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Suggest Treatment For Persistent Fever, Oral Thrush And Swollen Lymph Nodes
Question: I have multiple Tests everything inculde EBV, CMV, and HIV; All negative. Persisting fever, oral thrush, tinder swollen lymhnodes under armpit, neck, groin, Hot burning sensation in feet. Diarrehia etc. I cant sleep in nights since so much feversh in body.
I went to almost 4-5 different doctors and everybody doing same tests and nothing have been found yet.
I hope you guys atleast help
I went to almost 4-5 different doctors and everybody doing same tests and nothing have been found yet.
I hope you guys atleast help
Brief Answer:
Needs thorough investigation
Detailed Answer:
Hello,
persistent fever requires thorough investigation. EBV, CMV and HIV are a good place to start but many more tests are needed, including radiological ones. Very useful to consider include the complete blood count, erythrocyte sedimentation rate, c-reactive protein (quantitative measurement), liver function tests, chest X-ray, urinalysis, computed tomography of the upper and lower abdomen. Depending on the results other tests might be considered like bone marrow examination etc
If you've done more tests and can upload the results, it would be helpful for me. You can also describe your symptoms and duration in more detail. How high was the fever? When did the fever start? Have you lost weight? etc
If you'd like more information, you can continue this discussion. I'll be glad to help.
Kind Regards!
Needs thorough investigation
Detailed Answer:
Hello,
persistent fever requires thorough investigation. EBV, CMV and HIV are a good place to start but many more tests are needed, including radiological ones. Very useful to consider include the complete blood count, erythrocyte sedimentation rate, c-reactive protein (quantitative measurement), liver function tests, chest X-ray, urinalysis, computed tomography of the upper and lower abdomen. Depending on the results other tests might be considered like bone marrow examination etc
If you've done more tests and can upload the results, it would be helpful for me. You can also describe your symptoms and duration in more detail. How high was the fever? When did the fever start? Have you lost weight? etc
If you'd like more information, you can continue this discussion. I'll be glad to help.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have done complete blodd count, chest X ray, Liver ultrasound, ESR, chest X ra, urinalysis, Tb and all are normal/negative.
The symptoms were started after 10 days, sex woth a unknown girl. The sysmptoms are persisting from 16 months. During first 10 months i tested 8 Hiv tests include, RNA and antibody all negative.
4 months ago i started sex with my wife, she also experiencing same symptoms fever, burining hands and feet sorethroat, pink eyes etc. I am sure i trasffered to her during sexual contact.
But i have verified HIV tests for 10 months with 8 times of tests before i was sex with my wife. after sex, she also experciencing same symptoms. We are so depressed now.
The symptoms were started after 10 days, sex woth a unknown girl. The sysmptoms are persisting from 16 months. During first 10 months i tested 8 Hiv tests include, RNA and antibody all negative.
4 months ago i started sex with my wife, she also experiencing same symptoms fever, burining hands and feet sorethroat, pink eyes etc. I am sure i trasffered to her during sexual contact.
But i have verified HIV tests for 10 months with 8 times of tests before i was sex with my wife. after sex, she also experciencing same symptoms. We are so depressed now.
Brief Answer:
I don't believe this is caused by any sexually transmitted disease
Detailed Answer:
Hi,
I can't imagine of any sexually transmitted disease that can't be detected in the standard investigation for fever of unknown origin. Perhaps other causes have to be considered. Do you travel in developing countries? Do you have any pets? Any other contact with animals? Illicit drug use? Will you please name the tests you've done so far?
I don't believe this is caused by any sexually transmitted disease
Detailed Answer:
Hi,
I can't imagine of any sexually transmitted disease that can't be detected in the standard investigation for fever of unknown origin. Perhaps other causes have to be considered. Do you travel in developing countries? Do you have any pets? Any other contact with animals? Illicit drug use? Will you please name the tests you've done so far?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The sysmptoms started after 10 days after sex with a unknown girl, i dont think this is problem related to travel; i dont have any pets, no contact with animals, No drug use.
1. Complete blood count-7 times during 12 months
2. HiV antibody 2, 8, 15, 24, 36 weeks Negative
3. Hiv PCR RNA 5, 15, 42 weeks negative
4. EBV, CMV IDM negative, IGG postive
5. Chest Xray two times ngative/normal
6.Liver ultrasound Negative
7. STD panel include HepA/b/c negative 5 weeks
9.Tb negative two times.
My wife has also experineced same symptoms after sex. I defintely this is some thing dicease geeting via sexual contact.
1. Complete blood count-7 times during 12 months
2. HiV antibody 2, 8, 15, 24, 36 weeks Negative
3. Hiv PCR RNA 5, 15, 42 weeks negative
4. EBV, CMV IDM negative, IGG postive
5. Chest Xray two times ngative/normal
6.Liver ultrasound Negative
7. STD panel include HepA/b/c negative 5 weeks
9.Tb negative two times.
My wife has also experineced same symptoms after sex. I defintely this is some thing dicease geeting via sexual contact.
Brief Answer:
More tests are needed to exclude the most common causes
Detailed Answer:
Hi,
if the tests you've mentioned are all the tests you've done so far, then you're going to need more tests until the most common causes have been excluded.
I'll mention them:
- testing for various pathogens like rikettsiae, spirochetal diseases, testing for endocarditis etc.
- blood cultures
- computed tomography of the abdomen (upper and lower): this test may help to detect and abscess for example or swollen lymph nodes in the abdomen.
- testing for rheumatological/immune diseases: antinuclear antibodies and rheumatoid factor would be a good initial test. Other tests might be needed depending on the clinical picture and the results.
- if all of the above are negative then bone marrow examination might be helpful.
Kind Regards!
More tests are needed to exclude the most common causes
Detailed Answer:
Hi,
if the tests you've mentioned are all the tests you've done so far, then you're going to need more tests until the most common causes have been excluded.
I'll mention them:
- testing for various pathogens like rikettsiae, spirochetal diseases, testing for endocarditis etc.
- blood cultures
- computed tomography of the abdomen (upper and lower): this test may help to detect and abscess for example or swollen lymph nodes in the abdomen.
- testing for rheumatological/immune diseases: antinuclear antibodies and rheumatoid factor would be a good initial test. Other tests might be needed depending on the clinical picture and the results.
- if all of the above are negative then bone marrow examination might be helpful.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Do we need more Hiv tests? My wife have also same symptoms after we have sex.
The persisting fever, intense burning pain in feet and hand, thrush, swollen lymphnodes due to what ?? in both of me and my wife??
Dr, Dont you think this contagious febrile illness??
Do we need bone marrow tests in both of me and my wife??
The persisting fever, intense burning pain in feet and hand, thrush, swollen lymphnodes due to what ?? in both of me and my wife??
Dr, Dont you think this contagious febrile illness??
Do we need bone marrow tests in both of me and my wife??
Brief Answer:
No more HIV tests, I'll explain in full answer
Detailed Answer:
Hi,
testing for HIV more than 6 months after the suspicious event (particularly after having done RNA testing) is futile, so it's not recommended. I can't say if it's a contagious febrile illness or not but in cases like this the tests I've mentioned are very important. Having swollen lymph nodes, without positive inflammation markers (like ESR, CRP) needs investigation for hematological diseases. In such cases bone marrow testing is the best way to find out. If both of you have the same clinical picture then both of you should undergo testing.
I do understand your reasoning. Two people with the same symptoms usually have a contagious disease but it has to be proved! Checking for pathogens is imperative but other testing should go on as well. Rikettsial, spirochetal, chlamydial diseases, parasites (like toxoplasmosis) etc can be checked and confirmed or ruled out fairly easily (after 16 months!).
No more HIV tests, I'll explain in full answer
Detailed Answer:
Hi,
testing for HIV more than 6 months after the suspicious event (particularly after having done RNA testing) is futile, so it's not recommended. I can't say if it's a contagious febrile illness or not but in cases like this the tests I've mentioned are very important. Having swollen lymph nodes, without positive inflammation markers (like ESR, CRP) needs investigation for hematological diseases. In such cases bone marrow testing is the best way to find out. If both of you have the same clinical picture then both of you should undergo testing.
I do understand your reasoning. Two people with the same symptoms usually have a contagious disease but it has to be proved! Checking for pathogens is imperative but other testing should go on as well. Rikettsial, spirochetal, chlamydial diseases, parasites (like toxoplasmosis) etc can be checked and confirmed or ruled out fairly easily (after 16 months!).
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
After my exposure with unknown girl, I have waited 10 months and tested 8-10 hiv tests all were negative. So dr said ok I can have sex with my wife.
But after, I sex with my wife at 11 month and then 20 days after my wife has started febrile illness sore throat body aches etc..
I feel horrible because I took all guidance from dr and went so many tests to make sure I don't want to get all this to my wife. But, my wife has all symptoms which I have , so we both depressed. This seems a cantgious disease .
We can't have baby now??
Every night feel horrible with fever all over body and burning pain in feet and hands.
Please help if you have any information
But after, I sex with my wife at 11 month and then 20 days after my wife has started febrile illness sore throat body aches etc..
I feel horrible because I took all guidance from dr and went so many tests to make sure I don't want to get all this to my wife. But, my wife has all symptoms which I have , so we both depressed. This seems a cantgious disease .
We can't have baby now??
Every night feel horrible with fever all over body and burning pain in feet and hands.
Please help if you have any information
Brief Answer:
I'll mention some specific pathogens
Detailed Answer:
Hi,
I've already described to you the strategy for the investigation of fever of unknown origin (FUO). I'll mention some specific pathogens that have to be checked, if you haven't done so already.
Most of the testing can be done with simple blood tests - and I suppose that your doctor has ordered them.
- various rikettsiae like coxiella burnetti.
- parasites like toxoplasma, leishmania or trypanosoma.
- herpes viruses
- a sexually transmitted disease (STD) called lymphogranuloma venereum, which may rarely present with FUO.
- brucella
- various chlamydiae, like chlamydophila psittaci.
- pathogens that cause endocarditis (many) - blood cultures are needed to detect them.
If there is any defect in your immune system then many more pathogens have to be considered including fungi and rare pathogens.
I really hope you find what's wrong. Please take into account that more than 10% of FUO cases remain undiagnosed even after extensive investigation. Most of the undiagnosed patients (up to 75%) get well after a few months without ever identifying the cause.
Best wishes for your health!
I'll mention some specific pathogens
Detailed Answer:
Hi,
I've already described to you the strategy for the investigation of fever of unknown origin (FUO). I'll mention some specific pathogens that have to be checked, if you haven't done so already.
Most of the testing can be done with simple blood tests - and I suppose that your doctor has ordered them.
- various rikettsiae like coxiella burnetti.
- parasites like toxoplasma, leishmania or trypanosoma.
- herpes viruses
- a sexually transmitted disease (STD) called lymphogranuloma venereum, which may rarely present with FUO.
- brucella
- various chlamydiae, like chlamydophila psittaci.
- pathogens that cause endocarditis (many) - blood cultures are needed to detect them.
If there is any defect in your immune system then many more pathogens have to be considered including fungi and rare pathogens.
I really hope you find what's wrong. Please take into account that more than 10% of FUO cases remain undiagnosed even after extensive investigation. Most of the undiagnosed patients (up to 75%) get well after a few months without ever identifying the cause.
Best wishes for your health!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Mine already 16 months crossed. But the symptoms persisting.
Thank you for some elaboration.. Everyday I hope that I will get better one day.
the problems here is dr write only complete blood count and it always come negative. So drs have nothing to do other than saying there is no infection. I try convince them order more tests by telling all of my symptoms.. But there was no help. They just do CBC and that's it.
We both me and wife depressed with this unknown dicease.
Thank you for some elaboration.. Everyday I hope that I will get better one day.
the problems here is dr write only complete blood count and it always come negative. So drs have nothing to do other than saying there is no infection. I try convince them order more tests by telling all of my symptoms.. But there was no help. They just do CBC and that's it.
We both me and wife depressed with this unknown dicease.
Brief Answer:
Why don't you try to exclude my list?
Detailed Answer:
I see...
I don't know why your doctors do not want to investigate it any further but I would suggest to you to try my list of pathogens. Actually this is not MY list. It's common knowledge that these pathogens may cause FUO. Also please give a try to the other potential causes like the autoimmune diseases and the hematologic ones.
I really hope you do find the solution...
Kind Regards!
Why don't you try to exclude my list?
Detailed Answer:
I see...
I don't know why your doctors do not want to investigate it any further but I would suggest to you to try my list of pathogens. Actually this is not MY list. It's common knowledge that these pathogens may cause FUO. Also please give a try to the other potential causes like the autoimmune diseases and the hematologic ones.
I really hope you do find the solution...
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
One last question dr,
We want, me and wife go for a baby. What do you think in this situation??
My wife never examined for hiv test, Does she needed after this persisting sysmptoms?? But I did 8-10 time of testing before our marriage and sex life?? She started symptoms after we both had sex.
Does she need a hiv test to exclude completely hiv is our problem??
We want, me and wife go for a baby. What do you think in this situation??
My wife never examined for hiv test, Does she needed after this persisting sysmptoms?? But I did 8-10 time of testing before our marriage and sex life?? She started symptoms after we both had sex.
Does she need a hiv test to exclude completely hiv is our problem??
Brief Answer:
Everyone of you should be tested individually
Detailed Answer:
Hi,
regarding HIV testing, everyone should be tested individually, like if you were complete strangers. I do not consider this a major risk for her, since you're negative after repeated testing.
Regarding having a baby, I believe that your issues should be adequately clarified before you start trying - for many reasons. The most important one is that you may need to receive toxic treatment, which is not great news for a pregnant woman.
I advise you to continue and conclude the basic testing (please refer to my previous answer) before taking any decisions.
Kind Regards!
Everyone of you should be tested individually
Detailed Answer:
Hi,
regarding HIV testing, everyone should be tested individually, like if you were complete strangers. I do not consider this a major risk for her, since you're negative after repeated testing.
Regarding having a baby, I believe that your issues should be adequately clarified before you start trying - for many reasons. The most important one is that you may need to receive toxic treatment, which is not great news for a pregnant woman.
I advise you to continue and conclude the basic testing (please refer to my previous answer) before taking any decisions.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I don't understand why we require toxic treatmen??
Brief Answer:
You don't right now, but you may require treatment in the future
Detailed Answer:
Hi,
I'll explain what I meant. Right now, no diagnosis has been established, so no treatment can be given. Sometimes broad spectrum treatments can be given depending on test results though, when the investigation process has come to a dead end.
In the future, if your symptoms continue to be present, a diagnosis can potentially be established. Treating the unknown (right now) disease may require toxic treatments like chemotherapeutic agents, antiviral agents, long-term antibiotic treatment, corticosteroids etc that may impair normal development of the fetus. Or it may not... I can't say... but can you take such a risk?
I hope it's more clear now!
Kind Regards!
You don't right now, but you may require treatment in the future
Detailed Answer:
Hi,
I'll explain what I meant. Right now, no diagnosis has been established, so no treatment can be given. Sometimes broad spectrum treatments can be given depending on test results though, when the investigation process has come to a dead end.
In the future, if your symptoms continue to be present, a diagnosis can potentially be established. Treating the unknown (right now) disease may require toxic treatments like chemotherapeutic agents, antiviral agents, long-term antibiotic treatment, corticosteroids etc that may impair normal development of the fetus. Or it may not... I can't say... but can you take such a risk?
I hope it's more clear now!
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You created more panic in my mind. If that situation comes to me it has not in my hands, god may decide everything.
We try to go dr and donate blood as much as possible for this unknown diagnosis.. but nothing has been revealed yet. I think its all depends on luck or something.
I went to almost 4-5 doctors including infectious doctors.. they all good drs in our town but nothing has been found yet. I have to trust them since they doing their duty check for blood but nothing has been found yet.
Dr, Thanks for your time and help.
We try to go dr and donate blood as much as possible for this unknown diagnosis.. but nothing has been revealed yet. I think its all depends on luck or something.
I went to almost 4-5 doctors including infectious doctors.. they all good drs in our town but nothing has been found yet. I have to trust them since they doing their duty check for blood but nothing has been found yet.
Dr, Thanks for your time and help.
Brief Answer:
You're welcome
Detailed Answer:
You're welcome.
I'm sorry that I can't provide a real solution for you.
I can only provide ideas towards the solution.
Of course you should trust your doctors!
The very fact that all 5 of them couldn't reveal the real cause and treat it, proves that it's not due to the incompetency of any one of them. It's just a tough case.
Despite that I suggest that you proceed with further testing (including all the causes that I've mentioned in my previous answers) before giving up.
My best wishes for both of you!
You're welcome
Detailed Answer:
You're welcome.
I'm sorry that I can't provide a real solution for you.
I can only provide ideas towards the solution.
Of course you should trust your doctors!
The very fact that all 5 of them couldn't reveal the real cause and treat it, proves that it's not due to the incompetency of any one of them. It's just a tough case.
Despite that I suggest that you proceed with further testing (including all the causes that I've mentioned in my previous answers) before giving up.
My best wishes for both of you!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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