When well I start feeling better?

[mgsteele]

I am generally a pretty healthy person, but have been sick for over 3 weeks now.  It started with diarrhea, back pain. low grade fever and fatigue.  My Dr knows I have history of pancreatitis and did CT scan which was normal. Still having symptoms and back pain and abdominal cramps so doc put me on 1000mg daily of both Cipro and Falgyl.  After about 3 days, stomach got better, but developed cough, chest pain and fever.  Still having back and flank pain.  Went to emer. clinic and xray shows pneumonia in my right lung.  Have received a Rocephin shot for 3 days in a row and had breathing trtmts on Saturday and Sunday. I am also taking Augmentin at 875 mg twice per day.
My back is still killing me, I am still coughing and my sternum is really sore from that and still running low grade fever with frequent sweating.  Should all of these antibiotics be making me feel better adn what else can I do?  I still feel awful, even though I feel a little better than I did a few days ago. I just keep expecting for the antibiotics to kick in and they don't seem to be.  Any suggestions?  Any advice would be greatly appreciated!!

[National Jewish Health]

You have indicated that you have had a >3 week illness, involving the abdomen and chest and that you continue to have bad back pain, cough, fever, sweats and fatigue, but your “stomach is better”.  The back and flank pain, if not pleuritic pain (from pleurisy associated with pneumonia) is worrisome for disease of organs in that part of your body; that is, your kidneys and pancreas.  Was there a complete (not just the CT Scan) absence of evidence for recurrent pancreatitis; you may want to ask your doctor about that.  And, have they looked to your kidneys as the main site of disease, conceivably with a perinephric abscess.  This latter usually presents with fever, abdominal and flank pain, but presenting symptoms can be non-specific, with fever persisting after two weeks or more.  About 1/3 of persons with an abscess have no signs of infection in their urine.  Your doctors might want to consider repeating the CT Scan.

And, to answer your question, the presence of an abscess could explain your less than expected response to antibiotics.  And, with septicemia (bacteria in your blood), could also account for the pneumonia.

That you are still ill, with fever and sweats is a reason for your doctors to conduct an extensive search for a primary site of infection, including your heart for an infection called sub-acute or acute bacterial endocarditis.  At this point you should also request consultation with an Infectious Disease Specialist, if one is not already involved in your care.

Good luck