The misery of Pleurisy/Pleuritic Chest Pain and Prednisolone

[LupusKaren]

I am currently unwell, I picked up a virus 6 weeks ago, which morphed into chest pain on a pain level I have not experienced before. Fortuitous that I was seeing my Rheumatologist and she ordered necessary X-ray and CT scan to rule out PE, I have APS.

My APS markers off the scale, and my inflammatory markers highest ever been.

I was given a 12 day course of Prednisolone, which helped very much.

I have been off the Pred 4 days, and wham all my symptoms came back, but along with a really hacking cough, and sorry but phlegm that is bright green and could guide an aircraft down a runway.

GP has put me on Amoxicillan, 5 days in, no difference, I will go back to my GP but am thinking more Pred needed, as much as I hate it, it did help.

Thoughts please.

[PMRpro]

Pred for a bit longer - and a culture of the sputum to be sure that it is bacterial (they really are often viral and still have green gunk, it used to be thought that green meant bacteria, not so) and if it is - which antibiotic they should be using. If it is the wrong one - it won't work.

[LupusKaren in reply to PMRpro]

Thank you PMRpro, will get a sputum sample off to surgery on Monday.

[happytulip]

I very much suspect that you are on a dose of amoxicillan for a non lupus patient. I suspect you need a longer and stronger dose. The typical treatment (unless its changed) for community acquired pneumonia is doxycycline. However, that particular antibiotic is contraindicated in people with SLE and you'd be surprised as to how few GPs know this so thought I'd give you a heads up incase they try to switch you to it. Its even written in the drug info leaflet.

And I totally agree that you need it cultured.

Get better soon x

[Littlebitofftoday]

This happens to me all the time!!! It's a vicious cycle! I never fully get rid of my cough even when the chest pain and green mucus stop! I pray you get relief my dear.

[MOOG144]

Hi Karen

When I 1st started my treatment for SLE and Nephritis I was put on high dose pred and high dose MMF.... despite being warned about my lowered immune system I still went to work in a massive open plan office as I didn't want to sit at home feeling sorry for myself...

Well as is the norm a cold swept through the office and I ended up with a chest infection, as I'd been told to be careful when picking any bugs up... off I went to the out if hours doc who was fantastic and called my Nephrologist for advise... I was given 250mg amoxicillin for 5 days and sent for a chest x-ray. The X-ray can back clear but after a week of bed rest along with the 16 different meds I was on I honestly thought I was dying and just wanted to stop taking all the pills.... I have never felt as I'll as I did for the following month.

Another course of 500mg amoxicillin and complete bed rest for 4 weeks I slowly started to improve but by then my muscles in my legs had wasted away (kept falling over, legs giving out).

Took me nearly 2 months to recover...

But I did get better a and thankfully not caught anything since...

Get more antibiotics at a higher dosage and rest up.... bit try to keep mobile xxx

Hope you feel better soon as I know exactly how rough you must be feeling x