EBV or Parvovirus or something else?

I had a low grade (<101.5) fever for 12 days combined with fatigue, headache, muscle aches.  My doc tested me for Lyme as well as EBV, CMV and Parvovirus.  The Parvo came up high indicating a recent infection and they said that the EBV indicated an infection in the recent past, possibly a few months ago.  I have had intermittent fatigue for a number of months, but put it off to having 3 kids, working, etc., but had no other symptoms to indicate infection until 3 wks. ago.  I am still having fatigue, (it has been 19 days since the fever first started)but no fever now for 4 days. The fever & headache came back briefly for a day after having stopped for 2 days.  My concern is that I do not fit the "typical" symptoms of either virus.  My WBC count was low, 1.9, sed rate Normal, Lyme neg, RF negative.  Is there something else I should be tested for?  Is it normal with these viruses for the fatigue to continue? Am I contagious? Thanks for your help.

[Kevin Pho, MD]

It is certainly possible that a recent parvovirus infection can cause fatigue and lethargy.  It is less likely that it could be EBV since it was a past infection.  

Your WBC is low, suggesting a possible immunocompromised state.  There are many, many other things that can be tested for including the following:

HIV test
thyroid tests
blood cultures
PPD looking for TB
ANA, ESR and rheumatoid factors looking for any acute rheumatological states
CT scans looking for abscesses or lymphomas

These are all tests that should be considered if there is no clear source of fever.  More concerning is the fever in combination with the low WBC count - this should be evaluated by your personal physician or a hematology specialist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.