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Having Swollen Glands, Throat Was Red And Dehydrated. Feeling Dizzy And Light Headed. Diagnosed With Viral Syndrome. Treatment?

Posted on Mon, 23 Sep 2013

Question: My name is XXXXXXX XXXX. I was in Mexico last week and I became dehydrated. The doc told me I had swolen glands and my throat was red which I think is due to me vomiting. Anyway, he gave me an antibiotic and I was drinking alot of fluids. I felt fine the next 2 days. On the third day I became dizzy as I stood and walked around. The light-headed dizzy feeling didn't subside so I called my doctor here in the US. He suggested I drink alot of water and gatorade and for me to call him the next day when I returned home. I went to the ER and they took blood work and urine sample. They diagnosed me with Viral Syndrome. They also checked my inner ears and didn't find an irritation or infections. I saw my doctor 2 days after my hospital visit and he said I would be light-headed only for a couple more days. He also prescribedamlodipine benazepril to help regulate my BP. 5 days later I'm still light-headed and dizzy although not as bad...I've had this now for a week. Will this ever subside? Do I need a CT scan done? I just want to feel normal again. Is this truly a virus that my body is fighting?

Answered by Dr. Jorge Brenes-Salazar (35 minutes later)

Brief Answer:
Orthostatic symptoms

Detailed Answer:
Dear XXXXXXX

Thanks for your question. It appears that there is a very good correlation between the inciting event, dehydration, and your symptoms, which are very consistent with orthostatic hypotension, meaning low blood pressure when changing positions, particularly to the standing position. If you have done a good job at rehydrating yourself, the symptoms should gradually subside if that is the only cause; now, the interesting issue is that you have been prescribed a potent antihypertensive in the midst of this, and I would encourage you to be in close contact with your prescribing doctor and keep a good blood pressure log (2 or 3 readings a day) for the next time you see him; you should ask him as well to take your blood pressure while sitting and also after you stand.

Yours truly,

Dr Brenes-Salazar MD
Mayo Clinic MN

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jorge Brenes-Salazar (19 minutes later)

YES!!! Thank you so much. I do remember my doctor saying orthostatic hypotension. He did have me take my BP lying down and then standing up when I went for my follow up. When I stood up my BP dropped 24 points. Does that I mean that I still need to hydrate because he indicated that I'm not supposed to drop by more than 10 points. I will continue to drink water and gatorade.

Answered by Dr. Jorge Brenes-Salazar (7 minutes later)

Brief Answer:
Indeed

Detailed Answer:
Dear XXXXXXX

Im glad to hear you had that response because that change, a blood pressure change of at least 20 mmHg is diagnostic of orthostatic hypotension; if you still had a positive response a few days out it means "the tank is not full" yet. It is for us doctors like the dipstick in the car, it allows us to estimate how much fluid is there.

I agree with continued hydration and rest.

Best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jorge Brenes-Salazar (21 minutes later)

Thank You so much!!! I will continue to hydrate and rest. I just hope in a few days I can feel 100% again.

Answered by Dr. Jorge Brenes-Salazar (5 minutes later)

Brief Answer:
God speed

Detailed Answer:
Great XXXXXXX best wishes.

Dr B

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jorge Brenes-Salazar (2 days later)

Good morning Dr. Just wanted to let you know that sice Thursday my light headed feeling has not improved. Today my bp reading was 138/89 laying down and 148/96 standing. I've been drinking a lot of fluids and resting as much as possible. Friday was a better day but this weekend I've seemed to regress which has me concerned. My doctor wants me to continue with my BP mess and Meclizine. I'm thinking next week I should see a specialist. Will this dizziness take weeks to recover? I'm entering my second week and I'm not improving like I thought I would by this point.

Answered by Dr. Jorge Brenes-Salazar (36 hours later)

Brief Answer:
Agree with specialist visit

Detailed Answer:
Dear XXXXXXX

By the blood pressure numbers you have attached, your orthostatic hypotension has resolved, and if so, your symptoms should have fully subsided by now as you are volume replete. Alternative causes of dizziness, such as benign positional vertigo, labiryntitis, vestibular neuritis, etc, should be pursued given persistence of symptoms, and I agree with a visit to a subspecialist. For now, you should continue on your medications as prescribed.

Yours truly,

Dr Brenes-Salazar

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jorge Brenes-Salazar (14 hours later)

Thank you. I made an appointment with an ENT specialist. I'm wondering if any of those conditions can somehow be triggered by the hypotension or dehydration.

Answered by Dr. Jorge Brenes-Salazar (1 hour later)

Brief Answer:
unusual as a trigger itself

Detailed Answer:
Dear XXXXXXX

I agree with your thought process that in Medicine we tend to look for a unifying explanation; usually labirynthitis and vestibular neuritis follow an infectious process while benign vertigo tends to present insidiously as we age... therefore I dont see a clear connection. They may be 2 independent processes though (you were indeed dehydrated and orthostatic that is for sure)

truly yours

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar