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Suffering from fever, chills, back pain, night sweats and feeling fatigued. Proper diagnosis?

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Emergency Medicine Specialist
Practicing since : 2000
Answered : 2105 Questions
Here's the story: One evening three weeks ago, I was beset by severe fatigue that kept me inactive for about a week. Over this week-long period of mostly bed-rest and no significant exercise, I also began suffering uncharacteristic lower back pain extending to the hamstrings of both legs; it felt as if I had severely over-exercised (though I had not). After the first week concluded the fatigue resolved, but the pain persisted into the second week. During the second week, I began suffering chills and a low grade fever of about 99 starting in the afternoon, and rising to 100 - 100.5 by late evening. One morning during the second week, I awoke and found that the lower back/hamstring pain had completely resolved. But the chills and low grade fever persisted, and shortly thereafter I began experiencing moderate daily night sweats. The chills, fever and night sweats have persisted into the third week, and are my only current symptoms. I have no swollen lymph nodes, no aches & pains, no respiratory symptoms, no fatigue, and a normal appetite. My eyes are clear; I look healthy. But for the chills, fever and night sweats, I feel fine. Can you suggest a possible diagnosis? Note one observation: A day before the onset of symptoms in the first week, I awoke with a large apparent bite on my left thigh, with no redness or discoloration, that itched for several days before resolving. Besides that, I know of no other abnormalities. I'm a 46 year old male, heretofore in excellent health, and generally fit. I take no medication.
Posted Wed, 21 Nov 2012 in General Health
Answered by Dr. R.A. Singh 1 hour later

Thanks for writing to us.

Severe fatigue and a bite XXXXXXX followed by back pain extending to the hamstrings and then followed by fever with chills and sweat. This was the chronology of the events described. You currently have fever.

This kind of history needs further investigation. It looks to be an infectious cause so needs a battery of tests. The source of such an infection should be investigated.

Low back pain with fever associated with chills can be due to infection of the kidney. It might also be a possibility of the insect bite.

In my opinion you should get yourself investigated for the following :-
1. Complete Blood Count
2. Kidney Function Test
3. Malaria Test
4. Typhoid test
5. Urine examination

Treatment can be planned according to the reports of the investigations. Untill then take Tylenol DS each dose when required. It helps in quick resolution of fever and hydration.

I hope this is useful to you. If you have any doubts, I will be happy to help.

Wishing you a speedy recovery.
Regards. Thanks.
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