Pericarditis progress and recovery

I am hoping for some help with understanding how this disease and its recovery progresses.

My husband recently had an emergency pericardiocentesis (~1500 ml of fluid) diagnosed following an initial visit to his GP for a high fever (> 101). He was released from the hospital after 2 days with 1.2 mg colchicine and 1600 mg  ibuprofen medications. All the tests they ran on the fluid and his blood were negative, so the cause is assumed to be an undetected virus or idiopathic.

His EC and EKG after 8 days seemed fine (fluid mostly gone), so the ibuprofen was reduced to 800 mg/day. He was also allowed to resume exercise (moderate walking on a treadmill). After only five days, his symptoms--fever and shoulder pain--returned and the next EC showed that the fluid had increased. He was reluctant to take prednisone, so his ibuprofen was increased to 2400 mg. His EC one week later showed little change. Now, 2 days later, his fever has become quite high again (101.8).

He also has some other symptoms which may or may not be related: numbness and pain in his feet (no cause could be found for that either), extreme thirst, a hemoglobin A1C measure at the high end of the normal range (6.0), with other glucose-related results normal.

My questions are:

* How does the recovery from an effusion progress? Does reabsorption cause a fever as happens for, say, internal bleeding? Or is a fever always a sign of a worsening condition?

* Should this be considered a recurrence or was the initial episode just not resolved?

* Is my husband correct in trying to avoid steroids if at all possible? The recent literature seems to suggest this tactic.

* Has anyone experienced any of the other symptoms?

* How does one find a cardiologist who is well acquainted with pericarditis?

Any feedback and/or related experiences would be appreciated.

[richland]

I have had pericarditis since May. Actually, I think it really began in March. I woke in the middle of the night with horrible chest pain through to my back, chills, dizziness. It rapidly progressed to vomiting, body aches, fever and diarrhea. The chest pain stopped when the vomitting and fever started, so I thought I had a "flu".
6 weeks later I began to notice shortness of breath and mild chest pain when exercising. I had a cardiac workup and all was normal--except the echocardiogram showed a smaill area of inflammation and a very tiny amount of fluid. I was treated with prednisone(dose pack) to no avail. I began to worsen to the point I felt faint--sometimes even when laying down. Had a normal rheumatology workup. Tried Indocin and the pain and shortness of breath got worse. Went on colchicine and aspirin(per the COPE pericarditis study) about 6 weeks ago. Have improved a great deal--but it is not gone. I still experience chest tightness at times and mild pain.
I have a good cardiologist and we also keep the rheumatologist involved. Rheumatologists see a lot of illnesses that can cause pericarditis--so I figure they have dealt a lot with it. Indeed, if this does not resolve soon, my cardiologist is going to contact the rheumatologist for dosing and medication advice.