Discussions By Condition: I cannot get a diagnosis.

Unknown Fever

Posted In: I cannot get a diagnosis. 6 Replies
  • Posted By: mksadhvani
  • October 7, 2007
  • 00:38 PM

My wife(38 years) has had fever for the last 17 days with the foll. symptoms....

Extreme Body Pain, more frequent fever recurrence in the nights, no cough/ cold symptoms.

After a week of fever, a doc asked us for the foll. tests..
ESR(25),
CBP(WBC 28000, RBC 11.2),
LFT(ALT/SGPT-54; AST/SGOT-78),
FNAC of Cervical Lymph Nodes(suspected Lymphatic TB) as they were enlarged(was clear and the assessment was to conside viral aeitology),
Chest X ray (was also clear)

Despite these results doc made my wife start the anti-TB medication which made her condition worse(Loss of appetite/ Fever/ Stomach upsets). So she stopped taking those medications after 3 days.

We visited a 2nd physician(who said TB is not possible) who suggested that we do further tests and ran Urine microscopy /Urine Culture/ ESR/CBP/LFT/ Vidals test(for ruling out cholera). All results so far have been negative with respect to cholera, UTI. The other parameters remained more or less unchanged.

He has now suggested an ultasound of the abdomen, Mantoux test(TB again?)... Whats happening here ... Can some one with similar symptoms revert back to us with ideas.. what to look for???

Thanks
MKSadhvani.

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6 Replies:

  • The WBC count is actually 2800 and not 28000 as per my previous post. Also we did another LFT today... and the readings are SGOT(212); SGPT(160); However Bilirubin is at 0.13.... However physician is yet saying it is Typhoid considering clinical symptoms(Vidal test is negative, but he believes it will show up in the blood culture in 2 weeks time) She is also complaining abt abdominal pain...I am thinking more on lines of Hepatitis/ Abcess in Liver(or abdomen)/Liver tumor... So he has asked her to go for an ultrasound...... I am totally confused.... because I am not a doc. and what the physician says does not seem to make sense,,,, does anyone have similar experience,,, & obtain a proper diagnosis??mks
    mksadhvani 3 Replies
    • October 7, 2007
    • 06:15 PM
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  • How about getting an abdominal/pelvic ct (cat scan) along with an ultrasound? The liver enzymes are going up... maybe a virus or some other bug affecting the liver is going on? You wrote:FNAC of Cervical Lymph Nodes(suspected Lymphatic TB) as they were enlarged(was clear and the assessment was to consider viral etiology),Good luck; I hope your wife feels better soon and gets a diagnosis for her fever and severe body pain. Sounds like they should consider viral causes... given the lymph node result and the increasing elevation of the liver enzymes.BTW How old is your wife? Was she tested for Mono (Epstein Barr), Hepatitis and other viruses that can cause liver enzymes to elevate? Do you have a school nearby with a good infectious diseases department or have you been to one already? If the more common viruses get ruled out you may need to see such a specialist to look into the less common or trickier viruses to diagnose (if it is a virus). And a specialist can also rule out illnesses that look similar to a virus infectoon such as some auto immune disorders.I hope things get better for both of you soon.My wife(38 years) has had fever for the last 17 days with the foll. symptoms.... Extreme Body Pain, more frequent fever recurrence in the nights, no cough/ cold symptoms. After a week of fever, a doc asked us for the foll. tests..ESR(25), CBP(WBC 28000, RBC 11.2), LFT(ALT/SGPT-54; AST/SGOT-78),FNAC of Cervical Lymph Nodes(suspected Lymphatic TB) as they were enlarged(was clear and the assessment was to conside viral aeitology),Chest X ray (was also clear) Despite these results doc made my wife start the anti-TB medication which made her condition worse(Loss of appetite/ Fever/ Stomach upsets). So she stopped taking those medications after 3 days. We visited a 2nd physician(who said TB is not possible) who suggested that we do further tests and ran Urine microscopy /Urine Culture/ ESR/CBP/LFT/ Vidals test(for ruling out cholera). All results so far have been negative with respect to cholera, UTI. The other parameters remained more or less unchanged. He has now suggested an ultasound of the abdomen, Mantoux test(TB again?)... Whats happening here ... Can some one with similar symptoms revert back to us with ideas.. what to look for??? ThanksMKSadhvani.
    Anonymous 42789 Replies
    • October 11, 2007
    • 06:34 PM
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  • Thanks for the reply Liver enzymes are even higher now... 750 & 900, even though fever seems to be subsiding... did an ultrasound abdomen,,, liver was slightly inflammated ....so we did hepatitis a/b/c/e tests... B&C are negative...waiting for results of A/E... What else can the higher enzymes indicate... she is a non-drinker..eats moderately... age is 38.. if that is not positive, will have to consider biopsy of lymph nodes....for lymhoma...lets hope for the best mks
    mksadhvani 3 Replies
    • October 12, 2007
    • 06:17 AM
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  • Hi- have any tests for rheumatoid/autoimmune disease been considered? Examples would include ANA, RF, etc. Does she have any swelling of joints? Are her eyes red? Any lymph node swelling? Other symptoms? Weight loss? Dark urine? Skin changes? Pain with eating? I'll keep thinking about this one, and post again if I come up with anything...
    Anonymous 42789 Replies
    • October 12, 2007
    • 06:39 AM
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  • Hello again, No other tests have been done yet...until we get results of the HepA/E... Swelling of joints not present.... Eyes are not red Loss of appetite and extreme weakness,,, even though the percentage weight loss(1-2 kg) is not too much considering that she weighs only 45 kgs... Keep me posted... meanwhile i will update if i hv any further info.... Thanks... Mahesh
    mksadhvani 3 Replies
    • October 12, 2007
    • 06:51 AM
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  • could it be a viral hepatitis? have you been to malaria area in last year. TB is worth ruling out, its not impossible. what about HIV test?
    Anonymous 42789 Replies
    • October 12, 2007
    • 09:28 AM
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