
I’d Like To Know What Other Diagnostic Possibilities I Have



So now, we are scrounging for other possibilities. TB negative. HIV negative. 4 different funguses negative. And as for the pneumonia diagnosis, I only had the pain. No fever, recent illness, or coughing. CBC normal. ESR was normal and then was abnormal after 1st biopsy. ESR normal. One stain of biopsy showed nucleated red blood cells which so far seems to be the only abnormal thing.
Symptoms-extreme fatigue, appx 8 months. PCP said it was depression or fibromyalgia, still ongoing; drenching night sweats. Saw gynecologist. I’m not in menopausal age and all of my hormone levels came back just fine; shortness of breath, diagnosed with Emphysema. Long time smoker. Intermittent chest pain. Last 3 EKGs suggest prior heart attack. Had EKG last year and year before that was normal.
So what else could be going on? Any other possibilities we’ve not yet considered and/or tested for? False positive PET-CT, fatigue, night sweats, chest pain.
possibility of sarcoidosis or other auto immune mediated condition.
Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have read your query and here is my advise.
* The assembly of symptoms with excess fatigue, night sweats, chest pain
with this duration and negative evaluations suggestive of other
possibilities, I suspect possible auto immune disorder underlying which
may had flared up and presented as pneumonia at initial appearance
clinically ( though its process at subclinical level is hidden behind curtain )
* Sarcoidosis is one of the diagnosis of exclusion and should be considered,
important evaluation is serum ACE ( angiotensin converting enzyme ) level
and broncho alveolar lavage fluid analysis.
However, if you can provide scanned copies of all your available reports as attachment in follow up session, it would be of immense help to go through thorough details needed.
Awaiting for your response.
Regards.
Dr Bhagyesh ( MS consultant surgeon )

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