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Treartment for muscle ache, PAROTITIS and EBV.

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On Feb 7th I was with a woman and two weeks later I got really sick with flu like symptoms and I have been sick for the last six months. I was dx with parotitis on my left side which I still have now. I've have muscle ache, sore throat (lasted 2 months), weight loss and fatigue. Glands in neck are still swollen. My last set of test was three months after geeting sick, May 7( which I included ). My dx said that it may be EBV, but she was not sure. I'm also having some pain in my eyes and warm tingling feeling on back of left hand and top of foot. I really need help.

Category: Infectious Disease Specialist

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Category: HIV- AIDS Specialist
 31 Doctors Online

Hello. Thank you for posting your query at DoctorSpring.com
I understand your concern.
I have gone through all your reports, and they are suggestive of infectious mononucleosis in the recent past. Let me explain how i can come to that diagnosis. IGM antibody test if positive for any virus/bacteria, indicates an active infection. Once the infection has past its acute stage, it comes down. IGG antibody test is done to check for past infections, or also to test the immunity status. Since you took the tests after 3 months, by that time your IGM already came down, but IGG persisted, and hence it is still pretty high. You obviously have not been cured of mononucleoesis till now.
Normally mono is a self-limiting disease with an incubation period of 4-6 weeks, and then the disease manifests. The most common presentation will be that of sore throat, enlargement of neck lymph nodes, fever, constant fatigue, and in severe cases hepatosplenomegaly. Hence patients with mono, are advised not to go for contact sports, since they can easily injure their injured spleen which can be catastrophic. The surprising thing in your case is that it still has not subsided. There is no such vaccination but super added infections can be prevented.
Since you also have parotitis i will suggest you take the following medicine :
1) Tab. Augmentin ( Amoxycillin + Clavulanic acid ) 650 mg two tablets daily for the next one week.
2) Tab. Ibuprofen 400 mg SOS in case of muscular pain/ headache. ( Can develop along with fatigue )
In your case eye pain can be due to the constant fatigue that you have been subjected too since you acquired Mono.
3) Tab. Neurobion Forte one tablet a day ( or any other multi vitamin which is having B12 available locally ). Some viral infections can lead to neuritis or nerve inflammation leading to tingling feeling.
If your parotitis is still not resolving, it is better to get yourself examined by a general surgeon, who can assess if your deep lobe has already been involved. Then some fluid can be drained and sent for culture.
Once your super added infections are treated, mono should subside.
Feel free to discuss further,
Regards


Patient replied :

Could you tell me me why my Cytomegalovirus numbers are high alos could some other illness or virus triggered this? I really concerned beacuse of being sick for so long.


Hello. Thank you for the follow up.
Yes persistent infection with Mono, makes a patient more susceptible for other viral illnesses. CMV is also positive in your case and that could be causing the neuritis problem too, leading to the tingling you described. Please do not be worried, since both the diseases are self limiting, and more than 90 % of the population are infected with those viruses. Some people manifest the disease, and some don't.
You will definitely recover, it is just taking slightly longer.
Please take a course of the medicines i mentioned, and get back to me in 7 days. If there isn't much improvement, we can start anti-virals for you. Anti-virals are normally the last resort, since there are questions about their efficacy in CMV/EBV infections.
Feel free to discuss further,
Regards


Patient replied :

I'm really concerned based on the parotid swelling and the reactive ebv and cmv that this is HIV related. Everything that I read is stated that theses are initial signs of primary HIV. The augment had no impact at all. At this point I'm lost. Could it be that it's taking me longer to produce antibodies, because my system is so worn down. I also took your advice about the general surgeon. He said that although swollen there is no clear place to draw fluid.


Hello.

While parotitis, EBV and CMV can occur in patients who have HIV, they are quite common even in the normal population. So it does not mean you have HIV.

You do not have HIV because you have been tested and found negative. HIV tests are very accurate and a negative test after 6 weeks to months after exposure is conclusive and means that you do not have HIV.
Your body is healthy and producing the required antibodies. So please do not worry about this.

You only seem to have a sequelae of Mononucleiosis where some individuals continue to have myalgia (muscle aches), swollen lymph nodes etc. You can take an anti-inflammtory like OTC Ibuprofen 400 mg, after food, twice daily, for a week instead of SOS. This should work on resolving the persistent inflammation and also provide symptomatic relief.

I hope this helps.
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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