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Noticed rise in temperature, sweats and fatigue and sore throat. Took Augmentin. Suggest

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General & Family Physician
Practicing since : 1986
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About two weeks ago all of a sudden I had a rise of temperature to 39C which was accompanied with chills. A severe sore throat took place which was effectively managed with Augmentin 875 for a week. Yet low temperatures (37-37.2 in the evening) remained with sweats and fatigue. The CBC was OK but CRP showed 19.

After this the WBC was elevated to 0000 which mainly came from elevated neutrophils. CRP was 79. Then an xray was performed and bronchial pneumonia detected which was treated with Sumamed for 6 days (today is the last day). Yesterday the CBC was still the same (WBC 0000 from increased neutrophils) but CRP was decreased down to 10. The fever is gone yet I am feeling still terribly weak, any form of moving (eg walking on the street) causes quite quickly sweating and the pace can not be increased to normal. There is a light pressure on the chest. My doctor still ordered a new xray for the end of week as she was not confirmed this being over.

Please advise what is wrong. Being a little hyportonic, I am already afraid of cancer due to the WBC still being elevated and the fatigue being present. It is nearly spring outside so it feels weird to have pneumonia at this time of a year. Or can it be normal that the recovery from pneumonia on day 6 can still be felt in such a way? I must admit I did not stay home for the whole period, on 3 days I went to work for a few hours.

I forgot to mention also that I have a small yet persistent cough (dry type) and the heart rate is also faster than usually.

Looking forward to your reply,
Posted Sun, 9 Jun 2013 in Medicines and Side Effects
Answered by Dr. Nirmala P 4 hours later
Thanks for asking in Healthcare Magic.

Please rest assured. You don't have leukemia. A WBC count of 12,000 is quite normal following a lung infection. It will take some more time to come down. Raised neutrophils and total WBC count indicates that you are fighting with a recent infection. This indicates that your immune system is perfectly alright.

WBC count increases in many conditions like bacterial, viral infections, smoking, stress, TB, whooping cough, allergy or intake of antibiotics. If you are a smoker or if you have any known allergic lung conditions like hay fever, then your WBC would be on the higher side always and a lung infection would have increased it further.

CRP also indicates infection and is nonspecific in terms of diagnosis. Pneumonia can be caused by bacteria or virus. It is more common in winter and in persons susceptible to it. The incidence is high in people with chronic lung infection or with suppressed immune system.

Recovery is a little slow and may take several weeks. Cough may continue till the sputum is completely cleared from lungs. Persistent dry cough is also indicative of allergy (another condition where WBC is elevated) and you should rule it out. Azithromycin can also the reason for the dry cough. If cough worsens, then you should immediately consult your treating Dr. for further assessment.

Also, fatigue and reduced tolerance to exercise is common and that's why you are unable to do work. You need complete rest and nutritious diet as you are in the convalescence period. Stay at home and don't exert yourself. In case of smokers, an X-Ray should be taken at the end of 6 weeks to confirm complete clearance of lungs.

I hope this helps. Please address to me if you have any further concerns.
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Follow-up: Noticed rise in temperature, sweats and fatigue and sore throat. Took Augmentin. Suggest 6 days later
Thank you Dr XXXXXXX for an answer. Just wanted to follow up a bit. I have now finished the antibiotics and last friday the blood tests were back to normal again. However, my heart rate is some 20 points higher than usual and now when I have started walking again, it goes up pretty fast and I have sweat in the hair quite quickly. Basicly it is a cold sweat and head is pretty much the only area this happens. Is this still normal?
As for backround information I do not smoke but I am overweight (187 cm ca 130 kg).
If this is still post pneumonia symptom, could you kindly advise in a few words what is the best way to recover the strength and get rid of the sweats?

Thank you,
Answered by Dr. Nirmala P 1 hour later
Welcome back to Healthcare Magic.

Happy to know that your blood test reports are normal. Increase in heart rate and sweating of head indicates that you are still tired and weak. Since you are in the convalescence period, you should resume your activities slowly and should not exert yourself.

A good nutritious diet and sound sleep will get you back your stamina. High protein, low carbohydrate and low fat diet will help. Avoid saturated trans fats like fried food, red meat, egg yolk, high fat dairy products, butter, ghee, hydrogenated fats like cookies, cakes, donuts, fast food, starch food like pasta, white bread, pastries, potato, pies and rice.

Take whole grains like wheat, legumes, cereals, wheat bread, non starchy vegetables like beans, cabbage, spinach etc., oilve oil, soy products, fish like salmon, sardines, meckerel, tuna and fruits as it is also imperative that you should reduce your weight for a healthy life. Once you resume your normal routine, you can start going for daily walk. Take vitamin supplements too.

I hope I have given a satisfactory reply.
Get Well Soon.
Warm Regards.

Above answer was peer-reviewed by
Follow-up: Noticed rise in temperature, sweats and fatigue and sore throat. Took Augmentin. Suggest 1 hour later
Thanks a million doctor!
So did I understood it correctly that most probable the sweating is to do something with the previous pneumonia, not necessary a bad sign of something else?
Answered by Dr. Nirmala P 35 minutes later

For the present, yes. I feel that sweating is due to exertion and weakness. But if it continues for more than two weeks even after good rest, then you should consult with your treating Dr. about it. Please take adequate rest.

Wishing you speedy recovery.
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