Dr. Sadaf Mustafa
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have a low-grade fever for three months. I have three or four lumps on the left breast. There is a swollen gland in my neck and under my jaw. It swells and gets smaller. I have pain in my left shoulder and it crunches when I move it. I also have pain in my left elbow without injuries. Now, I have rib pain with a large nodule on the left side. It seems to be a floating rib. I have consulted the doctor several times. I have done blood culture, stool culture and did tests from HIV to mononucleosis. All the results are negative.
I have a decrease in the level of lymphocytes and the protein in my urine is abnormal. I have done a chest X-ray and it was normal. I have done a CT scan for abdominal pain and it showed inflammation in the lower colon and rectum. The stool culture is normal. Now, I have pain while breathing. I have pain in the left lower back with pain in the left ankle with swelling. My breast ultrasound is also normal. I have lost six kilograms. I have nausea and fatigue. My blood pressure is low with a level of 90/58 mm Hg. I am going to do a colonoscopy. Please suggest.
Hi,
Welcome to icliniq.com.
If you have night sweats, weight loss, and fever, then you need to worry about leukemia, lymphoma, mycobacterial infection, HIV (human immunodeficiency virus), and autoimmune disease. You need to do a peripheral smear, ANA (antinuclear antibody) with differentiation, lymph node biopsy, or biopsy of the chest wall mass. You need to do a CT (computed tomography) chest with contrast. It is good to hear that you have a negative result for HIV. I am assuming that you have done HIV testing using PCR (polymerase chain reaction) and not through HIV antibodies. The lymph node biopsy will provide you a clue for diagnosis and it is tested for infections. The colonoscopy will also provide you some answers. Please share your blood work and imaging results.
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Internal Medicine
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