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Symptoms of EBV infection - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Infections
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1722 Questions
Doctor :   Hi
Doctor :   How can I help you?
User :   hi doctor
User :   i had flu-like symptoms 12 months back and i was tested for hep A, B, C, HIV and mono and all came negative but i still have some symptoms re-occuring till now such pharyngitis, skin burning, skin itching, red eyes, strong urine color, blurry vision, fatigue, coated tongue, bowel symptoms....i visited many doctors and nobody was able to diagonase the problem...i am so worried
Doctor :   Have you been evaluated by the doctor, if yes, do you have the reports of the previous test?
User :   yes
Doctor :   Will you be able to send me the reports of the test that you have undergone till now?
Doctor :   If yes, you can send me the scanned copy of the reports
User :   so many tests and reports
Doctor :   May I know your age and gender?
User :   male / 38 years
Doctor :   Do you have any medical illness such as diabetes, hypertension, thyroid illness, anxiety?
Doctor :   Are you on any regular pills?
User :   no
User :   i tested for thyroid as well and it is normal
User :   i am not diabet as well
User :   CBC normal , Liver enzymes normal
User :   even i was tested for autoimmune Ab and test came negative
Doctor :   Ok
Doctor :   Do all these symptoms occur during a single episode ? Or do you have recurring episodes of these problems individually?
Doctor :   Do you have get fever with these episodes?
User :   recurring episodes
User :   no fever
Doctor :   Let me explain to you.
Doctor :   Your symptoms are varied and affecting different systems.
Doctor :   It is a hard task to obtain a probable cause for such varied presentation.
Doctor :   Since you do not report of any chronic medical illness and blood reports are not suggestive of immunocompromised state,
Doctor :   it is possible that all your symptoms could have been due to one of the 3 possible cause
Doctor :   1. An hypersensitivity reaction - specific allergies
Doctor :   2. Recurrent viral infections probably secondary to exposure or nutritional deficiencies
Doctor :   3. Stress and anxiety factors.
Doctor :   Are you following?
User :   yes
User :   but pharingitis and coated tongue are persistent
Doctor :   Recurring sore throat/coated tongue could be due to recurrent inflammation.
Doctor :   If autoimmune work up and immuno-compromised state are ruled out,
Doctor :   clinically the possible cause could be a fresh infection, /previously untreated infection / inflammation secondary to infection.
Doctor :   The only method of differentiation this is by
Doctor :   getting a swab test - microscopy/culture or serology done on the it.
Doctor :   This is best performed during the illness.
User :   i made swab test and i was negative
Doctor :   If the swab test was negative, then it probably could be inflammation secondary to allergic condition or a fresh viral infection.
Doctor :   A skin allergen test can differentiate between the both.
Doctor :   Nutritional deficiency and under weight individuals are prone to recurrent viral infection,
Doctor :   hence if they need to be sorted too; this can be done by regular sleep and healthy eating habits.
User :   but the question what was the reason of my flu-like symptoms one year back
Doctor :   Since I do not have the access to the records of the examination done during an year back, and also do not have access to the investigation reports,
Doctor :   it is a very difficult task to predict what may have caused the flu like illness an year back.
Doctor :   Your doctor who had evaluated you during the illness will be able to help you answer this query better.
User :   one doctor friend of mine suggests that it might be reoccuring episodes of EBV virus because he said that mono test might not be very accurate
User :   what do you think doctor?
Doctor :   EB Viral infection can cause recurring upper respiratory inflammation with enlarged lymphnodes, with spleen and liver involvement.
Doctor :   and this condition is usually a chronic one.
Doctor :   If physical examination reveals a persistently swollen lymphnodes, liver changes, spleen and neurological involvement
Doctor :   then EB virus can be considered as a possibility.
Doctor :   Again the test needs to be confirmed by investigations
Doctor :   If no other associated symptoms/physical signs are noticed, doctors will consider other common cause as allergic conditions as the possible cause for recurrent sore throat
Doctor :   Have you followed what I have suggested?
User :   yes
Doctor :   I would hence suggest you to involve in lifestyle changes, watch out for allergies, prevent exposure to dust and cold,
Doctor :   a healthy diet plan and regular sleep.
Doctor :   Regular follow up with your doctors with repeated blood counts and serological markers.
Doctor :   This probably may help in establishing the diagnosis.
Doctor :   Have you followed what I have suggested?
User :   yes doctor
Doctor :   Do you have any other query?
User :   but allergic condictions such as sleep, dust, cold can cause all these symptoms
Doctor :   Dust and cold exposure are one of the common cause of recurring upper respiratory inflammation and that can present with recurrent pharyngitis and coated tongue.
Doctor :   You need to also consider the role of stress and anxiety with the other symptoms that you mentioned, if no other cause is considered.
Doctor :   Hence my suggestion to improve your diet, regular sleep and relaxation techniques.
User :   ok
Doctor :   Repeated blood counts / serological test / regular follow up with doctors will keep you updated, if any other cause is associated with your symptoms.
Doctor :   Hope I have cleared your query.
Doctor :   Do you have any other query?
User :   one question: for EBV virus is there any ruling out test other than mono that can be done?
Doctor :   Other serological test such as IgM and Ig G antibody against the viral capsid can be done.
Doctor :   However mono spot test is used routinely for the diagnosis of EB virus infection.
Doctor :   Do you have any other query?
User :   no thank you very much
Doctor :   Thanks for consulting me.
Doctor :   Bye for now.
User :   bye
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