Re: Mycobacterium

[Guest guest]

It would be unusual to have the amount of liquid inside such a mass, and I have no explanation for it. The presence of calcifications suggests the thing had been there for quite a while, and I'm surprised that it wasn't detected sooner. Perhaps the accumulation of fluid is recent, and led to the increase in size?

Thanks, JB. The good news from the doctor yesterday is that the PCR came back negative for TB, so it's definitely not that. As you say, it could be another 5 wks before the cultures tell us what, if anything was growing in there. The .6 liters of fluid he drew out wasn't the lovely chevre you described, but more the color and consistency of a thick, rich chicken broth.

I should've mentioned that this isn't the first time something like this has happened. When I got PCP 13 yrs ago I never got the classic fatigue, fevers, shortness of breath, etc. Instead, the aerosolized pentamadine (remember that stuff?) caused the PCP to form a walnut-sized lump on my upper lobe (the only place it couldn't reach) The resulting mass eventually made my lungs collapse. The pleuridesis they had to perform to glue my lungs back in place left scar tissue in the pleural cavity. This has always shown up on xrays, so we didn't suspect that there was a fluid filled mass there as well until it changed size, and they did a CT scan w/iodine contrast to get a 3D picture...

So the upshot is we sit and wait. With over 1000 CD4s and no symptoms, the pulmonologist isn't terribly concerned. The only question remaining is if the cultures reveal something, will oral antibiotics actuallly reach the walled off reservoir to be effective? And was it an infection or something else that caused the fluid to accumulate there in the first place? He didn't have any answers for those.

Best,

Jeff in San Diego