Mono and Upper Back Pain?

[lmcare]

About 6 weeks ago, I (26 yr., female)after a jog suddenly started having severe constant upper back pain behind left shoulder blade with rapid heartbeat (120s to 160s).  I had just come back from extended trip in St. Lucia. Multiple CT scans of the chest came back normal except for "moderately severe" pectus excavatum pressing on heart (rule out aortic dissection, pulomonary emboli, aneurysm) and spine CT ruled out spinal issues. A week later got very ill with vomiting, malaise, chills. After 2 hospitalizations, the diagnosis was Epstein Barr Mono.  



However, the severe stabbing back pain has not been diagnosed, and I cannot take narcotic pain medication due to mono-induced severe inflammation of liver.  I'm on neurontin as a shot in the dark; it's not helping yet. Also, I continue to have scary palpitations, chest pain, and shortness of breath while on beta blockers. I'm following up on a tentative diagnosis of myocarditis.  Can the back pain be associated with mono and the heart issue?  The doctors here say it's not. For the past six weeks, I haven't been able to get out of bed b/c of this back pain.  If this pain can't be associated with mono, then what leads should I follow?



Sorry, but one more question.  In the past five weeks, I've had 4 ct scans with contrast (2 chest/abdominal with some pelvic, 1 chest, and a thoracic spine).  I'm freaking out about the radiation.  How elevated is my risk for cancer - esp. breast cancer from this radiation?



Thank you for your time and this forum.

[Kevin Pho, MD]

I am not aware of mononucleosis causing the back symptoms that you are describing.  



It certainly may be possible that the pectus may be contributing or causing the symptoms, and treatment can be considered via surgery.  You may want to show the CT scan and obtain another opinion with a thoracic surgeon for another evaluation of this.  



Another consideration for the back pain would be an orthopedic evaluation.  A back MRI would be a reasonable next step to evaluate for any herniated disks or cord compression which may be causing your symptoms.  



It is unlikely that 4 CT scans would increase the risk of breast cancer.  



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.

Medical Weblog:

kevinmd_b

[cquinn]

I have had shortness of breath for a couple months now (about 3). I got a very sharp pain in my upper back about month ago and some pain in my chest as well.  The pain in my back is usually on my left side (sometimes on the right or both) behind my shoulder blade and sometimes it only hurts when inhale.  My husband started developing the same symptons as me a few weeks after I initially started. Sometimes I just feel like  have a flu.  We both have a symptom of irregular heart beat or feeling like my heart is going to drop out of my chest like I was on a roller coaster.



They tested us for valley fever (cocci) and mono. I am waiting for the results. Our chest xrays did show nodules in the lungs -which can be associated with cocci. It is just very frustrating because somedays I feel okay and then other days ( most of the time) I feel very uneasy.  The pain in the back is really bad.



Can you get both at the same time?

[Caarp]

My daughter 16 years old, was diagnosed with Mono, Oct6, 2004. Starting with vomiting and Diarrehea, then flu like symptoms, then dehydration from not keeping any foods of fluids down, now has been suffering with back pain. 2 1/2 weeks ago woke up in the night with severe pain in her left arm.  After a trip to the emergency room, outruling a bloodclot, we returned home with vicadin pain killers.  Now she is suffering with servere back pain, from her tail bone up to her neck and a severe headace,  The Dr. seems to feel this is all mono related problems, we are ready to head to Mayo Clinic for some help.

Any suggestions please. Now taking pain meds, Dr has RX called in for Flexeril for muscle relaxer, not picked up yet, the pharmacy was closed.    Caarp

[MKC]

My 8yo son was diagnosed with Mono last Spring and shortly afterwards began having abdominal pains. Many test were done and found to be normal except barium gi test indicated acid reflux. Put on Prevacid till Fall then took off as pain subsided. Ab pains came back in Dec but meds did not help. Many more tests have been done and all show normal. My son has been out of school for three weeks due to the pains that come in waves throughout his abdomen. Dr's now suggest Psychiatry..they don't know my son. He doesn't want to do things he likes to due to these consistent pains! Thankfully talked with a woman today who said she had EBV and had various pains for two yrs following and couldn't get diagnosis and so gave up going to Dr's. Went to Naturopath dr's and was able to be treated with herbs, etc. This may be the route we'll take after our last set of labs next week to rule out other ab pain issues. Wish there was more medical information on post-Mono recurring illness or even the other  symptoms this virus can be associated with! I've been researching everyday trying to help my child.

[zlobo]

A related discussion, mononucleosis and back pain was started.