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A 28-year-old male asked:

Experiencing chronic fever for 23 days, night sweats and pain under right ribs. high lymphs, low neutrophils, high alt/ast and elevated crp. causes?

4 doctor answers4 doctors weighed in
Dr. Ed Friedlander
Pathology 44 years experience
Labs aren't key: In a fever of unknown origin workup, the routine blood work is seldom key. Get a competent physician. First and foremost, we need to rule out bacterial endocarditis. Especially if the fever jumps around, hodgkin's needs to be ruled in or out. You may have tuberculosis, malaria, sarcoid, a non-hodgkin's lymphoma or any of a number of other illnesses. Trust you're on no meds.
Dr. Michael Thompson
Hematology and Oncology 20 years experience
DDx: The differential diagnosis (ddx) for this is broad. That is a long time for a fever. Questions: how high a fever? Anyone else with symptoms? Have you had blood cultures? High lymphocytes can be viral or leukemia/lymphoma. High CRP is nonspecific. High liver tests (alt and ast) and "pain under right ribs" could indicate hepatitis. Acute hepatitis is a possibility.
Dr. Helmy Guirgis
Hematology and Oncology 46 years experience
Please see MD: Any weight loss? Any nodes or lumps? How high is the fever? The trial of fever, night sweats and pain is worrisome and raise many questions. Infection might be a cause but malignancy should be ruled out. Do not hesitate..
Dr. Thomas Knecht
A Verified Doctoranswered
A US doctor answeredLearn more
Viral infection?: Hi. It sounds like your liver's stressed out about something (elevated AST & ALT and right upper quadrant pain)! Maybe you have a viral infection with the high lymphs (e.g., hepatitis viruses, etc). Your doc who ordered those labs will tell you the plan or refer you to a specialist. Maybe even check flow cytometry to make sure there's no monoclonal population of lymphocytes. Follow up with doctor!

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Last updated Jul 28, 2014

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