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virus like symptoms, extreme fatigue & aches
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virus like symptoms, extreme fatigue & aches

I've been ill with something like a virus for over 3 months & have no diagnosis as of yet.  Have muscle aches, sore throat, occasional ear ache, occasional low fever of 99.5, worsening fatigue, weakness, shakiness, diarrhea & dizziness.  2 wks ago left parotid gland swelled, dr said was from virus or stone.  It drained but other symptoms remain.  Left cheekbone hurts as of 3 days ago.  Left neck lymph node is swollen and my armpits occasionally hurt as though they are also swollen.  Have seen my GP 3X since Oct & dr at walk-in clinic 2X since April, no diagnosis from either.

Current symptoms similar to sudden onset of fatigue, dizziness, occasional sore throat & earache in 2006.  Starting in 2006, also had recurrent sinus infections.  Had CT scan, facial x-ray & blood work but nothing found.  Felt better during some of 2007, but last October I got sinus infections again & have been sick since.  Sinus infection never resolved & in February it became bronchitis per my GP.  Took 4 rounds antibiotics from Oct-Feb.

Bronchitis resolved.  In March I had "stomach flu", which resolved.  A week later I got another "flu", i.e. the symptoms I still have today.  

Other info:  I'm a 36-year-old female, obese, on lisinopril for high blood pressure and Flonase for seasonal allergies.  Take multi-vitamin & do nasal rinses daily.  I have extremely heavy menstrual bleeding.  Also cramps & pelvic pain most of the month, which the OB/gyn thinks is endometriosis.  Blood tests in 2006 & 2007 were normal except my glucose is kind of high (112) and I was anemic in October.  Started on iron supplements and as of last month I was not anemic anymore (13.4).  In 2006 I was told my thyroid was "a little low but nothing to worry about".  

Do you think my current symptoms are a virus?  If so, is it normal for a virus to last this long?  Could it be related to the undiagnosed problems I've had since 2006?  What could cause these frequent infections & fatigue?
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I agree with the workup this far, and it has been comprehensive.  

A variety of infections are possible  Testing for HIV can be considered, as well as Epstein-Barr (leading to mononucleosis).

I would consider blood cultures, and if positive, an echocardiogram to exclude endocarditis.

You mentioned CT imaging.  Ensure it was done of the chest and abdomen, as an abscess or lymphoma can be excluded.  

A referral to an infectious disease specialist can also be considered.

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

Kevin, M.D.
www.kevinmd.com
5 Comments
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Avatar_f_tn
Thank you Dr. Pho, I appreciate these suggestions greatly.

Today I was surprised by a sudden opening with my new doctor's nurse practitioner, and she ordered blood work and a UA.  I know she was testing for HIV but I will check on Epstein-Barr, and suggest it if they have not already thought of it.  The CT imaging was not of the chest and abdomen, it was only of the head, so I will mention that as well.  Thank you again for your ideas.
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393587_tn?1211056644
i recommend having your thyroid checked again.  i had a viral infection with no flue/cold/sinus symptoms, that wrecked my thyroid, and decreased the strength of my heart by 20%.  if you see a cardiologist, or your GP will order it, i'd also recommend an ultrasound of your heart to make sure it's not compromised.  better safe than sorry.  the only reason i found out about my cardiomyopathy is because i already have a Premature Ventricular Tachycardia w/ arrhythmia  witch was found at age 14, diagnosed as congenital, and i have a great cardiologist i've seen the last 13 years.  i went hyperthyroid first, raising my already high heart rate, and my blood pressure, which was usually on the low side, then it crashed, and i'm now Hypothyroid, which pretty much slowed everything down, except my heart rate is still 100-160 at rest, which i take Toporol for to prevent any further damage of my heart.  i had nasty viral infections constantly as a child... usually incredibly resistant to treatment, and every time i get around a large group of people i get a hardcore sinus infection that wipes me out for weeks.  i hope you find some answers... i've still not been given a diagnosis relating all of my illnesses, with i believe with all my heart, is an autoimmune disorder.  each specalist treats every symptom separately, and no one will look at the big picture.  it's been an ongoing struggle my entire life.  i wish you the best of luck:-)  keep in touch and lemme know what they find, and if you ever wanna chat,  i can give you my aim, gmail, email, etc. info.  i know it REALLY helps talking to someone who can empathize.  i'm currently reading 2 books on autoimmune disorders, and i've done a lot of research on the different symptoms of the different diseases.  please feel free to contact me any time.  talking to other people going through the same things as i do, really helps.  

take care
-Becky
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Avatar_f_tn
Thanks for your kind words.  I'm sorry to hear of your struggle with your symptoms.  I also find doctors either focus on one specific illness or don't find anything wrong immediately and lose interest.

In case anyone comes across this in a search, I wanted to follow up on what the nurse practitioner's office said.  All I know is she didn't think it was a virus, and my thyroid function seems fine.  It'll be weeks before I hear anything else.

The flu-like symptoms continue.  My muscle pains are very much out of proportion to my activity level.  My biceps hurt as though I've been exerting myself greatly although I haven't, I continue to have diarrhea and shakiness, although the sore throat and fatigue have gradually improved.  Who knows.
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Avatar_f_tn
not complicate matters...

but, first, your sinus problems could be completely separate...you sound like you're going through the same exact symptoms I was going through.  I have chronic sinusitis and it flares up, first in my forehead region, now in my cheekbones. Unbearable pain like someone has taken a hammer to my pain face.  Multiple sinus infections with unknown causes.  Could be contaminants that haven't been found yet...mold tests?  Discovered mold in the house due to a plumbing leak; poor ventilation at work?  Have that as well.  Keep searching for anything that is setting your sinuses off.  They progressively get worse with age and may get worse with a weakened immune system.

For the rest, I also had a low grade fever, 99.5 (normal temp for me is 97.1), so in retrospect, 99.5 is very high for someone who normally has a low temp.  I had severe muscle aches, so badly I couldn't walk up the stairs without stopping and waiting for a while.  This from a person who was working out for an hour a day, four times a week.  I was also experiencing shakiness, extreme fatigue, not sleepiness, just the inability to do anything, and extreme vertigo, forcing me to go to the ER, which I dread.  After rounds of countless pain meds for the headaches, vertigo, and to balance the other problems, I gave up going to doctors...internists, cardiologists, neurologists.  My GP was treating everything like they were individual symptoms and I asked him to treat them like they were one giant one (minus the sinus problems, which existed prior, just not this badly).

Have you been out of the country recently?  Exposed to anything abnormal?  You'd be amazed at how many parasites can cause these symptoms and can go undetected through simple blood tests.  Tests search for specific parasites and for their eggs; if they didn't lay eggs at that moment, they won't see the parasites, hence you need to be re-tested within a certain time-frame.  If they didn't, you'll never know.  If you were in a malaria infested area, which many places are these days...Mexico, Jamaica, South America, etc., the U.S. labs don't test properly.  Tests must be performed within 16 hours or they will always read a false negative because the parasties die.  Only one form of malaria is considered deadly, the other three just make you feel like you want to die.  I do believe I could have contracted malaria while in Jamaica, but the lab waited 48 hours to test giving a false negative.  I was even breaking out in really bad sweats, but only had a 99.5 temp, so they continually disregarded my concern.  But for my normal temp, 99.5 is on fire.  I NEVER have a fever...not even when I gave birth, had surgery, nothing.

Since they couldn't figure anything out, after five months of suffering and 25 pounds of weight loss and massive stomach pain, I treated myself.  Starved myself for two weeks, did the best parasite flush I could find at a nutritional center, and stuck to a strict gluten-free diet (for easy digesting) to ensure that I wouldn't feed any parasites along the way.

This also could treat the possibility of candida overgrowth of the intestines, which commonly goes undiagnosed because most doctors won't recognize it.  It's worth looking up, especially if you're fed up of feeling miserable all the time.  After all, if the treatment is cleansing your system and eating healthy (although it doesn't taste very good), and taking probiotics to ensure a healthy digestive tract, is it so bad, even if it doesn't work?  It's always worth a shot, if everything else has failed.

Good luck to you.  I know how miserable this truly is and I do hope you feel some relief soon.  It took about a month for me to start feeling well (somewhat normal again).  But I am back to normal and eating the same junk I used to eat. I can't confirm for certain what caused me to be so incredibly ill for five months of my life and the waiting list for the infectious disease doctor would have killed me alone, but I do believe my own treatment of healthy eating and cleansing my system had something to do with it.  Oh, and if your stomach is weak, vitamins can be very harsh.  Maybe take liquid vitamins until your stomach is healed, and in small doses, or the vitamins alone can be making you sick as well as the iron.  Take it from someone has had a bad stomach since birth.
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