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Have had severe pneumonia. Started back pain. Scan showed fluid in lungs. Suggest some effective cure

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Pulmonologist
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My brother is 35. He was a smoker. He had severe pneumonia, in July, this year. It started with the unbearable pain in his back. He couldn't sleep, move or else for days, he was in the hospital for 20 days, where he was treated. He made many X-rays and 2 CT scans. He had fluid in lungs (Pulmonary Edema). The cause of pneumonia was chlamydia bacteria (Chlamidya trachomatis). His last CT scan, showed small emphysemic bull, a lot of scars, fibrous scars. Pulmonologist said that his lungs were badly damaged. In few months he will go on a 3. CT scan. He stopped smoking. He never coughed, not now not before. He doesn't have any chest pains. He still feel pain in his back, especially in the morning. Still has a heavy breath (when climbing upstairs) and gets tired easily. He still feel pain in his back, especially in the morning. Why does he sometimes feels that pain in his back? Will he be allowed to go out into the open this winter (few months after pneumonia, when the weather is cold) and hike in the woods? What about scarring of his lungs? Will this ever get better? What can he do about it? Is there any special tea or kind of food that I can prepare for him that he gets better? What can we do for him at home? Please, help. If you need more info's I'll write it down. Thank you in advance.
Posted Sat, 27 Oct 2012 in Lung and Chest disorders
 
 
Answered by Dr. Gyanshankar Mishra 3 hours later
Hi,
Thanks for posting the query on XXXXXXX
After going through your query, I would like to comment the following:

1. Your brother had suffered from an episode of chlamydia pneumonia in July this year.
2. The infection seems to have been in a diseased lung (emphysematous bullae with fibrosis- secondary to previous smoking).
3. Please note that emphysematous bullae and fibrosis are ususally irreversible changes in the lungs.
4. As he was evaluated by a Pulmonologist please ascertain the diagnosis. Is he suffering from some form of interstitial lung disease or obstructive air way disease with secondary infection.
5. He needs to get his pulmonary function tests done and initiated on inhaled and oral drugs as per the reports.
6. Avoiding cold winter weather is definitely recommended.
7. Any form of dietary supplements have no confirmed role in improving such condition.
8. Scarring of lungs is usually irreversible as already stated.
9. A pulmonary rehabilitation program can help him but after confirmation of diagnosis and determination of further line of action (In consultation with Pulmonologist).
10. If he is hypoxemic (low Oxygen saturation of the body - can be measured by pulse oximeter) then oxygen therapy may be considered.
11. Also he needs to be considered for annual flu and 5 yearly pneumococcal vaccination for prevention of severe respiratory infections in the future.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by
 
Follow-up: Have had severe pneumonia. Started back pain. Scan showed fluid in lungs. Suggest some effective cure 2 hours later
Thank you very much doctor. What else could I ask? I can rewrite some details from his last CT:
"ST Post pleuropneumoniam billateralis. Good expansion of lung parenchyma. Small emphysemic bull. Band inflammatory scarring changes...there is no more fluid in lungs.. XXXXXXX
Pulmonologist didn't send him for further tests, except new CT scan (for 4 months) and spirometry examination.
Chlamydia is a bacteria that is spread through sexual contact, so we can not understand how it got into the lungs? He has a fiancee, she said, that she had candida but not chlamydia. We wonder whether he is now rid of that bacteria, because he had to take all sort of antybiotics in hospital.
WHY he still feels pain in his back (only in the mornings)? Could it be pleuritis? Or just consequences from pneumonia that will go away, in time?
In my hometown we don't have a pulmonary rehabilitation program. Can I find any program on internet that he can practice at home?
He is trying to eat healthy so that he can improved immunity. He walks every day for an hour. Can lungs be recovered and rebuilt or no? When my brother will start to feel better (considering he was hospitalized in July)? Will he be able to drive a bike in free time? Can he go to work this winter? Lot of questions, but I am so worried and I try to help as much possible. Thank you very much.
 
 
Answered by Dr. Gyanshankar Mishra 7 hours later
Hi,
Thanks for the follow up query.
After going through the follow up query, I would like to comment the following:

1. Your brother seems to have developed post infective fibrosis in an pre existing lung with obstructive air way disease.

2. Chlamydia can spred through inhalational route also.

3. Residual back pain could be due to the lung involvement - fibrosis and emphysematous bulla. The last Ct did not show any fluid so less chances of pleuritis.

4. For pulmonary rehabilitation programme, you may consult your Pulmonologist or a Physiotherapist. Also incentive spirometry does help in cases of fibrotic lungs.

5. The state of his functional status is hard to predict but pulmonary fibrosis is usually irreversible. Do continue the exercises and healthy dietary practices.

6. Fitness for work will depend on his symptoms and spirometry test results.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by
 
Follow-up: Have had severe pneumonia. Started back pain. Scan showed fluid in lungs. Suggest some effective cure 4 hours later
Thanks for the clarification. So, this is my last query.
I don't understand, how he can develop post infective pulmonary fibrosis when it is not followed by strong, irritated cough? Does it mean that it is not so serious, when there's no cough? He just feel that back pain sometimes.
Will this converting of the lungs in fibrous tissue, continue, or it is stopped now? Will his lungs always look in a way, they looked on last CT scan? Or it can progress in worse?
We live in a Mediterranean climate. We planned to go on vacation in Swiss Alps in November. The temperature will be in the range of 0 to 15 degrees C. Do you think he should go? Is it advisable for him to go? Will the forest air be beneficial for him, or the cold air can harm his lungs? Can cold weather accelerate formation of new scars? Can the cold and windy weather cause pneumonia again?
Thanks for all the responses and I wish you success in your dedicated work.
 
 
Answered by Dr. Gyanshankar Mishra 38 minutes later
Hi,
Thanks for the follow up query.
After going through the follow up query, I would like to comment the following:

1. Fibrosis is one of the mechanisms of aberrant healing. Cough is present only when the fibrotic lung is secondarily infected.

2. Post infective fibrosis is normally not progressive. However repeated episodes of infections can lead to progression of the same.

3. It is usually recommended to avoid cold weather due to increased risk of infections. Cold air does not accelerate formation of new scars.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by
 
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