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Hi, Six Weeks Ago I Developed A Sudden Fever Of
Question: Hi, Six weeks ago I developed a sudden fever of 100.5 to just over 101 with body aches, chills, sweating, and mild headache and muscle aches. It lasted for four days, then went away for three. As soon as the fever went away, I felt fine (no aches or headache). The fever returned two more times, each time for about four days with a break in between where I felt tired but okay. Each time it returned, the fever went higher (the last time it stayed in the 102-103 range) and the headaches were bad and in the front of my head. After the last fever, my temp stayed just below 100 for a week or so, and my doctor put me on an antibiotic for possible Lyme disease, and on day three of the antibiotic, my temp dropped to normal and has stayed there. The fevers and headache are gone, but I have SEVERE fatigue. I can't walk any distance, I get exhausted shampooing my hair even using a shower chair. I was tired for a month or so before the first fever but not sick. Prior to that, I was very active and strong, and could easily do hard physical work for hours without tiring. Now I struggle to do dishes, can't carry laundry, get short of breath with any exertion, etc. Any advice? WBC is normal, platelets were a little low, albumin a little low, calcium a little low, B12 high (though I'm a vegetarian and haven't take a supplement for quite some time). Chest x-rays, mammogram, and pelvic exams are all fine. Thyroid is fine, West Nile is negative, Lyme test done early on was negative, but I'd been in the woods/meadows within a few weeks of the fever so it could be too early for the test to show up positive. The only other symptom I had was some chest pain that I thought was esophageal spasm (which I've had before) but it felt somewhat different, and I also felt a little heart fluttering a few times. Any suggestions?
Brief Answer:
Possible causes and some tests examinations to investigate the cause of fatigue explained below
Detailed Answer:
Hello and welcome to "Ask a Doctor" service,
I carefully read your query.
Fatigue can be a symptom caused by many conditions and a long time may pass before the patient is definitely diagnosed and treated. In your case, because you have gone from a very active woman to have it difficult to do simple daily activities, thorough examination and tests may be indicated.
You have mentioned several tests you have already done, you may have done other tests as well but I am going to make a list of possible helpful examinations to pinpoint the cause of fatigue.
A thorough physical examination (including a neurological exam that evaluates your balance, muscle strength, reflexes and muscular tone) is very important and also the following tests can be ordered:
- ERS and CRP (to see if there is something your body is fighting)
- liver function tests (ALT, AST, Bilirubin), kidney function tests (electrolytes such as Na+, Cl-, K+ and also creatinine)
- fasting blood glucose or HbA1C (to rule out diabetes)
- RF and ANA are some antibodies to check for autoimmune conditions
- Test for EBV (because you started with symptoms similar to a viral infection and because EBV may cause lasting fatigue, it is good to have this test done)
- ECG and heart ultrasound to check your heart
- check for lymph nodes in your armpits, groin area, neck, etc
- tests for hepatitis B, C, and HIV as routine checks in case of fatigue
- sleep tests may be indicated if problems with sleep are suspected as the cause of fatigue
- side effects of medications should be considered if you have been using anything in the last months.
- screening for depression and anxiety (these are questionaries that may help identify possible mood and anxiety problems which may also cause fatigue).
I hope this answers your query.
I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
Possible causes and some tests examinations to investigate the cause of fatigue explained below
Detailed Answer:
Hello and welcome to "Ask a Doctor" service,
I carefully read your query.
Fatigue can be a symptom caused by many conditions and a long time may pass before the patient is definitely diagnosed and treated. In your case, because you have gone from a very active woman to have it difficult to do simple daily activities, thorough examination and tests may be indicated.
You have mentioned several tests you have already done, you may have done other tests as well but I am going to make a list of possible helpful examinations to pinpoint the cause of fatigue.
A thorough physical examination (including a neurological exam that evaluates your balance, muscle strength, reflexes and muscular tone) is very important and also the following tests can be ordered:
- ERS and CRP (to see if there is something your body is fighting)
- liver function tests (ALT, AST, Bilirubin), kidney function tests (electrolytes such as Na+, Cl-, K+ and also creatinine)
- fasting blood glucose or HbA1C (to rule out diabetes)
- RF and ANA are some antibodies to check for autoimmune conditions
- Test for EBV (because you started with symptoms similar to a viral infection and because EBV may cause lasting fatigue, it is good to have this test done)
- ECG and heart ultrasound to check your heart
- check for lymph nodes in your armpits, groin area, neck, etc
- tests for hepatitis B, C, and HIV as routine checks in case of fatigue
- sleep tests may be indicated if problems with sleep are suspected as the cause of fatigue
- side effects of medications should be considered if you have been using anything in the last months.
- screening for depression and anxiety (these are questionaries that may help identify possible mood and anxiety problems which may also cause fatigue).
I hope this answers your query.
I remain at your disposal in case further medical assistance is needed.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
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Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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