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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18461
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I was recently dx with pneumonia. The xray showed what they

Customer Question

I was recently dx with pneumonia. The xray showed what they said is subtle pneumonia left lower lobe. I'm scared it's lung cancer. I also now have a swollen lymph node in my neck. I've been treated with antibiotics and I'm on day 5 after dx....still coughing like crazy (less phlegm the before and it's now clearing before it was green) fever is gone but I'm worried that may be it's lung cancer
JA: Are you keeping a personal medical record while dealing with this?
Customer: I am
JA: Anything else in your medical history you think the doctor should know?
Customer: I was given 1g rocephin, zpak 500mg x 3 days, and an inhaler
Submitted: 9 months ago.
Category: Medical
Customer: replied 9 months ago.
My O2 was at 94% in hospital. It's now 96-98%....I also have anxiety. Would the chest xray find lung cancer? Would they tell me if they seen anything like that?
Customer: replied 9 months ago.
Does subtle mean there was just a little?
Expert:  Dr. D. Love replied 9 months ago.

Hello from JustAnswer. This is Dr. Love and I will be assisting you today.

While it is true that people with lung cancer are at increased risk of developing pneumonia, the vast majority of cases of pneumonia happen in people that do not have lung cancer. Even in someone with a history of cigarette smoking, the vast majority of cases of pneumonia occur in people without lung cancer.

It is also common for pneumonia to get into your system in other ways. In some people, the germ from the pneumonia actually started in the head, and then traveled into the lungs. We can also grow the germ from the pneumonia in cultures of the blood stream in some people with pneumonia, which shows that the germ has gotten into the blood stream. So, it is not surprising that lymph node swelling occurs in the neck.

Pneumonia is so common that we typically are not concerned about lung cancer unless there are other signs that are worrisome for lung cancer or if the pneumonia does not clear with antibiotics. The fact that you are still having a significant cough is not a sign that the pneumonia will not clear with the antibiotics. The inflammation in the lungs associated with the pneumonia will commonly takes several weeks to completely resolve, even after all the germs are killed.

It is also worth noting that the azithromycin in the Z-pak is incorporated into white blood cells in your body that your immune system will send to the site of infection, so the antibiotic effect will continue for about 5 days after you take all of the pills.

A chest x-ray may detect lung cancer, but can only detect cancer of a certain size. If something were seen that was worrisome for lung cancer, though, they would have commented upon it. Subtle refers to only small or little changes in the chest x-ray, but the chest x-ray can lag a day or two behind the clinical symptoms, so subtle changes does not necessarily mean that the pneumonia is mild.

Therefore, at this point, there is nothing in your description that is worrisome for lung cancer. It is appropriate to see if the pneumonia continues to improve, and as long it resolves, there is no reason for you to be concerned about lung cancer.

If I can provide any additional information, please let me know. Once we are done, please remember to provide a positive rating so that I am credited for assisting you.

Customer: replied 9 months ago.
I also have a bit of rattling when I breathe out at times but also not like it was. So the continued cough and rattling are all normal symptoms of pneumonia even after being treated with 2 antibiotics. I go to have a re xray tomorrow. I'm just scared at what it will show I guess.
Customer: replied 9 months ago.
I forgot to mention they did a blood draw also and my wbc was elevated they said due to the pneumonia
Expert:  Dr. D. Love replied 9 months ago.

Yes, the cough and rattling are all common with a pneumonia, and some of the cough and rattling will not completely resolve until after the five additional days that the azithromycin in still in your system. As long as the symptoms are steadily improving, then there is no reason for concern.

Yes, an elevated white blood count is to be expected with a pneumonia.

Customer: replied 9 months ago.
normal healthy ppl can get pneumonia doesnt mean there's an underlying health condition
Expert:  Dr. D. Love replied 9 months ago.

Yes, completely healthy people can get pneumonia. It does not mean that there is an underlying health condition.