Question: I went to the ER mid August with a fever of 104 (untreated) and got admitted with fever and high liver enzymes. I had no rash indicative of a tick (or HIV for that matter) and no other symptoms, but the fever. My CBC WBC: 5.1 Neutrophils: 85% Lymphocytes 7%. Liver enzymes extremely high (ALT 310) with the fever. They tested for mono, typhoid, blood cultures for bacteria, and only found some abnormalities in urine. Doctors seemed stumped for two days. They treated me with general antibiotics and then antibiotics for tick after a ID consult. While in the hospital for 4 days my WBC fluctuated from 3.5 - 5.1 Infectious disease doctor said it was most likely a tick illness (even though no rash) or small chance urinary tract infection that went sepsis. My fever broke after 3 days (1 day upon starting doxycycline for tick) and within two days of ER visit my WBC was 4.5 Neutrophils 70% Lymphocytes back up to 20%. Doctors checked lymph nodes in neck and arm pits all normal. Blood work has ALL been normal since was pulled twice in September including my liver enzymes back to normal including ALT. I have not had sex in over a year so I'm not worried about ARS, but when I got discharged I started googling why my lymphocytes were low (wrong thing to do) I guess my question is if I were HIV positive and lymphocytes happened to be pulled down by HIV would they increase (triple) like that within two days? I didn't have high risk behaviors, don't use drugs, etc. was just going through a divorce a year ago and after googling thought what if he cheated. The Infectious Disease doctor said he was certain this was caused by a tick an didn't see a need to further investigate. The fever has not returned since I have left the hospital and have no other symptoms. Upon coming home from the hospital and further testing my lymphocytes continued to be above 20% in three blood draws between mid august and now and liver enzymes back to normal and WBC always above 4.0. Doctors said I'm healthy and don't need to see me until January. Below is my blood work when I got into the hospital and when I was discharged. Any thoughts?

Admitted to Hospital:
Admitted:
Wbc Count 5.60 K/uL
Rbc Count 5.03 M/uL
Hemoglobin 15.1 G/DL
Hematocrit 42.8 %
Mcv 85.1 FL
Mch 30.0 PG
Mchc 35.2 G/DL
Platelet Count 172 K/uL
Rdw 12.8 %
Mpv 9.2 FL
Neutrophils % 85.5 %
Lyphocyte % 7.0 %
Mono % 7.1 % 0.0 - 11.5 %
Eosinophils % 0.0 %
Basophils 0.4 %
Neutrophil Absolute 4.80 K/CU MM
Lymphocytes Absolute 0.40 K/CU MM
Monocyte Absolute 0.40 K/CU MM
Eosinophil Absolute 0.00 K/CU MM
Basophils Absolute 0.00 K/CU MM

Serum Albumin      4.4 GM/DL      
Total Protein      7.4 GM/DL      
Bilirubin,Total      1.2 MG/DL      
Alk Phosphatase      123 U/L      
Ast      310 U/L      13 - 39 U/L
Alt      261 U/L      7 - 52 U/L
Bilirubin,Direct      0.4 MG/DL

1 Month Later
WBC: 6.0
RBC. 4.40
HGB: 13
HCT: 39.5
MCV: 89.7
MCH: 29.5
MCHC: 32.9
RDW: 13.2%
PLT: 256
LY%: 20%
MO%: 5.7%
GR%: 74.3%

AST: 20
ALT: 15
ALK: 100

Thank you very much. In genera in HIV, would lymphocytes triple within 2-3 days? Mine have never gone back down since the few days in the hospital. I guess not having a true diagnosis (never having a tick rash or being tested for all tick borne illnesses) has me wondering. I would assume if it was HIV after a year of no sex these symptoms wouldn't be cured by an antibiotic and everything back to normal and feeling great. Thanks for your time.

Thank you maybe 20% lymphocytes are my normal even on the lower end. Have a good weekend I need to stop thinking about what I had and know it's gone. If it were HIV symptoms wouldn't show for a day after a year and disappear with antibiotics. Appreciare your feedback

I feel a lot better thank you and happy to not have any symptoms since leaving the hospital especially liver enzymes back to normal. They even tested for Hepatitis which was all negative. Would a patients blood work that was HIV positive look different then mine and/or take longer to recover from an infection like I had (possibly with the tick and 104 fever). thanks again you have given me peace about this! It was just in the back of my mind, but I do know I'm healthy :-) I know WBC can not have such rapid swings with HIV through research.