Lower Back Pain After Pneumonia: Causes & Relief

Question
Hi Pam:  It looks like you've got a really comprehensive background and have seen it all, so I hope you might be able to help me.   I was diagnosed with bilateral bacterial pneumonia a week ago. Spent 3 days in a hospital on bed rest under IV and antibiotics (lavaquin and vancomycin). Was released home to continue a 10-day course of lavaquin. My breathing is normal with occasional shortness after stairs, but I seem to have developed a sharp pain in my lower left back/side. For a few days, it felt like a muscle spasm or pinched nerve, but starting today the pain is localized in under the lower back rib cage. Hurts badly on coughing, burping, etc, and seems particularly bad at night, when lying down (even though I can only sleep on my back). All the vitals are normal. No health issues. Never smoked, eat healthy, stay active. Is this pain pluresy or some internal organ issue? I have been taking Acetamenophen. I had an x-ray today and the technician read the x-ray with me and said the left lung looked still half filled, and a doctor on the phone said it could be fluid, which seemed like pleural effusion - could it be pleural effusion?  Also, is it normal that the first treatment in the hospital and afterwards of antibiotics will not resolve the situation, and therefore to still need to take a second course of antibiotics?  Thank you so much, Ellen

Answer
Dear Ellen,

Thank you for writing in. Pneumonia is a serious infection of the lungs. As you know, it is difficult for oxygen exchange to take place, and therefore shortness of breath occurs. The pain you are describing sounds like pleurisy.  The X-ray does suggest plural effusion, which is fluid between the chest wall and the lung. If it does not clear on its own, it will need to be aspirated since it further compromises the ability for the lung to fully expand in the thoracic cavity, causing the shortness of breath you are describing. There are several causes of pleural effusion, with infection and inflammation being only a couple of them. Once the fluid is aspirated, it will be sent to microbiology for further examination.

I strongly recommend you seek the consultation of a pulmonologist. This type of physician only deals with lung infections and infections of the respiratory tract. They are experts in their field. And there is a good possibility that you were seen by one while you were in the hospital.
Please let me know if there is anything further I may assist you with.