r/Pulmonology

53M, thalassemia minor, 40 pack/year smoker, 187 lbs (85kg), 5'10" (178cm). No other medications, no known allergies. Based in Istanbul, Turkey.

Current medications: None (ENOX stopped at discharge)

Diagnoses:Thalassemia minor

Situation:

Admitted May 11-14 2026 to a chest diseases hospital with 2-3 months of progressive cough and dyspnea, worsening over last 20 days. No fever, no chest pain, no weight loss. Good appetite, sleeping well.

CT (11.05.2026, non-contrast): No mass, no lymphadenopathy. Right pleural effusion reaching 6cm thickness with adjacent atelectasis. Bilateral emphysematous changes.

Pleural fluid (12.05.2026): LDH 1020 u/L, glucose 10 mg/dL, protein 63.8 g/L, albumin 26 g/L. Yellow, serofibrinous appearance. Exudate by Light's criteria.

Blood labs (11.05.2026): CRP 9.02 (ref <5), WBC 8.97 (normal), LDH 222 (normal), INR 1.52 (high), APTT 46.1 (high).

Treatment:IV Tazobactam x2 days only. Doctor stated "there is infection." No culture sent (or not shared). No oral antibiotics on discharge. No ADA test done.

Discharge codes:C34.9 (unspecified lung malignancy) + J90. Cytology pending 30-45 days. PET-CT planned.

Mu questions

1. Pleural glucose 10 + LDH 1020 with no CT mass - does this point more toward empyema or malignancy?
2. Was it appropriate to stop antibiotics without oral continuation?
3. Should ADA have been tested to rule out TB?
4. Is 30-45 days for cytology acceptable in this situation?
5. How urgently should we pursue PET-CT privately?

I keep getting denied of a ct scan on my chest every dr I see because of “radiation” so the two chest x-rays I’ve gotten showed nothing but I’m positive I have stage 4 lung cancer that has spread to my brain and liver, I coughed a teaspoon of blood last year around my birthday when my throat felt like itching powder and I ate acidic foods it was followed by severe gum bleeding (I have dental issues) I have not coughed blood since but I woke up spitting a bit of blood recently, that night I ate pizza on my stomach and had one of my extremely tight chest episodes (which are gone now) I still taste blood in my mouth even when I’m not spitting up blood, oxygen keeps showing up as being hypoxic in the drs office 78, 89, 81 then going up to 100%, the lines on the machine looks weird and “?” I feel absolutely nothing when those numbers show up, I get shaky my fingers get cold but even with a hot pack on my left hand first very number was hypoxic…it just KEEPS HAPPENING and they keep explaining it away they listen to my lungs and nothing but when I’m breathing calmly it’s above 90 and it stays there but I heard that it can be inaccurate on black people, I’m a black woman. now with my heartburn that I’ve had for years I keep feeling food stuck in my chest and throat, throat feels tickle I keep choking on what I’m eating, my calcium has rose to 10.5 but last I checked it was 9.9, inr is 1.2 (elevated) potassium low bun low lost 10 lbs in under a month, my anxiety is crippling me so I don’t take care of myself. even the roof of my mouth I can taste blood, in a hot shower it makes me chest breathe feels suffocating. Thumbnails purple when cold. Read I have months to live if I have this

Hi everyone, this is my first post here. Nearly 2 months ago I (21F) went to the ER for chest pain and shortness of breath. I've been using disposable nicotine vapes for 5 years but have cut down drastically in the past 3 months and am now taking about 20 puffs a day. They did blood tests, ECG scans and a chest x ray which all came back perfectly normal. I still haven't recovered and the chest pain has only gotten worse. I'm not wheezing or coughing, just super short of breath and tight in the chest. I went to the doctor a few days ago and he said i might have asthma so I'm now on 2 inhalers which I have listed below. This morning I woke up and every 10 minutes or so I get this feeling like someones gripping my lungs for about 2 seconds then it goes away. I'm actively attempting to quit vaping, I don't smoke anything else. I have anxiety and autism and this has really been impacting my mental health as I cannot seem to get a solid answer of whats going on. I dont want to die or end up in hospital or something so if you think of anything please let me know! I hate going to the hospital and have only ever had kind of shitty experiences so anything to avoid that.

Height and Weight: 170cm, 87kg

Meds I'm on: Quetiapine for sleep since 2019, vortioxetine since 2021, ventolin and rilast inhalers for a few days

From Australia - Don't drink alcohol. Occasional edible.