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    Would high liver enzymes count and abnormalities in urine test while experiencing fever point towards HIV?

Posted on Tue, 14 Jan 2020 in Medicines and Side Effects
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 would feel fine after a dose of tylenol. My CBC WBC: 5.1 Neutrophils: 85% Lymphocytes 7% (full blood work below). 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%. While in the hospital doctors checked lymph nodes in neck and arm pits all normal. Blood work has ALL been normal since was pulled in Sept 2017 and August 18. I included WBC and lymphocyte count below since August. I did not test positive for lyme disease or babeosis back in August and Infectious Disease doctor looked over my work saw the fever go down with doxycycline and said he was 99% sure it was a tick, got discharged and that was it. Fever has never returned and no other symptoms. In passing a internal medicine resident said possible HIV.... the ID doctor said this blood work was not normal of HIV and I have a tick not to worry. Since then of course I googled wrong thing to do! I feel healthy and other then that 104 fever for a few days have had nothing. I did not engage in "risky" behaviors, but would this blood work below in August and since august (WBC/Lymphocyte) point toward HIV? I wouldn't think so and the ID doctor said he would see other things besides fever when I was there.. just that residents comment made me think. I"m a 34/female

Admitted to Hospital:
Admitted August 2017:
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 %

September 17
WBC: 6.0 lymphocytes 20% (1200)

January 18
WBC: 6.3 lymphocytes 29.1% (1,833)
Answered by Dr. Noble Zachariah 52 minutes later
Brief Answer:
Normal result now and no suggestion of HIV any time.

Detailed Answer:

Welcome back and thanks for your query.
As we had discussed, you had a tick borne bacterial infection in August last year and responded well to Doxycycline.
There was no blood change suggestive of HIV and the low percentage of lymphocytes was only due to the acute bacterial infection.
Your lymphocyte percentage returned to normal with the control of infection and is remaining normal in your January 18 test also.

So have no fear of HIV and relax.

Have a great day.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Noble Zachariah 7 minutes later
Thank you.

Are hematologic changes seen in HIV over months? I would imagine they would worsen not get better stay stable. I rapidly went from 104 fever to normal very quickly.

I need to enjoy my healthy life and I suppose just take a test to put it out of my mind forever. Its hard not having a clear tick born illness.. but was told by the ID doctor there are tons of tick borne illnesses and tests aren't reliable.

Thanks doctor
Answered by Dr. Noble Zachariah 23 minutes later
Brief Answer:
The right antibiotic for the infective organism brings quick results.

Detailed Answer:
Welcome again.
When the organism is highly susceptible to the antibiotic, the resolution of the illness is quick. We see this often with early use of appropriate antibiotics.
The lymphocytes that go down in HIV is the subset CD4 of T lymphocytes .
Since you had no risky behavior, there should be no concern about HIV from your current results.

Wish you good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Noble Zachariah

Internal Medicine Specialist

Practicing since :1974

Answered : 2276 Questions


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