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What Can Be Recurrent Diarrhea With Mild Fever,weakness,headache And Decreased Urine Flow ?

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Posted on Sun, 22 Apr 2012
Question: Hi, for aproximately for 2 months I was suffering from diarhea on and off and haven't been feeling 100 percent since.For the past 2 weeks I have been suffering from chills, mild fever, lower left abdominal pain, fatigue, weakness, decreased urine flow and daily headache. I went to my doctor 4 days ago, and he prescribed me Septra. I haven't had much improvement yet, other than the chills and extreme sweating have seemed to stop. My doctor thinks I have a hernia, along with a bacterial infection. There were no leukocytes found in the urine, and my bpm is 80, blood pressure normal.
doctor
Answered by Dr. Jasvinder Singh (1 hour later)
Hello XXXXXXX

Thanks for posting your query. It is good that your urine has come clear of leukocytes which rules out any urine infection. Three possibilities are coming to my mind which need to be ruled out in your case. These include:

1)Typhoid fever: It is caused by Salmonella bacterial infection and causes fever weakness, fatigue and abdominal pain and diarrhea/ vomiting. You need to get a stool examination and a blood test for IgM typhi done from a physician.

2)Amoebiasis: It is caused by intestinal infection with the amoeba. To rule it out you need to get done a stool examination and serological or blood tests for antibodies detection.

3)Intestinal tuberculosis: It is caused by tuberculosis bacteria and may produce chronic pain in the abdomen, diarrhea or constipation, fever, night sweats, rapid loss of weight, generalized weakness and fatigue. To rule it out you need to get ESR, tuberculosis antibody, sputum for AFB, ultrasound of abdomen and CT scan of abdomen done.

My suggestion is to consult a gastroenterologist and get investigated for these three possibilities.

Till that time, incorporate these lifestyle changes to prevent further spread of infection:
1)     Wash hands thoroughly with a antiseptic soap after using the toilet or before handling food.
2)     Clean bathrooms and toilets often especially the toilet seats and taps.
3)     Avoid raw vegetables and street foods. Also drink clean and boiled water.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jasvinder Singh (6 hours later)
Hi, I had a stool sample done about 2 months ago, they were looking for possibly c-diff, as my friends son was quarantined in the hospital with c-diff and my diarhea began soon after. They also did a test for parasites, and "no news is good news" I was told, and never heard back. Would they see the abnormalities you spoke of with these tests? (ie)antibodies. As far as intenstinal T.B. I think that might be too exotic for my location (middle class small town Canada) and I had a full spectrum of blood tests done a year ago, I have been with the same girl for the past 3 years, and no lifestyle changes.
doctor
Answered by Dr. Jasvinder Singh (5 hours later)
Hi XXXXXXX

I do understand that tuberculosis is less likely in your part of the world. However, with the presence of HIV in the west, the incidence of tuberculosis has gone up and should always be in the back of the mind of the treating physician.

Clostridium difficile colitis is much more common in those who have been hospitalized for sometime and are on prolonged antibiotics. It is also known as antibiotic associated colitis.

The possiblity of a bacterial infection seems most likely in your case and enteric/typhoid infection always needs to be ruled out in such a scenario. A blood culture and typhidot IgM helps in the confirmation of the diagnosis.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Note: For further follow up on related General & Family Physician Click here.

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

Internal Medicine Specialist

Practicing since :1998

Answered : 1578 Questions

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What Can Be Recurrent Diarrhea With Mild Fever,weakness,headache And Decreased Urine Flow ?

Hello XXXXXXX

Thanks for posting your query. It is good that your urine has come clear of leukocytes which rules out any urine infection. Three possibilities are coming to my mind which need to be ruled out in your case. These include:

1)Typhoid fever: It is caused by Salmonella bacterial infection and causes fever weakness, fatigue and abdominal pain and diarrhea/ vomiting. You need to get a stool examination and a blood test for IgM typhi done from a physician.

2)Amoebiasis: It is caused by intestinal infection with the amoeba. To rule it out you need to get done a stool examination and serological or blood tests for antibodies detection.

3)Intestinal tuberculosis: It is caused by tuberculosis bacteria and may produce chronic pain in the abdomen, diarrhea or constipation, fever, night sweats, rapid loss of weight, generalized weakness and fatigue. To rule it out you need to get ESR, tuberculosis antibody, sputum for AFB, ultrasound of abdomen and CT scan of abdomen done.

My suggestion is to consult a gastroenterologist and get investigated for these three possibilities.

Till that time, incorporate these lifestyle changes to prevent further spread of infection:
1)     Wash hands thoroughly with a antiseptic soap after using the toilet or before handling food.
2)     Clean bathrooms and toilets often especially the toilet seats and taps.
3)     Avoid raw vegetables and street foods. Also drink clean and boiled water.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.