Throat infection w/ fever, night sweats, joint ache and tiredness

I started to feel a sore throat about four weeks ago. Four days later, I was immunized for yellow fever. Three days after that, I began taking Malarone. Then I went to Guinea for a week. The right side of my throat got very swollen and I got a fever and tiredness. While I was there I lost my appetite, drank very little water, and lost a lot of weight. I have been getting night sweats, and I have been feeling very tired. I have a sexual partner who began to get night sweats after spending time with me. I have felt some slight pain in my knees a few times since my return, and once during my trip. I went to my doctor to see about my throat and the fever. He prescribed antibiotics and cortizone for what he considered a case of tonsillitis. I took the antibiotics for five days, and the swelling did go down, but it did not go away entirely. A few days ago, I was feeling tired went to the emergency room. They gave me a blood test. My leucocytes are high (12.38), as are poly. neutrophiles (71.4/8839), poly. eosinophiles (2.6/322), poly. basophiles (1.3/161), reserve alcaline (32), and my Reactive C Protein (14.9). My trou anionique is low (7.0). Everything else is within range. I asked for an HIV 1/2 and for a malaria test, but they could not do them. At no point have I had any symptoms of cold or flu. No runny nose, no headache. I would like to know if I can rule out HIV? What could it be? Mono? Rheumatic fever? Strep? I should mention that I have had strep before in the past year.

[Kevin Pho, MD]

I agree with testing for various viruses that can cause a prolonged sore throat.  Blood tests should be done for HIV and EBV (mono).  A throat swab should be done to rule out strep, although the antibiotics should appropriate treat this.

If the symptoms continue, non-infectious causes like post-nasal drip, sinusitis, allergic rhinitis, or GERD can all be considered.  Further investigation can be done with a laryngoscopy or upper endoscopy.

These options can be discussed with your personal physician.  An ENT referral can be considered if the causes are unclear.

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.

Kevin, M.D.
kevinmd_