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What Does A Sudden Onset Of Severe Nausea Along With Fatigue Indicate?

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Posted on Thu, 16 Feb 2017
Question: Last Thursday night (almost 5 days ago), an illness came fast and swift. Although feeling perfectly fine throughout that day, around 10pm that evening, sudden onset of nausea turned into a night of vomiting. My last vomit was in the morning around 10am. I still, however, felt incredibly weakened and fatigued. Then having a terrible headache that evening, I believe I was dehydrated as well. I chalked this all up to either food poisoning or stomach flu (aka norovirus). Over the course of the next few days of bed rest I began improving, gradually increasing my food intake and variety to the point where my body for the most part feels back to normal. The reason, however, I am writing now is that a day after the first sudden symptoms of vomiting, I began getting terrible night sweats - the kind where your shirt and sheets are completely soaked, like somebody dumped water on you in the bed. These night sweats also seem to be getting worse, to where I have to change my shirt multiple times last night. I also have had a pain on the right side of my neck starting around my first onset of illness that also seems to be getting progressively worse to where it is now. I don't recall injuring it in anyway, but initially thought it could have been from the straining of forceful vomiting. I still have movement and mobility with it up and down and front to back, but the side to side is very painful, even interfering with my sleep. Are these current symptoms normal after a stomach flu or might I have some other illness? Should I get tested by a doctor? I am also a 32 year old male, not overweight, nonsmoker.
doctor
Answered by Dr. Rahul Tawde (39 minutes later)
Brief Answer:
Possible Sepsis/Meningitis

Detailed Answer:
Hello,

I'm sorry to hear you are experiencing such symptoms. I'll be honest, some of these symptoms can be normal.

At times a viral or flu like illness can truly cause chaos for the body. Still, neck rigidity, night sweats. These things scare me as a potential worsening of your illness to a level of either septic infiltration or potential meningitis.

Though I cannot perform a physical and cannot diagnose you based on this limited consultation, I will say that I highly recommend a visit with either a physician as soon as possible or to Urgent/Emergency care facilities to assess for such. What they will then likely proceed with is blood tests, vitals and physical testing to determine if you're still having an infection.

Where it likely is, and or any other components that need addressing (i.e. if it has infected your lungs, spinal matter, bloodstream).

To determine such things a physical visit is required. I highly suggest anti-inflammatory medication such as Ibuprofen, and vigorous (3+ Liters of hydration per day) in the meantime.

I wish you the best.
Kind Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Rahul Tawde (4 hours later)
Thank you for your help. I took your advice and went to the local urgent care a bit ago. The doctor ruled out meningitis (says almost always connected with fever and neck pain in back of neck and head, rather than side of neck and shoulder). She thinks the neck pain is muscular and caused by poor position, perhaps due to not moving much while recovering from my prior infection. She ran a swab for strep throat, which came back positive. She believes that the severe night sweats is likely from this infection, rather than the previous one (in other words, she believes I contracted 2 separate infections - one viral and one bacterial). She put me on 5 day course of antibiotics. Do you agree and is there any other advice to give me? Thank you again!
doctor
Answered by Dr. Rahul Tawde (1 hour later)
Brief Answer:
Very Good

Detailed Answer:
I will trust their judgement. A positive strep test is certainly accurate enough to begin antibiotic treatment. This can definitely explain many of your symptoms. I'm very glad you're on the path towards improvement!
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Rahul Tawde (2 days later)
Hi Dr. Hatkoff,

Just one follow up here - today is day 4 on my 5 day antibiotic course. I still do have a white spot in my throat along with headaches and neck pain. I also am still having night sweats. Is this normal for recovery even with antibiotics? Or do I need to follow up with the prescribing doctor for perhaps extending the course? Thank you,

Will
doctor
Answered by Dr. Rahul Tawde (15 hours later)
Brief Answer:
Following Advice

Detailed Answer:
Hello Will,

I would certainly call their offices, and as they are the prescribing physician so they can more intimately guide you towards the next few necessary steps.

I am sorry you are still experiencing symptoms, and perhaps; you need a step up antibiotic medications. I must ask/ did they prescribe amoxicillin or penicillin ?

Often times a step up from Amoxicillin is Amoxicillin-Clavulanate, otherwise known as Augmentin. That may be the next clinical step, please discuss this with your doctor too. Stay positive.

Warm Regards,
Dr. Andrew


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Rahul Tawde (5 hours later)
Thank you for following up! I was prescribed a 5 day course (2 pills first day, 1 pill next 4 days) of 250mg of z-pak aka zithromax aka azithromycin. The biggest symptom pointing to strep I hadn't noticed until seeing the doctor were 2 large white spots in my throat. One of them has now gone away, but one is still present. Today is my last pill of the antibiotic, so I just didn't know if it usually takes some time for the antibiotic to kick in, or if I needed an increased or extra dose. Still feeling about the same with dull headache, minor fatigue, and serious night sweats.
doctor
Answered by Dr. Rahul Tawde (5 hours later)
Brief Answer:
Antibiotic

Detailed Answer:
No worries. It does take some time yes but >5 days of symptoms after starting antibiotics is generally when you should be concerned and or at least make visit to a physician for changes of Antibiotic regimen. I dont believe it is quite day 5 yet so stay strong.

Warm Regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Rahul Tawde (43 hours later)
Hi Dr. Hatkoff,

I took your advice and went back to the prescribing urgent care. The doctor on duty examined me and said I still had reddened throat and swollen glands along with the lingering white spot. He also ran another strep swab, but this time it came back negative. To be on the safe side though, he prescribed me a 10 day course of Augmentin (2x a day). I also told him that I was still having night sweats, which he explained was a symptom of fever, even if I'm not symptomatic of fever while I am awake. My question now is how long should I this antibiotic take to work before I expect symptoms to subside? Thanks again for all your help,

Will
doctor
Answered by Dr. Rahul Tawde (3 hours later)
Brief Answer:
Augmentin

Detailed Answer:
Did your doctor give you a recommended time as to take the medications? I personally would take at least 5-7 days dosage. To my understanding, this should be a 10 day recommendation on the bottle. Regardless. however long the doctor prescribed the meds, or how they are described on the bottle would be best.

Warm Regards.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Rahul Tawde

General & Family Physician

Practicing since :1980

Answered : 1 Question

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What Does A Sudden Onset Of Severe Nausea Along With Fatigue Indicate?

Brief Answer: Possible Sepsis/Meningitis Detailed Answer: Hello, I'm sorry to hear you are experiencing such symptoms. I'll be honest, some of these symptoms can be normal. At times a viral or flu like illness can truly cause chaos for the body. Still, neck rigidity, night sweats. These things scare me as a potential worsening of your illness to a level of either septic infiltration or potential meningitis. Though I cannot perform a physical and cannot diagnose you based on this limited consultation, I will say that I highly recommend a visit with either a physician as soon as possible or to Urgent/Emergency care facilities to assess for such. What they will then likely proceed with is blood tests, vitals and physical testing to determine if you're still having an infection. Where it likely is, and or any other components that need addressing (i.e. if it has infected your lungs, spinal matter, bloodstream). To determine such things a physical visit is required. I highly suggest anti-inflammatory medication such as Ibuprofen, and vigorous (3+ Liters of hydration per day) in the meantime. I wish you the best. Kind Regards