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You could have had a flare up without infection. You can't bug your doctor every time you have a flare up. Don't beat yourself up about it. I have had two pretty tough flare ups and several minor ones the past year. I did not call the doctor. I did my flare up plan daily (breathing exercises, inhaler, meds, etc), and got them to clear up. Also, if I had a temperature of 99, I would not even give it another thought. Since, 98.6 is normal temp, 99 doesn't exactly scare me. When I had pneumonia in Oct 2021, I did not have a fever. The only reason I went to the ER was because I was coughing up a lot of blood from my lungs. That ended up being a 5 day stay in ICU. Afterwards diagnosed as mycobacterial pneumonia and Moderate COPD. The COPD most likely weakened your immune system and made you a little more susceptible to pneumonia. My lungs have not recovered fully and never will. All we can do as COPD sufferers is do our best to control it and keep it at bay for as long as possible. I am sorry if I took your post in the wrong way. The way you worded it made it sound as if you were blaming yourself for not jumping on the flare up right then and there. Most likely, the pneumonia is what caused the flare up. The temp rise was your bodies way of saying, "I am hurting, go to the doctor". I also know this post was a warning to all sufferers to not ignore symptoms of a bad flare up. One more thing, if you do not have an emergency flare up plan, get with your medical providers and discuss getting a plan together. Take care and God Bless