Persistent Flu-like symptoms

[Yamar]

I have been sick now for 12 weeks. It started with a flu (headache,fatigue,head in a fog,fever but no nasal congestion). The symptoms persisted longer than usual. After 2 weeks I saw a microbiologist who gave me Biaxin XL for 7 days which dropped the fever (38.2) and dimished my symptoms, but I was still unwell. I have remained unwell since and my symptoms persist...I have severe hot flashes (feeling like I am under a very hot lamp), periodic night sweats, fatigue, the sensation of having high fever (but my oral/rectal temperature is normal), headache, slight hand tremor, dry cough, occasional shortness of breath, hoarseness, sore throat, mild pressure in the ears, sensitivity to loud noises. Surprisingly, no nasal congestion or runny nose.
I started feeling slightly better 2 weeks after the Biaxin and went back to work. I got progressively more sick and tired. I had to stop work and also was given a 14 day course of Avelox, which did not help. In fact on the first night of Avelox, I had the most severe night sweats. At one point the headache was so severe that I ended up in the ER and had an LP which was normal.
The slightest activity makes me sick. I noticed a pattern. If I get fatigued (which takes very little) I will start feeling hot, then my cough will start and I will become slightly short of breath, then I will feel exteremly feverish (normal T). It then takes me 2-3 days of complete rest to get partially over it.
I have had numerous tests:  my CBC is normal, my ALT is slightly elevated at 77. Monospot negative. EBV, CMV, Parvovirus B19, cold agglutinins, throat swab, influenza, RSV all negative. ESR is 2, TSH is 0.92, CRP is below 6. Urinalysis normal. PPD negative.  HIV, Hep A, B & C are all negative. CXR was normal 3 times.  CT chest and head (both non-infused) were normal. Abdo U/S was normal except for a 1.5 mm left kidney stone. The docs don't know what I have, and I am desperate. I was previously very energetic and I want to go back to my normal life and back to work. Is there anything you can recommend?

[Kevin Pho, MD]

You have been on broad-spectrum antibiotics already, which would treat many of the major bacterial conditions.  

I agree with the viral testing, including EBV, CMV and HIV.  The thyroid test and CRP is negative.  Head CT negative.  

At this time, chronic infections like endocarditis should be ruled out.  Blood cultures should be taken, and if possible, followed up with an echocardiogram.  I would also consider an abdominal CT scan to rule out any abscesses.  An ANA level can be considered to exclude rheumatologic disease.

These options can be discussed with your personal physician.

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_

[CC2007]

Sounds like Lyme disease.....

Musculoskeletal System
Joint pain or swelling or tenderness
Stiffness of joints, back, neck
Muscle pain or cramps
Bone pain
Heavy feeling in one or more limbs

Neurological System
Tremors or unexplained shaking (especially at night)
Burning or stabbing sensations in the body
Weakness or partial paralysis/stroke-like symptoms
Pressure in the head
Numbness in body, tingling, pinpricks
Poor balance, dizziness, difficulty walking
Increased motion sickness
Lightheadedness, wooziness
Sudden jerking of fingers or entire limbs
Pain in spinal column

General Well-being
Unexplained weight gain, loss
Extreme fatigue
Swollen glands
Unexplained fevers (high or low grade)
Continual infections (sinus, kidney, eye, etc.)
Symptoms seem to change, come and go
Pain migrates (moves) to different body parts
Early on, experienced a "flu-like" illness, after which you have not since felt well.  (If it was mild, you may not even recall this.)

Eyes/Vision
Double, blurry or dim vision
Increased floating spots
Pain in/behind eyes, or swelling around eyes
Over sensitivity to light
Flashing lights
Optic neuritis

Ears/Hearing
Decreased hearing in one or both ears
Buzzing or clicking noises in ears
Pain in ears or sound sensitivity
Ringing in one or both ears
Pressure or feeling of fullness in ears

Digestive and Excretory Systems
Diarrhea, irritable bowel
Constipation
Irritable bladder (trouble starting, stopping)
Frequent urination that is not normal
Upset stomach (nausea or pain)

Respiratory and Circulatory Systems
Shortness of breath, cough
Chest pain or rib soreness
Night sweats or unexplained chills
Heart palpitations or extra beats
Heart blockage

Psychological well-being
Mood swings, irritability, rage
Unusual depression
Disorientation (getting or feeling lost)
Feeling as if you are losing your mind
Overemotional reactions, crying easily
Too much sleep, or insomnia
Difficulty falling or staying asleep

Mental Capability
Memory loss (short or long term)
Confusion, difficulty in thinking, brain fog
Difficulty with concentration or reading
Going to the wrong place
Speech difficulty (slurred or slow)
Stammering speech
Forgetting how to perform simple tasks

Head, Face, Neck
Unexplained hair loss
Headaches, mild or severe
Twitching of facial or other muscles
Facial paralysis (Bell's Palsy)
Tingling of nose, cheek or face
Stiff or painful neck or creaking
Jaw pain or stiffness
TMJ – sudden onset, jaw spasms
Sore throat, hoarseness
Loss of sense of taste
Difficulty swallowing, throat spasms

Females only:
Unexplained menstrual pain, irregularity
Unexplained breast pain, discharge

Males only:
Testicular or pelvic pain

LYME FACTS
1. You do not have to recall a bite or have gotten the target rash to have Lyme disease. Less than 50% of people with Lyme do.
2. The tick that carries Lyme is as small as the period at the end of this sentence and their nymphs are nearly microscopic.  Ticks are on the move at 35º and above. It’s a year-round problem.
3. You do not have to experience ALL of these symptoms to have Lyme disease.  It is also typical for many of these symptoms to come and go or occur once and never occur again.
4. It is possible to have Lyme disease and have a negative test result.  After Lyme bacteria enter your system, it tricks your immune system into no longer producing antibodies to fight it, hence, a negative test result. There are also other numerous factors that can affect the results. (Google: Lyme disease negative test results.)
5. Lyme bacteria hide in the spinal fluid, bone, tendons, muscle and nerve fibers and tissues and in many cases are not “floating” around in the bloodstream where they can be picked up on a test. It is a cousin to the syphilis bacteria and very difficult to eradicate.
6. It takes a LYME SPECIALIST to diagnose, test for and treat Lyme disease and any of its associated co-infections. To find one go to www.LymeNet.org.
or www.ilads.org.  Lyme specialists do not require a referral.  

NOTE: Everyone may have symptoms that appear on this list; however, it does not mean he/she has Lyme disease.  If one has numerous symptoms on this list and no other explanation for them, consider Lyme.

[optermist16]

A related discussion, flu like symptoms was started.