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5+ months of low grade fever

I'm sorry this is going to be a long post...unfortunately it is a long story!'ve been feeling lousy since at least December '09. At the beginning of December I had a sinus infection that turned in to a scary peri-orbital cellulitis landed me in the hospital. Since then I've been exhausted, run down and sick off and on and running low grade fevers. It took about a month after the hospital for my white counts to get to normal again. Since then I've had another sinus infection that was confirmed.Still feeling lousy and went to see several specialists. My white counts  and platelets have been consistently high. I've been treated for suspected sinus infection once and had several ct scans of the sinuses. I've been on and off of antibiotics and it seems my counts go to normal after antibiotics only to rise again within a week or 2.  

In April my low grade fever turned into a 102 temp, which sent me back to my internist.  We  ruled out sinus as the cause of high white counts and are now looking at other things. My counts have been all over the place.  Monday at the internist's my white count was elevated, but by Tuesday when I went to see an infectious disease specialist they had returned to normal range.  Monday's blood  showed a very low TSH of .06 which was a thing new for me. I had'nt had my TSH tested in at least a year. She ordered the test and did an EKG because I had a very high heart rate, was "very agitated", have been complaining of stomach issues for a while and was not "myself" to her. My internist didn't think this is the reason for the high white counts and the fevers but referred me to an endocrinologist and I had an appointment  a few days later. She also ordered additional thyroid tests that seemed to rule out Grave's disease.
Went to the endo.. He ran a bunch more bloodwork. TSH was fine as well as the antibody tests. No Grave's. I had asked him to run a cortisol test which he did. I had once been told that I had Low Cortisol, so i was curious how this would turn out. At that point it was actually in the high range. He told me at the time (this was back in May) that he thought it was Silent Thyroidosis that we would follow up on in 4-6 weeks. Fast forward to now-I've still have the low grade temp and absolutely NO energy. I can't get enough sleep...very unlike me. No appetite. Night sweats, which are new. Irritated eyes all the time.  I've been through the ringer with testing...countless blood tests, 3 different CT of sinuses, CT of pelvis/abdomen, chest X-ray, upper GI, echocardiogram, bone marrow biopsy, pelvic ultrasounds, Gallium Scan, etc. All are normal.  I've been called a "medical mystery" by my internist as well as the many specialists that I've seen. Infectious Disease doctor just referred me back to Endo as his follow up on TSH showed it to be "Hyper" again and he is attributing my symptoms to this. Endo rechecks it and it is totally normal, however my Cortisol is now LOW again. I am going back on Monday or Tuesday for some kind of Cortisol Stimulation test...I think they take blood, then inject me with something, then take blood again in an hour.
So--here are a few questions--1) Does this all sound like it could be Adrenal Insufficiency? 2) While I am there, should I ask the doctor to run any other blood work? 3) Any questions I should be asking him about? 4)Any other ideas of what this could be? Any help would be appreciated. Thank you.
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Avatar universal
My Endocrinologist appointment is tomorrow morning, can anyone suggest any questions that I should be asking?
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Avatar universal
Thank you! A lot of these have been ruled out, but I will definitely look at a few that I haven't heard of and see if any fit. I'm being treated mostly by an Infectious Disease doctor and my internist. And now seeing and endocrinoliogist. I've also seen an ENT, Gastro, Hematologist, Immunologist and probably someone that I am forgetting about. Is there any other specialist that you think might be able to pin this down better? I'm at the point of seriously looking into going to the Mayo clinic in Minnesota (across the country from where I am) for a full workup. Obviously I would rather not do that but am seriously at my wit's end! Do you have any suggestions for who best would be able to diagnose anything auto immune related?  We'ver ruled out TB, RA, UTI, Sinus, IBS, HIV, STDs, Endocarditis, Lymphomas (the bone marrow biopsy would have caught that, right?), PID, Menopause, and Polycystic Ovary. Also I think the scans and bone marrow biopsy would have found any fever causing cancers too, right?  I know we've also ruled out: Lyme, CMV, EBV. And I'm sure others as well. Are there any specific blood tests for parasitic/fungal/bacterial infection that I can ask for?
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351246 tn?1379682132
MEDICAL PROFESSIONAL
Hi
Welcome to the MedHelp forum!
I can see that you have undergone extensive testing. However it does not sound like adrenal gland problem. Recurrent or chronic fever is seen in tuberculosis, SLE, rheumatoid arthritis, Polyarteritis nodosa (PAN) and other auto immune disorders, UTI, drug fever, sinusitis, glandular fever (check this), otitis media (check this), IBS, HIV, STDs (check this), endocarditis (check this), parasitic infestations, fungal infections, lymphomas and other cancers etc. In women, even polycystic ovary, menopause, PID (pelvic inflammatory disease) should be investigated for. Dehydration is a frequent cause of low grade fever with malaise. So drink plenty of fluids and see.
It is difficult to comment beyond this at this stage. Please discuss these possibilities with your treating doctor. Please let me know if there is any thing else and do keep me posted. Take care!
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