Viral pneumonia, COPD can cause shortness of breath

DEAR DR. ROACH: I am an active 68-year-old woman. I still work part time, walk 2-3 miles a day and enjoy gardening.

In late April, I noticed that I was short of breath after exertion, like when walking upstairs or with intensive gardening. Two weeks later, I was so short of breath that I was hospitalized. I had a chest CAT scan, an echocardiogram and a nuclear stress test. The only finding was ?a ground glass opacity in my lower lobes.?

I saw a pulmonary doctor and had pulmonary function tests, which were normal. I was treated with Levaquin when hospitalized, and have been on Symbicort (two puffs twice a day). My doctor thinks I had viral pneumonia and will have an eight-week recovery. I?m still not feeling well. I tire easily and am short of breath on exertion. Thoughts? — M.L.N.S.

ANSWER: A ?ground glass? opacity is a radiology term describing the appearance of the lung tissue on X-ray; it doesn?t mean anything literally about glass. The list of possibilities (doctors call this a ?differential diagnosis?) for a bilateral (both lungs) ground glass opacity is very large. There are a lot of lung diseases that may look that way.

Viral pneumonia is one. If that?s the case, the X-ray gradually will return to normal. The uncertainty is reflected in your treatment: Levaquin is a powerful antibiotic that treats both common and atypical bacterial pneumonia, whereas Symbicort is a medicine used mostly for asthma and chronic obstructive pulmonary disease.

The fact that your pulmonary function tests were normal is very good news: Lung physiology (that is, how well your lungs work) is more important than how they appear on an X-ray. The symptoms you have are nonspecific and compatible with many lung diseases, including recent infection.

I wholeheartedly endorse going back to the pulmonary doctor: Some of the possibilities (such as pulmonary fibrosis, sarcoidosis and fungal infection) will benefit from treatment. Sometimes a biopsy is necessary to make a diagnosis.

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