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Have Sweats, Enlarged Lymph Node, Sore Throat, Rash On Body. Normal Lab Tests. Just Flu Virus?
29 year old female Veterinarian (companion animals/ rodents /birds) Previously in excellent health 3 months ago • acute onset of 3 week high fever chills sweats myalgia stiff neck and headache • Fever resolved after 3 weeks but lingering fatigue neck/muscle pain, migranes and vertigo/ataxia/tingling in fingertips over 2+ months. 2 weeks ago • Migranes/vertigo/fingertip tingling resolved. • Fatigue and chills remained In last 7 days • recurring flu like symptoms- sweats, submandibular lymph node enlargement sore throat • acute onset diffuse multifocal rash- back/chest/neck- raised red lesions with vesicles of clear fluid- burst and scabbed over. Mild non productive cough • Currently the rash improving but lingering sweats/chills Testing • Leptospirosis/Brucella/Bartonella /Toxoplasmosis serology negative • Chest Xray normal • MRI head and C spine normal. • CT body scan normal. • Abdominal ultrasound normal • CBC and Biochemistry were taken 3 months ago and were normal apart from occasional reactive lymphocyte and chronic exposure- IgG+ Epstein Barr virus but cytalomegalovirus negative ? if the most recent symptoms are just a flu virus or other differentials?
Sat, 18 May 2013
hello,
By history one clinical finding is very significant. That is neck stiffness.
I may consider Aseptic meningitis as a differential diagnosis.
There are certain signs which may be to this diagnosis.
Vertigo, headache, ataxia.
Cerebrospinal fluid analysis may help us more to come to this diagnosis.
One thing which goes against it is that the MRI brain is normal.
It may be labyrinthitis also.
By history one clinical finding is very significant. That is neck stiffness.
I may consider Aseptic meningitis as a differential diagnosis.
There are certain signs which may be to this diagnosis.
Vertigo, headache, ataxia.
Cerebrospinal fluid analysis may help us more to come to this diagnosis.
One thing which goes against it is that the MRI brain is normal.
It may be labyrinthitis also.
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