How typical is it to be misdiagnosed with X-ray and CT Scan?
I am a 34 year old non-smoker. I smoke a pack a day in my youth, but have been free of that for almost 8 years. I was diagnosed wth asthma at 14, but did not receive proper care or care for my asthma responsibly. I was always short of breath, but did not use my inhaler unless I was having an acure attack.
Last February I was ill. I don't remember much, only that I was tired, cold, and a little delirious. My oxygen was down and my heart rate was up. I don't know if I had a fever. I was confused and a little combatative. I had an x-ray at the hospital and was told I did not have pneumonia. The Dr. suspected a blood clot in the lung and sent me for a CT. The radiologist diagnosed pneumonia in the Lower left lobe. The right lung was completey clear. I was given 10 days of Levaquin. 7 days after starting the Levaquin I started noticing some aches and paines in my hands. It spead througout my body and everyone suspected the Levaquin. I finished the treatment and sought opinions from 3 doctors about my possible injury. I underwent numberous tests and too many rounds of steroids, cortisone injections, and OTC meds, but didn't experience relief. I developed flu like symptoms more than a week after the onset of arthritis symptoms. I developed swelling and severe pain in most of my joints, and have had periods of intense flare ups since then. It is sometimes so bad I cannot brush my own teeth or hair. Othertimes, I forget I have OA unless I try to open with a twising motion, or hold something cold or too large for my hands. I was told I did not have RA or Lupus, but it was a suspected autoimmune response to the Levaquin and that it was possible I have an autoimmune disorder.
I have also had some other weird symptoms that have gradually become worse. In May I developed a swollen area under my hairline at my widow's peak. It became very red and warm. It was almost an inch across. Most of my hair fell out. It has been a cycle of redness, swelling, some pimple type activity, hair falling out and then healing. Not all of the hair has grown back.
In December, I began to feel as thogh I couldn't keep up at the gym. I had to stop and catch my breath and my Doctor game me Advair and encouraged me to use my inhaler before working out. I also noticed that after working out I experience moments of feeling as though I were breathing out "vapors." I had the same symptom in January and was starting to develop some weakness and became tired much quicker.
In February I was exposed to mold spores and toxic paint. I completely lost my voice withing 2 days and started to feel heavy in the chest 4 days later. I began to cough up sputum that progressed from pale yellow to green to black and clumpy. I went to an emergency clinic where my white blood count was up slightly. I did not present with any wheezing. I was told I probably had a sinus infection and maybe my asthma was flaring up. I was hypersensitive to any odors and constantly felt as though I was gasping for air. I was given a stong antibiotic, a steroid shot, albuterol for the nebulizer, and was encouraged to take mucinex. The sputum cleared up, but I experienced 2 seperate nights of waking up choking and unable to catch my breath. I saw the same doctor again 6 days later and was told my lungs sounded clear and my white blood count was up slightly. I requested an x-ray because I was producing a foamy substance with my coughs that tasted weird. The doctor told me the x-ray was clear and I was later informed that the Radiologist concured. I expressed my continued and worsening symptoms of being unable to catch my breath, feeling very weak and tired after a small activity, and continued waking at night choking. I was referred to a pulminogist. I also followed up with my PCP 11 days after going to the Emergency Care Doctor and was told I had decreased breath sounds. I was given another antibiotic, a strong round of steroids and a change in medicine. I began to sleep propped into an upright position with pillows because I felt as if I were being crushed anytime I lay down flat or semi-flat. The Pulmonologist changed some of my medications and raised the dose on one. He reviewd my x-ray and CT from the year before and pronounced them both abnormal, but stated that he thought it was a misdiagnosis and that I did not have pneumonia. He scheduled a CT, bloodwork, and a breathing test for a month later. At this point I was having troible maintaining a conversation due to the need to stop and gasp for air. I also became tired after standing or walking for 15 minutes of more. The veins in my hands and arms, feet and legs would bulge after a short period of walking or standing, and sometimes while doing nothing. I noted that my toenails were usually very pale, almost white with a pink dot at the end and my fingernails were pale, almost white with a darker reddish brown at the nail line. I would experience extreme exhaustion after these episodes and would have to lie down almost immediately at which point I would qiuckly fall asleep and shiver. I felt extremely cold after each of these episodes. After having an episode at work where I was unable to even drive, I went to the ER. I had a stinging sensation in my right shoulder, I was confused, tired, and having trouble standing due to weakness. After an EKG I was told I was fine, my lungs and heart all sounded perfectly normal. I followed up with my regular doctor, who also heard clear lungs, was talking to me when my slightly high for me blood pressure of 140/90 dropped to 108/66, began to worry that I had a blood clot. She sent me for a CT with contrast and I was told I had Aspiration Pneumonia. This was 13 days after the clear x-ray. When I questioned the lack of symptoms, that 8 doctors had listened to my lungs in 31 days and only one of them heard anything abnormal, the length of time from onset of acute symptoms and the fact that I had taken antibiotics for 17 days in March, and that I was fairly certain I had not aspirated anything, and that the symptoms had started much earlier and were just getting worse, my PCP contacted the radiologist that reviewed my CT. Both X-rays were completely clear, 13 months apart. Both CT Scans with contrast showed the right lung completely clear and the lower left lung with "possible aspiration pneumonia" and aspiration pneumonia. 13 months apart. The radiologist is now reviewing the all of the films, scans as well as the pulominologist.
I have been tested for diabetes, Rheumatoid Factor, Thyroid, Iron, Mono, Electrolytes, Flu, Gout, CBC and a few others that they thought would be the problem. They were all fine and I am awaiting results on the last set of labs.
Finally, my questions are; How common is it to not see pneumonia on an x-ray but on a ct, is it normal to see pneumonia in the same place on subsequent ct scans, is it common for pneumonia to be misdiagnosed, and if so, what else could it be?
Thank you for reading my very long winded description of events.
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