingly. TLC shot up from14000 to 32000 within a week. Then he was hospitalised and diagnosed as pleural fluid in right lung. Sever chest pain and cough. Treatment given for accute pneumonia. Pleural fluid drained around 80 ml which showed improvement in X Ray taken after 3 days.Pain increased after 3 days on 6th day in repeat x ray found 500~600 ml of fluid. Drained 500 ml of fluid pale yelllow . No puss. Still after 2 weeks ESR 139., TLC 6.4 (within range) Hemoglobin 10.8. Fever persistent, cyclic, low grade. (Early morning ~98.6 evening 100.9) breathing improved. Feeling mild pain in right chest. Cough releived. Taking his meal . Able to walk. In general he was having very good health. Consulted several doctors they are not able to decide whether it is T. B or pneumonia or something else. Still in Hospital.
Thu, 22 Nov 2018
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General & Family Physician,  's  Response
Hello,

It can be difficult sometimes to find the real cause of the pneumonia with pleural effusion and tuberculosis (TB) is high in the list of the possible causes. There are several tests that the doctors can do to try to isolate TB bacilli if they are causing the infection.

First is a skin test called Manotoux that tells us if he has been in contact with the infection or not and also sputum cultures with the specific culture for tuberculosis (other culture mediums will not isolate TB so specific medium is needed for TB isolation).

Because he is improving very likely it is not TB infection. Pneumonia with common pathogens can take weeks to give full recovery especially if pleura is involved.
Every worsening or not improving needs to bring the high suspicion for TB and TB drugs started.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj
General & Family Physician
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What Causes High Fever Along With Severe Chest Pain And Cough?

Hello, It can be difficult sometimes to find the real cause of the pneumonia with pleural effusion and tuberculosis (TB) is high in the list of the possible causes. There are several tests that the doctors can do to try to isolate TB bacilli if they are causing the infection. First is a skin test called Manotoux that tells us if he has been in contact with the infection or not and also sputum cultures with the specific culture for tuberculosis (other culture mediums will not isolate TB so specific medium is needed for TB isolation). Because he is improving very likely it is not TB infection. Pneumonia with common pathogens can take weeks to give full recovery especially if pleura is involved. Every worsening or not improving needs to bring the high suspicion for TB and TB drugs started. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Antoneta Zotaj General & Family Physician