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Suggest Treatment For Fever And Extreme Fatigue
Question: Hello -- my fiancee has been suffering from low-grade fever and extreme fatigue, on and off, for several months now. She has been taking prescribed cycles of Prednisone to relieve this, but with no specific diagnosis.
She has also had extensive blood tests, but no concrete results. She has also had recurrent early-morning digestive problems -- diaherrea and nausea. Early this morning, a few hours after a slightly indulgent dinner including conch fritters and empanadas, she awoke in severe gastric distress "like knives" in her stomach, and general gastric distress. I ate all of the same foods and have no symptoms. Her paid is low to be in the gall bladder -- lower intestines, she says. She also says her ... rear lower extremities burn like fire. The pain has abated a bit now.
Should we try to get her admitted? Does she need an abdominal ultrasound? She has suffered from the constellation of issues loosely called (and derided) CFIDS / ME (chronic fatigue) and does not think this is a concrete condition, but the reaction specifically after fatty food and the severity of the pain and gastric distress has me concerned. We did not "gorge" on the naughty food, by the way. Two coconut shrimip each, two small fritters, two small empanadas. She also had two alcoholic drinks, which she rarely does.
She has also had extensive blood tests, but no concrete results. She has also had recurrent early-morning digestive problems -- diaherrea and nausea. Early this morning, a few hours after a slightly indulgent dinner including conch fritters and empanadas, she awoke in severe gastric distress "like knives" in her stomach, and general gastric distress. I ate all of the same foods and have no symptoms. Her paid is low to be in the gall bladder -- lower intestines, she says. She also says her ... rear lower extremities burn like fire. The pain has abated a bit now.
Should we try to get her admitted? Does she need an abdominal ultrasound? She has suffered from the constellation of issues loosely called (and derided) CFIDS / ME (chronic fatigue) and does not think this is a concrete condition, but the reaction specifically after fatty food and the severity of the pain and gastric distress has me concerned. We did not "gorge" on the naughty food, by the way. Two coconut shrimip each, two small fritters, two small empanadas. She also had two alcoholic drinks, which she rarely does.
Brief Answer:
Please see description
Detailed Answer:
Hello
My name is Dr Muhammad Ali Rauf & i will look into your problem.
I have gone through the query in detail. As there are multiple issues so i would carry each one separately:
1. Low Grade fever & fatigue:
Chronic low grade fever with fatigue and weight loss(if present) suggests chronic illness and most common is tuberculosis. This needs further workup in hospital by undergoing some investigations like chest X-Ray, CBC, sputum for AFB.
2. Epigastric(stomach pain) Pain:
There are a number of causes for epigastric pain. Most common are Acid Peptic disease, GERD, pancreatitis, heart problem & cholelithiasis. As you mentioned that pain aggravated with food and that to with fatty meal so most common cause of pain with fatty meal is cholelithiasis (stones in gall bladder). They cause severe pain in right upper part of abdomen. Diagnosis can be confirmed by Ultrasound abdomen & LFTs. Does pain occurs every time she eats food or pain gets worse on empty stomach?
3. Allergic Element:
If she gets pain & diarrhea after eating some particular food then there are high chances that you fiancee is allergic to that particular food. In such cases whenever patient takes such food then body responds by symptoms like diarrhea, pain abdomen(particularly in stomach region), itching, rash, etc. So such food should be avoided in any case.
4. Decision for admission & workup:
As you mentioned that she is suffering from severe problem so i would recommend you that she should be admitted in tertiary care hospital where an extensive workup would be required to reach a final diagnosis and yes an ultrasound abdomen would be of great help to rule out pathology of gall bladder & liver.
Conclusion:
> Stomach pain can be due to acid peptic disease, pancreatitis or cholelithiasis.
> low-grade fever needs workup for chronic illness
> Admission is required at hospital for detailed workup including imaging studies & lab tests.
Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing her good health !!
Please see description
Detailed Answer:
Hello
My name is Dr Muhammad Ali Rauf & i will look into your problem.
I have gone through the query in detail. As there are multiple issues so i would carry each one separately:
1. Low Grade fever & fatigue:
Chronic low grade fever with fatigue and weight loss(if present) suggests chronic illness and most common is tuberculosis. This needs further workup in hospital by undergoing some investigations like chest X-Ray, CBC, sputum for AFB.
2. Epigastric(stomach pain) Pain:
There are a number of causes for epigastric pain. Most common are Acid Peptic disease, GERD, pancreatitis, heart problem & cholelithiasis. As you mentioned that pain aggravated with food and that to with fatty meal so most common cause of pain with fatty meal is cholelithiasis (stones in gall bladder). They cause severe pain in right upper part of abdomen. Diagnosis can be confirmed by Ultrasound abdomen & LFTs. Does pain occurs every time she eats food or pain gets worse on empty stomach?
3. Allergic Element:
If she gets pain & diarrhea after eating some particular food then there are high chances that you fiancee is allergic to that particular food. In such cases whenever patient takes such food then body responds by symptoms like diarrhea, pain abdomen(particularly in stomach region), itching, rash, etc. So such food should be avoided in any case.
4. Decision for admission & workup:
As you mentioned that she is suffering from severe problem so i would recommend you that she should be admitted in tertiary care hospital where an extensive workup would be required to reach a final diagnosis and yes an ultrasound abdomen would be of great help to rule out pathology of gall bladder & liver.
Conclusion:
> Stomach pain can be due to acid peptic disease, pancreatitis or cholelithiasis.
> low-grade fever needs workup for chronic illness
> Admission is required at hospital for detailed workup including imaging studies & lab tests.
Hope I have answered your query. If you have any further questions I will be happy to help if not then don't forget to close the discussion and rate it.
Wishing her good health !!
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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