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Is Prednisone safe for pleural effusion treatment?

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Internal Medicine Specialist
Practicing since : 2003
Answered : 959 Questions
I want to know if my doctors diagnose is right. About 3 weeks ago my heart felt like it was going to explode chest tightness, pressure which radiated to my back and hurt to breath. He said I had pleural effusion and put me on prednisone for 10 days. Then a couple weeks ago my son and I were both sick so we both went to doctor and he said bronchitis and commented on how swollen my nodes up front were and put me on chaflaxon 500 mg. Then last Wednesday my left one was super swollen so back to doctor I went and he measured at 5 cm and told me to go home and wait until Friday to see if better. Come Friday it still wasn't better and my chest pain was back in full force so he wanted me to come in again where as again pleural effusion back on prednisone for 5 days. He also tested for mono and came up negative and drew blood hemoglobin was low but everything else was normal. Then on Monday I woke up and it felt like I couldn't get in a deep breath so I called the clinic and my doctor wasn't in so another doctor called me back right away and said because of my symptoms he wanted me to come in as soon as my doctor came in. My doctor diagnosed me with asthma and said my swollen lymph nodes were due to a horrible infection. He also did a influenza test and came up negative. Then today I have pressure in my chest it don't hurt but it's there and they said take 2 puffs of inhaler every 4 hours. I am currently on albutral. He said if not better in a week he will put on different inhaler that starts with an s. I have been waking up drenched in sweat. I am always so exhausted no matter how much sleep I get although I do have 3 kids. When my lymph nodes are swollen they are itchy along with I am itchy on my legs and arms. My lymph nodes are finally back to normal. Is my doctor right?
Posted Tue, 25 Feb 2014 in Medicines and Side Effects
Answered by Dr. Vaddadi Suresh 53 minutes later
Brief Answer: was chest X ray performed Detailed Answer: Hi XXXXXXX welcome to XXXXXXX I have gone through your question. I have some doubts regarding the diagnosis made, though your description is incomplete. Pleural effusions are generally not treated with steroids (prednisolone) without a definitive diagnosis, as they increase the chances of infections, as has possibly happened in your case. Asthma does not start over night, it generally starts during childhood and stays episodic, showing seasonal variations for a long time. So your new diagnosis of asthma at 30 without any history in the past seems a little unreasonable. (if you have past history, it's OK) Swollen lymphnodes are generally due to infection. so your nodes normalized once you were kept on antibiotics. But bronchitis do not generally show out as swollen lymphnodes in neck; So, was an infection somewhere else missed? Heavy chest pressure and drenching sweats need some cardiac conditions to be ruled out, though less likely in your case. was that done? finally, was chest X ray performed or not. so please provide the answers, so that we may help.
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Follow-up: Is Prednisone safe for pleural effusion treatment? 14 minutes later
He just listened to my chest front and back and told me it was fluid in the lungs the only thing that happened at that time was the intense chest pain that was bringing me to my knees and making my eyes water. I don't have past history I have never had issues before this I have been healthy for the most part. He never did find out what was causing my swollen lymph nodes. I have not had a chest x ray or a cardiac work up. My mom is a nurse and she said she is worried it might be lymphoma and she feels the doctor is dropping the ball do you think that could be it? Thank you.
Answered by Dr. Vaddadi Suresh 17 minutes later
Brief Answer: I strongly recommend you to visit chest physician Detailed Answer: Hi, In that case, he was not going in the right way. Atleast an X ray chest and an EKG should have been ordered with that severe symptoms. Lymphomas will also have history of fever, weight loss, anorexia and persisting lymphnodes which grow over weeks or months. They wont regress with antibiotics.(though some may reduce with steroids). So don't worry about that possibility. I strongly recommend you to visit a chest physician (pulmonologist) as there are many conditions like atypical pneumonias, ricketssial infections which are very much treatable. If he rules out them, you may volunteer to ask for a cardiac check up. You may post me directly to my ID, if you have any further queries. All the best.
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