Pulmonologist Questions

“Should I go to the ER or try the rx antibiotics?”

My sister (44F) is a kidney transplant recipient (2013) and currently goes to dialysis three times a week. She’s had a cold for three weeks and it isn’t getting any better so we took her to urgent care. Her chest X-ray showed bilateral diffuse hazy airspace and interstitial reticular opacity. The doctor put her on amoxicillin and doxycycline and referred her to a pulmonologist. However, the earliest they can see her is nearly a month away. Is this something to be worried about? Should we take her to the ER or wait for the appointment with the pulmonologist?

Female | 44 years old
Complaint duration: Three weeks
Medications: Tacrolimus, myfortic, levothyroxine, metoprolol, famotidine, fluoxetine, Reno cap, iron, insulin
Conditions: Kidney transplant recipient, type 2 diabetes, high blood pressure

1 Answer

Pulmonologist
Based on her history of kidney transplant and secondary immunosupression, and the appearance of her CXR, I would recommend an ER visit. The CXR appearance is more consistent with atypical pneumonia and less likely to be due to fluid overload. She will need an echocardiogram to assess her heart function and a CT Scan followed by maybe a Bronchoscopy. It would be helpful to have an older CXR to compare.