Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Thank you for asking on HCM!

I understand your concern, and would explain that it is necessary to perform a comprehensive differential diagnosis between different infectious disorders and autoimmune disorder, which may mimic this clinical scenario.

I recommend consulting with the GP for a careful physical examination and some blood lab test :

- complete blood count
- inflammation tests (PCR, sedimentation rate, fibrinogen)
- kidney and liver function tests
- blood electroltes
- fasting glucose
- Lactate dehydrogenaze plasma levels

and an urine analysis.

Immunological blood lab tests such as: Rheumatoid factor, ANA, XXXXXXX ENA, anti streptolyzine O titer, Complement plasma levels, C3/C4 plasma levels, etc to rule in/out a possible immunological disorder. (These disorders are commonly associated with fever and joint stiffness.)

Further tests for specific infectious disorders are needed (Weil XXXXXXX Wright, Widal, etc) to exclude some main infectious disorders.

Hope to have been helpful!

Best wishes,

Dr. Iliri

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Brief Answer:
An infectious disease specialist opinion is necessary.

Detailed Answer:

Hi again,

Coming to this point (your husband has a history of Lyme disease), I would recommend consulting immediately an infectious disease specialist, as a possible Lyme relapse should be ruled in/out. Besides a careful physical exam and the above mentioned tests, some specific tests like elispot, lymespot, lymphocyte transformation tests, some CD markers, etc. should be checked.

Remember that Lyme disease needs a very long treatment (several weeks to months) and a careful follow up, to avoid if possible chronic disease evolution.

Best regards,

Dr. Iliri

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