AboutNeha Dahiya MD Expertise I can help patients understand their lab report results, help them with queries regarding what pretest preparation is required. How often a follow up test needs to be done. What does a particular tissue biopsy report mean in everyday English. I can explain the biopsy or cytology procedure. I can deal with Histopathology / cytology / clinical pathology and clinical chemistry queries. Helping in this manner will be my contribution to the community.
Experience I am a pathologist and director of clinical laboratory services. I have been a practicing pathologist for last 9 years in a 350 bed multi specialty hospital laboratory.
Organizations Indian association of pathologists and microbiologists.
MIAC - Member International Academy of Cytology
International association of Pathologists - indian division
Indian association of Cytology
Question QUESTION: Dear Dr. Dahiya,
I am concerned about my wife. I have know her for 10 years and she may have had some short term illness but as of today she has had for 3 weeks: cough, daily low grade fever, and mild fatigue. she is not completely wiped out but she's still not herself. Originally, she started with a sore throat for which she was given an antibiotic. She no longer has a sore throat but continues with the other symptoms. her fever only reaches 100 to 100.4 at the end of the day. she returned to her primary on monday and she did some blood work. I will list that below.
AST-33
ALT-29
WBC Count-3.4
RBC Count-4.01
Hemoglobin-12.2
Hematocrit-35.1
MCV-87.1
MCH-30.4
MCHC-34.7
RDW-13.1
Platelet Count-267
ABS. Neutrophils-2264 66.6%
ABS. Lymphocytes-935 27.5%
ABS. Monocytes-126 3.7%
ABS. Eosinophils-68 2.0%
ABS. Basophils-7 0.2%
Her primary said she has seen alot of patients lately with chronic fever with cough and feels that it is a virus. We are still waiting for a flu culture to come back. My question is should we be concerned about her situation. she's not getting worse but she's not getting better. I tend to worry towards the worst and have had Lymphoma on my agenda so to say. She does have a very small lymph node behind he left ear and a very small on ein the left groin that her primary looked at and felt there was no cause for alarm. Please let me know what you think an thank you in advance for your help.
Gregory
ANSWER: Hello Gregory:
A low grade fever for 3 weeks is a cause for concern if no specific reason is found.
The bloodwork is all within normal range and does not point towards anything specific.
Her hemoglobin is towards the lower limit but that should not cause fever.
Tiny lymph nodes less than a cm are insignificant. I would wait for the culture report and then go on from there.
If everything comes out normal... she may have chronic fatigue syndrome which is a known entity but even that does not explain the low grade fever. I would favor a virus too.
Let me know how the culture report goes.
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QUESTION: Dr. Dahiya,
The flu cultures on my wife came back negative. I did start to give her both Ecchinacea and another strong anti-viral, Grapefruit seed extract yesterday and she says that today she is beginning to feel better. she states her cough is lessened and whereas her fever was 101 yesterday, at 2:30 PM today it is only 99.2. She just recently spoke with our doctor who was glad that she did not have the flu. She reassured my wife that, especially in light of feeling better today she is convinced it's a virus and that she is returning to normal. She has no weight loss, no night sweats, and only a small lymph node in her groin (I think the small one in her neck has decreased. Part of my problem, honestly, is that when I look on the internet, you either have a virus or cancer. At this point I understand that if she continues to progress it's not a problem. If she continues to have the same low grade fever (never above 100.5) is there anything else you would recommend. Thank you so much for taking the time to help. Your advice is very helpful.
Gregory
Answer Hello Gregory:
At this point the symptoms and their response to treatment seem to favor a viral infection.
If the fever continues to be low grade - without an enlarged lymph node a lump or mass in the body it is difficult to test for cancer. In addition some screening blood tests are available to check for cancer but they are non specific and without any physical signs and symptoms will not provide definite direction.
Another test which can be done if there is continuous fever to have a culture for more exotic organisms. I would recommend that you consult an infectious disease specialist if the fever does not subside.
Good luck. I think your wife will soon be back to normal health and energy levels.
