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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Male Having Fatigue, Sore Breast And Lymph Node. CAT Scan Report Normal. Have Alopecia Areata. Do I Have Chronic Fatigue Syndrome?

Male 47 years old, left breast prickly sensation and at times lymph nodes sore around breast, armpit, very fatigued. I had mono last year. I ve been on antibiotics a lot! I had a cats scan of breast/chest area, negative for lumps . My left breast is discolored slightly and a little swollen. To top it off I ve developed Alopecia areata . I was wondering should I get my hormones checked for low testosterone and have a needle biopsy of breast tissue? My doctor says I have chronic fatigue syndrome , but I would like a second opinion.
Mon, 10 Dec 2012
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General & Family Physician,  's  Response
Dear Concerned.,

Thanks for writing to us.

The presence of Chronic Infectious Mononuceosis (EB Virus) in dormant phase is one of the causes for Chronic fatigue Syndrome.The size of nodes not mentioned.Did you undergo FNAC of nodes also?FNAC is diagnostic for breast/lymph node condition.Antibiotics have not helped in your case.
Definition :the presence of easy fatiguability in a person after adequate sleep reducing average activity to more than 50 % to premorbid levels constitutes Chronic Fatigue Syndrome.
The chronic Epstein-Barr virus syndrome is a poorly defined symptom complex characterized

primarily by chronic or recurrent debilitating fatigue and various combinations of other

symptoms, including sore throat, lymph node pain and tenderness, headache, myalgia, and
arthralgias. in addition to complete Clinical work up,these investigations need to be done.
Investigations;
Pls have your serial temperature checked for a week, Serological Tests for Anti-EB Virus Antibodies,ESR,Complete Blood Count.,Urinalysis,Thyroid Function Tests,HIV Antibodies,Diabetes work up.Kochs work up including CXR PA view and lateral view.
The doctor shall exclude various causes and finally comes to Chronic fatigue syndrome as a diagnosis.
In addition to treating the cause of your fatigue, in case the cause is diagnosed.,there is a Psychological approach of "cognitive behavioral therapy" instituted by Psychiatryst.
Wish you a speedy recovery.
Best regards.,
Dr Lt Cdr ASN Bhushan,
Ex-navy.
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Male Having Fatigue, Sore Breast And Lymph Node. CAT Scan Report Normal. Have Alopecia Areata. Do I Have Chronic Fatigue Syndrome?

Dear Concerned., Thanks for writing to us. The presence of Chronic Infectious Mononuceosis (EB Virus) in dormant phase is one of the causes for Chronic fatigue Syndrome.The size of nodes not mentioned.Did you undergo FNAC of nodes also?FNAC is diagnostic for breast/lymph node condition.Antibiotics have not helped in your case. Definition :the presence of easy fatiguability in a person after adequate sleep reducing average activity to more than 50 % to premorbid levels constitutes Chronic Fatigue Syndrome. The chronic Epstein-Barr virus syndrome is a poorly defined symptom complex characterized primarily by chronic or recurrent debilitating fatigue and various combinations of other symptoms, including sore throat, lymph node pain and tenderness, headache, myalgia, and arthralgias. in addition to complete Clinical work up,these investigations need to be done. Investigations; Pls have your serial temperature checked for a week, Serological Tests for Anti-EB Virus Antibodies,ESR,Complete Blood Count.,Urinalysis,Thyroid Function Tests,HIV Antibodies,Diabetes work up.Kochs work up including CXR PA view and lateral view. The doctor shall exclude various causes and finally comes to Chronic fatigue syndrome as a diagnosis. In addition to treating the cause of your fatigue, in case the cause is diagnosed.,there is a Psychological approach of cognitive behavioral therapy instituted by Psychiatryst. Wish you a speedy recovery. Best regards., Dr Lt Cdr ASN Bhushan, Ex-navy.