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Suggest Treatment For Chronic Fever And Swelling On Left Side
Question: You will need to refer to my most previous questions to help me. I am still suffering from fever every day now for almost two months. It gets up to 102 if I don't get enough aspirin, tylenol or ibuprofen in me. I also still have the swelling on my left side and now it has progressed all the way up to the base of my neck.
This has been the most frustrating medical event of my life. I have had chest xrays, mri, ctscan and 3 weeks ago today I had an ultrasound guided fine needle biopsy at the request of my doctor. I was supposed to get results in 5-7 days. One week passed and i called my doctor to see what it said. I was told he left on vacation to Europe for two weeks and nobody there knew anything about it. This a a small farming community. I kept calling to see if there was any report and there was none. My doctor finally returned Monday of this week and he went to work calling the lab. It seems the lab that took the biopsy sent my tissue samples on to a university for more testing as they could find nothing other than (reactive lymph gland). The university med center kept saying that they had nothing to report until today. My doctor called and said they told him there was not enough tissue to adequately test. So here I am back where I started. I am getting sicker and sicker. I am going in to see my doctor tomorrow and I think I will tell him I want all my records and am taking them to the big city to an internist. Do you think I should do this and do you have any idea what could be wrong with me? thank you.
This has been the most frustrating medical event of my life. I have had chest xrays, mri, ctscan and 3 weeks ago today I had an ultrasound guided fine needle biopsy at the request of my doctor. I was supposed to get results in 5-7 days. One week passed and i called my doctor to see what it said. I was told he left on vacation to Europe for two weeks and nobody there knew anything about it. This a a small farming community. I kept calling to see if there was any report and there was none. My doctor finally returned Monday of this week and he went to work calling the lab. It seems the lab that took the biopsy sent my tissue samples on to a university for more testing as they could find nothing other than (reactive lymph gland). The university med center kept saying that they had nothing to report until today. My doctor called and said they told him there was not enough tissue to adequately test. So here I am back where I started. I am getting sicker and sicker. I am going in to see my doctor tomorrow and I think I will tell him I want all my records and am taking them to the big city to an internist. Do you think I should do this and do you have any idea what could be wrong with me? thank you.
Brief Answer:
Tumor and medication require further evaluation
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Looking at the continuing clinical symptoms, my opinion is as follows:
1. It could be a chronic inflammatory response to infection or medication induced or possible tumor.
2. Did the MRI scan detect any other lymph nodes in the body?
3. The new swelling at base of neck, is it painful. Is it lymph nodes?
4. At present, what are the medications you are on? Need full list including chronic conditions treatment being taken if any?
5. If its a new swelling? FNAC will be required again. Can you attach recent hematological investigation along with other reports?
6. Inflammation this long, hematological abnormalities should have been present. Tumor and medications needs further evaluation.
Please get back with recent investigations.
Take care
Dr. Prakash HM
Tumor and medication require further evaluation
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Looking at the continuing clinical symptoms, my opinion is as follows:
1. It could be a chronic inflammatory response to infection or medication induced or possible tumor.
2. Did the MRI scan detect any other lymph nodes in the body?
3. The new swelling at base of neck, is it painful. Is it lymph nodes?
4. At present, what are the medications you are on? Need full list including chronic conditions treatment being taken if any?
5. If its a new swelling? FNAC will be required again. Can you attach recent hematological investigation along with other reports?
6. Inflammation this long, hematological abnormalities should have been present. Tumor and medications needs further evaluation.
Please get back with recent investigations.
Take care
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The new swelling is only slightly painful. I am going to ask my doctor in morning if it is lymph nodes. The mri and ctscan only showed swelling of lymph glands. I take the following medications. For blood pressure I take Exforge and bystolic. For gout I take Uloric. For urinary help I take tamulosin. I also take hyrochlorothiazide for slight swelling I used to have around my ankles. I also take a baby aspirin a day as per doctor recommendation. I am going to bed now but feel free to comment and I will respond in morning. thanks.
Brief Answer:
Require present list of medications
Detailed Answer:
Hi,
Thanks for asking again.
I went through the list of medications. These appear to be your usual medications. Do not stop any of them.
At present, are you not on any medications? for fever, pain etc -- like paracetamol, antibiotics etc.. If possible, do mention dosage also.
Medications which have been started in last 2-3 months are more important.
Do reply and do get back after discussing with your doctor.
Take care.
Dr. Prakash HM
Require present list of medications
Detailed Answer:
Hi,
Thanks for asking again.
I went through the list of medications. These appear to be your usual medications. Do not stop any of them.
At present, are you not on any medications? for fever, pain etc -- like paracetamol, antibiotics etc.. If possible, do mention dosage also.
Medications which have been started in last 2-3 months are more important.
Do reply and do get back after discussing with your doctor.
Take care.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes, I take ibuprofen, Tylenol, and aspirin when necessary to control the fever. As I mentioned in previous questions, I have tried different antibiotics during this sickness and none of them have worked. While my doctor was gone, his PA put me on Valtrex for a week thinking that I might have internal shingles, but it did not work either. I will let you know what my doctor says this morning, but I have all but decided to move on and take all me records to a big city internist to find out what is wrong with me. I still have a lot of faith in my local doctor, but he is just not getting anywhere on this illness. thanks. XXXXXXX
Brief Answer:
FNAC of new lesion possibly helpful
Detailed Answer:
Hi,
Thanks for asking again.
It does not appear to be shingles. However, your doctor has tried something new, hoping it might work.
As you meet your doctor, do get an FNAC of the new lesion in the neck done.
If it is painful, possible inflammation, might lead to the cause of fever.
If not inflammation, further evaluation of lymphnode might be required at a higher center.
The symptoms are at present very much limited to two locations, other than regular fever. If FNAC does not help, get it excised and send it for histopathology.
You can go to meet the internist, however see if new FNAC does lead to anything meaningful.
If it is another lymphnode enlargement in neck, evaluation for lymphomas is important.
Any further queries, happy to help again.
Take care.
Dr. Prakash HM
FNAC of new lesion possibly helpful
Detailed Answer:
Hi,
Thanks for asking again.
It does not appear to be shingles. However, your doctor has tried something new, hoping it might work.
As you meet your doctor, do get an FNAC of the new lesion in the neck done.
If it is painful, possible inflammation, might lead to the cause of fever.
If not inflammation, further evaluation of lymphnode might be required at a higher center.
The symptoms are at present very much limited to two locations, other than regular fever. If FNAC does not help, get it excised and send it for histopathology.
You can go to meet the internist, however see if new FNAC does lead to anything meaningful.
If it is another lymphnode enlargement in neck, evaluation for lymphomas is important.
Any further queries, happy to help again.
Take care.
Dr. Prakash HM
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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