26 y/o male with fever & chills but no flulike symptoms. malaria not seen. rbc normal, wbc 3.6/l, platelet 129/l. all others normal. possible causes??

Extensive work up: necessary. First, need to confirm whether there is blood in stool. If so, then a GI focused work up should commence. If not, then systematic work up for “Fever of unknown Origin “ is required. Infectious Disease can be consulted to help prioritize this process. Good luck. Careful attention to exposures, work-lifestyle history may be useful. Temperature curve should be charted.

Fever,chills: With the low white blood cell count a viral infection appears likely. Watch for sore throat, head cold, cough,rash, nausea,vomiting or diarrhea as any of these symptoms help localize the site of infection. At this time rest, take adequate amounts of fluid, light diet and take Tylenol as needed. If symptoms persist blood and urine cultures & tests for mononucleosis and hepatitis can be done also

Viral syndrome: Commonly causes drop in WBC count, high fevers/chills, drop in platelet count = pancytopenia... several viruses can do this, Adeno, influenza A, EBV, Enterovirus...