virus or infection?

[wasdca]

Hi,

I'm a 38 yr old female  currently living in the caribbean. Otherwise healthy, no previous history of allergies or asthma.

I started having an odd sensation in my chest, some shortness of breath, in January. No other symptoms- no cough, fever, loss of appetite etc. I assumed it was viral and waited a few weeks for it to resolve. It didn't, and the discomfort  increased as did the episodes of breathlessness.

I went to a health care provider and presumed this was either bronchitis or RAD due to the pollution and particulate matter. I was given albuterol, and the first time I used it my lungs did open up (max FEV went from 350 to 475), I could breath better, but I also started coughing up some green phlegm. after a couple of days I had a low grade fever on and off. I went back, was given a z pack, and that seemed to help- no more coughing etc. But within the week I started to have night sweats and episodes of fever a couple of times a day, and have been coughing, sometimes productive, but mostly a dry cough. I seem to get better for a couple of days then the cycle starts again.

I did provide a sputum sample to a local health clinic for bacterial evaluation, and it came back negative. However, they do not have the best track record for accuracy.

Does this sound like a viral illness? any suggestions? I am still able to do things, but I am extremely fatigued and find the short fevers and night sweats uncomfortable. Also, in the past couple of days I have added a sore throat to the list. I thought it might be from coughing, but there are also some white spots. I had my tonsils out years ago and hadn't had a sore throat since. I should also note the white spots appeared within a few days of having turned in the sputum sample.

Sorry for the rambling. I'm really not sure which symptoms may be related.

[wasdca]

1. I haven't had a chest x-ray. I did have a
2. Negative PPD
3. Nothing substantial recently, I think.
4. I've been here for about a year. I was in outer mongolia for a couple of years prior. I've spent brief periods in the US.
5. Cuba
6. I have no idea what they actually tested- the choices are bacteriological testing or fungal testing, and I thought I'd try the bacteria first. The report I received just said the sputum sample was negative for bacteria.
I'm a never smoker but have lived and visited some highly polluted cities. Which reminds me that I was in the path of the mosquito control truck spraying a couple of times.

Thank you for your time and thoughts.

[swampcritter]

Swampy also wonders (as a non-doctor!):

1. How long have you lived in the Caribbean?
2. Are you a smoker? If yes, how much and for how long?

[Philip D Parks, MD, MPH, MOccH, FACOEM]

Dear Wasdca:

A couple questions for you before I provide my comments.

1. Have you had a chest x-ray?
2. Have you had a tuberculosis skin test?
3. Have you been exposed to someone with tuberculosis?
4. Have you traveled in the last year out of the area where you live?
5. Where to you live in the Caribbean?
6. Did the clinic test the sputum for acid-fast bateria (tuberculosis)?


~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.