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Can there be a chronic infection lasting for years with a normal complete blood count?

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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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Published At June 13, 2021
Reviewed AtJune 23, 2023

Patient's Query

Hi doctor,

I am a 36-year-old male with a height of 5.5 feet and a weight of 125.6 lbs. I have weight loss of 5% on average every year for the last six years. I am eating very well or better to get back to my average weight. Six years back when I moved to a new room as part of a new job and stayed with few men. After a year, I realized one of them was going to the wrong places, which could cause health issues, and I moved out. I think I got sick one time for a couple of days when I stayed there. During that stay, that guy used to prepare food sometimes, and we even shared room items. The new job was also stressful for few years. I do not know if I am overthinking here. I noticed that my weight started lowering at an average of around 5% each year, and I started developing allergies to pollen, dust, and morning sneezing. CBC (Complete Blood Count) and CMP (Comprehensive metabolic panel) came normal for the last three years. So I decided to wait and watch. However, I see weight loss continuing. Over the last two years, I have slight joint pain, digestive issues sometimes. I did a CT(Computed Tomography) scan and upper endoscopy. Doctor found no related problems. In recent blood work, I got to know I have Hashimoto’s thyroiditis. I also read like some infections could cause symptoms like weight loss and autoimmune disorders like Hashimoto’s. In the list of viral infection tests I did so far, I have HSV-1 detected. But I read that it is more common, and it will not create any symptoms other than mouth ulcers. I am also attaching a copy of my recent blood work and stool test to check for any pathogens. Based on this, could you please help me with the below details? Could there be some chronic infection lasting even for five to six years with normal CBC and CMP results? If so, is there any test I could do to check for all possible infections or all viral infections? If a condition lasts for around six years, could that be viral, bacterial, pathogen? Any test to check for chronic viral disease? Is there any component in annual blood that typically indicates signs of possible chronic infection?

Hello,

Welcome to icliniq.com.

I understand your query, and I saw your reports attached (attachment removed to protect the patient's identity). Your positive ANA (antinuclear antibody) test report and associated symptoms like joint pain suggest autoimmune disorder. However, it is not suggestive of an infective etiology. Do not worry. You will not have any chronic infection. No need to test for other infections. Your symptoms do not look like infectious origin. Instead, it seems like autoimmune disease etiology. There are many tests available, but I want to ask few questions before going into these. Are you married? Did you have any unprotected sexual exposure with community sex workers? Do you have any history of night sweats? Do you have any history of recurrent respiratory tract illness? Do you have any history of recurrent fever? Do you have any history of jaundice before? Based on your reply to the above questions, I shall suggest a few tests. Do not worry. Do not get stressed.

Take care.

Patient's Query

Thank you, doctor,

I am not married. I do not have any unprotected sexual exposure with community sex workers. I do not remember have a history of night sweats. Sometimes I wake up in between because of the cool room temperature. I get stuffy and runny nose and continuous three to four sneezing for an hour after waking up most of the days, mainly during pollen season and rainy days, or waking up a little early. After that, most of the daytime will be fine. I do not get a cough anytime. I have a pollen and dust allergy too. I do not remember having a fever in the last two years. No history of jaundice. Previous three years, CBC blood work came normal. Differential WBC count remained at the same standard level for the last three or four years. Is it possible to have these in normal range with some underlying infection? I started investigating too much because many things look related, like weight loss is consistently happening for the last six years, I am feeling a little bit weaker day by day, developed autoimmune Hashimoto's without a family history. I want to make sure I am not having any chronic viral, bacterial, pathogenic, or fungal infection that makes me weak year by year. I also read Epstein-Barr Virus, and some HPV could cause autoimmune disease. Can you please recommend the tests?

Hello,

Welcome back to icliniq.com.

Thank you for your reply. On seeing your clinical history, I suggest that there is no need for any further tests. You do not suffer from any chronic microbial infections. There is no need for any examination for Epstein-Barr virus, HPV (human papilloma virus), and all. Your weight loss is due to your autoimmune disease etiology. Many tend to develop autoimmune disorders like Hashimoto's without any family history. Do not worry. Do flow the below advice: Drink two to three liters of water per day and keep yourself hydrated. Take food rich in Vitamin A, Vitamin C, Vitamin D3, Vitamin B12, Zinc, and Folic acid. All these help in improving your general immunity and basal metabolism of the body. Take substances rich in flavonoids such as green tea twice a day. It, too, will regulate your basal metabolism. Take protein-rich food like two eggs per day, three cups of milk, and cereals daily. Engage yourself in morning walking, yoga, and meditation. These three are very effective in improving your circulation and regulating metabolic rate. Addition of natural anti-inflammatory food substances like ginger, garlic, and turmeric reduces your inflammation which happens in autoimmune disorders to a great extent. I will recommend annual health check-up consisting of complete blood count with peripheral smear, thyroid function test for FT3 (free triiodothyronine), FT4 (free thyroxine), TSH (thyroid-stimulating hormone), rheumatoid factor, C-reactive protein, liver function test, renal function test, fasting and postprandial blood sugar, complete urine analysis, ultrasound scan of the whole abdomen. You can take multivitamin supplements for two months. I will suggest tablet Zincovit one tablet daily morning after food for two months. Try to avoid stress in your daily routine. Try to keep yourself engaged in some work. Listen to soft music to keep yourself calm and relaxed. Measure your weight once in two months only and note it in the calendar. Do not check your weight frequently. Follow my advice, and you will see good changes in few months. You can contact me anytime when you have a problem or health query, and I will solve your health issues. You will be fine. Take care.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. N. Ashok Viswanath
Dr. N. Ashok Viswanath

Infectious Diseases

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