Suggest Treatment For Pain In Sternum And Navel Area Along With High Fever

Posted on Thu, 29 Oct 2015

Question: My son is 22 and had a lot of problems lately without a diagnosis. It started in XXXXXXX with 103 fever out of nowhere and no other symptoms. Doc said sinus infection. Fever was gone in 2 days. After a few days, very tired, no energy, abdominal pain, could not tolerate dairy. Fever of 103 again in August, lasted one day. Still fatigue, no energy, lost 15 lbs over last 4 months. Went to another doc, blood work showed elevated AST of 74, low vitamin D of 20.8, high platelet of 418. Normal EKG. All symptoms are.now gone with the exception of daily abdominal pain after eating. Pain is burning and dull located between sternum and navel, never radiates. He thinks it's an ulcer and Pepto helps. I'm wondering could it be mono or Lyme. Should he have those tests run or does it sound like something else. The fever concerned me along with the high AST.

Also of note, he does not drink alcohol regularly but did drink a wine cooler the night before each episode of fever. He does not take any ilicit drugs, and is now taking 2000 IU of vitamin D3 daily plus an iron pill daily. No other medications. He was tested for HIV, hepatitis C, all negative. No STDs as he has never been sexually active.

One more note, was drinking protein shakes and still is but now with Lactade milk (one shakes every couple of days with weigt gainer protein).

Answered by Dr. Tushar Kanti Biswas (6 hours later)

Brief Answer:
Unintended weight loss & fever

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

Your son needs further investigations like Ultrasonography abdomen to detect any liver pathology.Upper gastro-intestinal endoscopy (UGIE) to detect any ulcer or helicobacter infection as predominant symptom is epigastric pain.
Unintended weight loss with occasional bout of fever :
In ~15% of patients suffering from Lyme disease, the infection presents with nonspecific systemic symptoms like fatigue and lethargy,fever, chills .
Enzyme-linked immunosorbent assay (ELISA)for both IgM and IgG to spirochete (Lyme borreliosis) can be undertaken as screening as fever,weight loss remain undiagnosed. Has he got any lymph node enlargement?
The QuantiFERON®-TB Gold ,a blood test can also be undertaken to rule out any Mycobacterium tuberculosis infection ( latent or active tuberculosis disease).

High platelet count is acute phase reactant and non-specific.
Once cause of weight loss is diagnosed and treated,protein supplement will help in gaining weight.
Dr. T.K. Biswas M.D. XXXXXXX

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj