What’s Wrong With Me?

Reader's Digest (Canada) - - Contents - BY LISA BEN­DALL IL­LUS­TRA­TION BY VIC­TOR WONG

A med­i­cal mys­tery re­solved. LISA BEN­DALL

MARIA WAS ex­hausted and hadn’t been able to work in weeks. In March 2018, the so­cial worker had de­vel­oped a mys­te­ri­ous fever that came and went, and her lower ab­domen burned with pain. Her fam­ily doc­tor pre­scribed an­tibi­otics for a sus­pected uri­nary tract in­fec­tion, to no ef­fect. In the night, she would wake up so drenched in sweat she’d have to change all her bed­ding.

By mid-April, Maria had lost more than three kilo­grams and, around that time, ex­pe­ri­enced two episodes of an in­tense, stab­bing chest pain that made her fear for her life.

A chest X-ray and ab­dom­i­nal ul­tra­sound came back nor­mal, but af­ter a lab test found Maria’s C-re­ac­tive pro­tein count to be high—in­di­cat­ing in­flam­ma­tion some­where in her body—she was re­ferred to Geneva Univer­sity Hospi­tals.

A fever of un­known ori­gin—or FUO—is one of the most oner­ous di­ag­nos­tic chal­lenges, says Dr. JeanLuc Reny. By def­i­ni­tion, it’s a per­sis­tent fever last­ing more than three weeks that can’t be ex­plained af­ter a full in-hos­pi­tal workup. “Solv­ing it is like run­ning a marathon. It’s a mat­ter of train­ing and pa­tience.”

There are over 200 po­ten­tial causes of an FUO, the most com­mon be­ing in­fec­tion, in­flam­ma­tory dis­ease and ma­lig­nancy. Many cases are never solved, and a small frac­tion of

THE PA­TIENT: Maria*, a 61-year-old so­cial worker

THE SYMP­TOMS: Fever and lower ab­dom­i­nal pain

THE DOC­TOR: Dr. Jean-Luc Reny, head of the Di­vi­sion of Gen­eral In­ter­nal Medicine, Geneva Univer­sity Hospi­tals, Switzer­land

*Bi­o­graph­i­cal de­tails have been changed.

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