Brief Answer: See below Detailed Answer: Hi and thank you so much for trusting us with your health queries. I am so sorry to hear about this illness that has been going on for almost 4weeks. Your symptoms raise the possibility of a lung infection. This is consistent with the findings of the x-rays which suggest consolidation(infection) and inflammation. Chronic cough with blood in sputum, night sweats that fails to resolve on antibiotics raises the concern of pulmonary tuberculosis. I will like your doctors to investigate and rule this out as a possible cause of your symptoms. The most important test would be to collect a sample of your sputum and analyze in the laboratory for the presence of acid fast bacilli which is the cause of tuberculosis. Other conditions that can cause similar symptoms are fungal infections and cancers in the lungs. Should your doctor fail to identify the exact cause and treat according, you should be referred to see a pulmonologist. He has had enough time that if he cannot give precise answers, make you feel better, then you should be referred for specialized attention. Have you had any recent travels in areas where tuberculosis is prevalent like Africa, south XXXXXXX Asia? Also, have you been smoking for the past 4years or did you stop smoking 4years ago? Thanks for using our services and do feel free to ask for clarifications if need be. I wish you the best of health. Dr. Ditah, MD.

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Brief Answer: Thanks for following up with me. Detailed Answer: When consolidation is reported on an Xray, it suggests pneumonia. However, the cause of this pneumonia remains to be identified. It could be caused by bacteria, fungal, allergic conditions, etc. Because antibiotics have failed to resolve the symptoms for over 1month, it makes me to think that it is not caused by a common bacteria. This is the reason why we have to consider less common causes like allergies, fungal, tuberculosis, etc. You mentioned that you have blood in your sputum. This cannot be ignored. It must be investigated and like I mentioned earlier, the most common cause of this is tuberculosis, cancer and fungal infections. I am in no way confirming any but raising the possible disease conditions that need to be considered as we seek to pinpoint the exact cause and offer treatment options to you. I am happy to know that all of these detailed imaging studies have ruled out the possibility of any mass in the lungs which could suggest cancers. The answer is Yes you have got pneumonia but what is the cause remains to be identified. My suspicion of a bacteria infection is very low. I will go for cause like mycobacterium, fungal, allergic pneumonitis, etc. I hope this helps. if you have not met a pulmonologist, I will suggest that you consider meeting with one for a more detailed evaluation and even Biopsy if indicated. I wish you well. Dr. Ditah, MD.

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Brief Answer: Sorry about these disturbing thoughts Detailed Answer: Hi and thanks for following up with me. I certainly understand your fears. They are real and almost everyone in your place would feel and react same. For now, all the tests ave been unable to show a mass or swollen lymph nodes suggestive of cancer. Though the risk is real and more so because of your smoking history. I will not want to put this as the number one cause of your symptoms because all tests have failed to show that. And beside, you have done very detailed exams that in most cases should pick some clue. For now, I don't just have enough information to say so. You have pneumonia. It is a very vague term that has several different causes. Broadly speaking, it signifies inflammation of the lungs. The causes are so many and that is what makes the difference in terms of treatment. I hope we get to identify the exact cause and address it. I already mentioned some of the non typical causes like fungi, mycobacterium, allergies, etc. A pulmonary consultant would be very helpful here. I will suggest you follow up with him and hope that he brings on board some detailed expertise touch to help resolve the worries. I hope this helps. I wish you the best of all possible outcomes with this. Dr. Ditah, MD.

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