Pneumonia or not pneumonia; that is the question.

I just went to the hospital for fever, chest pain, cough and fatigue.  I had a chest x ray and white blood cell count was higher than normal.  The doctor said my x ray showed signs of having pneumonia.  Today I received a call that the radiologist reviewed the x ray and his/her diagnosis is that it is within normal range.  What exactly does that mean and can you have that diagnosis and still have pneumonia?  So confused!

[David Tinkelman, M.D.]

The diagnostic findings of pneumonia on Chest X-ray can be subtle, especially in the early stages of infection and there can be honest disagreement between doctors regarding the changes of pneumonia being present or not.  The fever, chest pain, cough, fatigue and elevated white blood cell count are all consistent with the diagnosis of pneumonia.  In addition, if the doctor heard abnormal sounds (rales or crackles) when he/she listened to your lungs, antibiotic treatment for pneumonia would be appropriate, despite the X-ray interpretation being “within normal range.”

If you are raising phlegm, submitting a specimen of it to the lab for bacterial culture could be helpful.  And, if you continue to have fever especially fever while being treated with an antibiotic, culture of your blood might also provide good information.

The important thing at this time is that you receive close medical follow-up by your physician for at least another week.

Good luck