I am 19, male, a student, seemingly healthy, fit. However, I am deeply, deeply anxious, and am presenting with a baffling clinical history. I would greatly appreciate some help.
My story begins way back in April, when I was on holiday with my family. One day, around the middle of the month, I developed a pain in my scrotum, with a small bump on the right testicle. About the same time, I started having night sweats - severe enough that they would soak my sheets and wake me up. I also found myself to be passing stools that were runny, frequent, and containing undigested bits of food (type 5 or 6 on the Bristol Stool Scale). This continued for a week or so, and, though the testicular pain subsided, the small bump remained.
I went back to university a couple of weeks later, and the night sweats and mild diarrhea continued. I had also noticed a swollen lymph node - flat, 0.5 cm, firm (rubbery), mobile, painless - on the middle of the right-hand side of my neck, in the superficial lateral chain. Fearing the persistent (but unchanging) bump on my testicle, I booked a doctor's appointment that occurred a week later.
Between then and the appointment, I noticed I also had swollen nodes on both sides of my groin (numerous, firm, mobile, painless, size of 0.4 - 1.5 cm), a couple of shotty nodes of about 0.3 cm diameter on the right side of my neck beneath my ear by the end of my jaw, a single (firm, mobile, painless, bean-shaped) node of 1.0 - 1.5 cm length in the left jugulodigastric region, and three or four similar nodes in my right armpit.
I explained all these symptoms to the doctor, and had a physical examination. She believed none of the nodes to be clinically significant, despite my other symptoms (sweats, stools), and, though not concerned about my testicle, referred me for a scrotal ultrasound. I had also begun to feel incredibly thirsty most of the time, regardless of the amount of liquid I consumed.
One day soon after, after eating lunch, I felt incredibly queasy. I decided that, for a day or so, I should be more cautious with my eating. There was also one occasion around this time that I felt rather light-headed and nauseous during a class.
Gradually, though, the symptoms subsided. The testicular bump disappeared, the night sweats stopped, I ceased feeling constantly thirsty, and the stools returned to normal. By this time, I had had comprehensive (but basic) blood tests done - complete blood count, liver function, monospot - and they had all returned normal, though I had a slightly raised white blood cell count, of which around 70% were neutrophils, and 15% lymphocytes. I had seen a couple of other doctors, and they, too, had assured me that, in all likelihood, all was well.
Nonetheless, the lymph nodes did not subside, and the other symptoms have come and gone since: although the night sweats have not returned with such a vengeance, I have had recurrences of the strange mild diarrhea, thirst, and light-headedness. Ten days ago, I went to another doctor back home, who felt my neck lymph nodes and also thought they were normal, but referred me for blood tests the next day anyway. The results were again normal, though the WBC and neutrophil counts were both elevated (the former, I suspect, because of the latter), and the pathologist noted that an "occasional hypogranular neutrophil" was seen.
I have just returned from a holiday sight-seeing in Rome with some friends. During that time, my mind was occupied by other things, and, with the sole exception of the persisting lymphadenopathy, I experienced no other symptoms. On returning home, however, I am not so sure, having spent a day or so feeling queasy again, and having suddenly begun to feel very fatigued.
Does anyone know what could present in this unusual drawn-out way? I have not come across any case of lymphoma with this presentation, though undoubtedly I do exhibit a few of its characteristic symptoms. My past medical history (about three years ago) includes immunotherapy for hay fever - a course of injections of grass pollen allergen bound to a monophosphoryl lipid A substrate - and I am worried that that has provoked some obscure T cell mutation. On the other hand, I think that my symptoms do closely match those of some forms of acquired Toxoplasmosis, and so I am wondering if there are presentations of that which match mine. I do have two cats at home, and am fairly adventurous with what I eat, though I cannot remember so far back to pick out an incident which may have caused me to become infected.
Basically, I am worried, even if my doctors aren't. I just wish to feel well again, and no longer to feel those blasted nodes. Thanks for reading, and sorry for the length.
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