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  • Possible Mono Misdiagnosis?

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    Old 10-29-2014, 07:49 AM   #1
    sickstudent
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    Question Possible Mono Misdiagnosis?

    For the past eight months following two bunion surgeries I have been having some issues with general malaise as to be expected from recovering from surgeries. Recently though things have been getting weird.
    Two weeks before starting a new job a horizontal indentation appeared on my right thigh (about 5 inches long and 1 1/2 inches wide). I can not recall any kind of injury to that area that would cause this. The thigh felt heavy and weak for a few days once it appeared. That following week the thigh developed soreness in the muscle. Then the week after both legs became very sore and weak. I went to see my primary care provider to show him the thigh. Him and another one his fellow doctors had never seen anything like it before. I was sent to have an ultrasound of the right and left thigh for a comparison. Everything came back normal.
    During this time I lost my health insurance. The weakness, pain/ soreness in my legs became so bad that I went to my county health clinic's urgent care center the night after I was having a one time occurrence of tingling and burning in the effected thigh, and in both lower arms and hands accompanied by severe muscle spasms only in legs. No one there had ever seen a thigh indentation like mine. I discussed my problems with them, and with the idea from my step mother who is a nurse, I was tested for mononucleosis using the spot test. It came up positive. Later that night I woke up with pain in the right corner of my mouth behind my back tooth, and to my surprise it was a swollen open mouth sore that took about 4 days to disappear.
    I was very surprised because I haven’t had and problems with being sleepy or tired however I had a low grade fever for a few days. I did not have a sore throat, swollen lymph nodes, cough, enlarged spleen or kidneys, and I was not nauseous at any point. To complete their diagnosis they had an EBV blood test done as well as full lab panel for Lupus, Lymphoma, and some other things. Everything came up normal except for my creatinine levels being low and my ALT was high. The EBV came back as inconclusive so I am having that done again soon. Everything is being done at a snail pace until I am able to get back on my old health insurance, which will hopefully be done soon.
    ANA and HIV were negative, and my TSH was within the normal range. I asked my physicians if it is possible to have a false mono spot test result and they said that it is. I am waiting to have an xray done of my thigh, and my physician wants to see an xray of my lower spine from a previous diagnosis I received two years ago of lumbosacral transitional vertebrae. They are sticking to their guns that it has to be mono.
    I am now on week four of all of this, and I have not been able to work my part time job because of the pain and weakness in my legs. The low grade fever still shows itself every once and a while. If I walk around at all during the day, especially at school that I have twice a week, I am paying for it that night in my legs, and the whole next day. Also, a there has been a few new things that I have noticed such as tender scalp and hair loss (probably from stress). I have read online that most people with mono have abnormal levels of white blood cells ( mine where completely normal), and abnormal amounts of lymphocytes which was also normal according to my blood work.
    I wanted to see if anyone else has had this problem and that you might have some suggestions for me. I would really appreciate it.

    Last edited by sickstudent; 10-29-2014 at 08:48 AM. Reason: symptom addition

     
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    Old 10-29-2014, 08:34 AM   #2
    sickstudent
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    Re: Possible Mono Misdiagnosis?

    Also, I consider myself a generally healthy 21 year old. Suggestions and ideas would be greatly appreciated as I am seeing a new PCP on 11/3! Thanks for reading my lengthy rant up above ^^^

     
    Old 10-29-2014, 09:52 AM   #3
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    Re: Possible Mono Misdiagnosis?

    Indendations in the fat under the skin can be caused by inflammation called panniculitis. It is often a part of another rheumatological disorder that can cause general malaise, fever, muscle aches and pains and inflammation in the muscles, joints and elsewhere. A full work-up should be done for inflammation (sed rate, CRP, complement levels) and abnormal antibodies seen in rheum conditions including anti SSA (anti-Ro), a CK for muscle enzyme elevation, and urinalysis. If nothing shows up, then a subcutaneous biopsy with immunofluorescent studies can be done to get at a diagnosis. Sometimes panniculitis shows up before other markers in the blood are seen. This is not a symptom of mono. Panniculitis is not common, but a derm and/or rheum would be most likely Drs. to be aware of it.

     
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    Old 01-04-2016, 08:03 AM   #4
    sickstudent
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    Re: Possible Mono Misdiagnosis?

    Quote:
    Originally Posted by ladybud View Post
    Indendations in the fat under the skin can be caused by inflammation called panniculitis. It is often a part of another rheumatological disorder that can cause general malaise, fever, muscle aches and pains and inflammation in the muscles, joints and elsewhere. A full work-up should be done for inflammation (sed rate, CRP, complement levels) and abnormal antibodies seen in rheum conditions including anti SSA (anti-Ro), a CK for muscle enzyme elevation, and urinalysis. If nothing shows up, then a subcutaneous biopsy with immunofluorescent studies can be done to get at a diagnosis. Sometimes panniculitis shows up before other markers in the blood are seen. This is not a symptom of mono. Panniculitis is not common, but a derm and/or rheum would be most likely Drs. to be aware of it.
    Thank you for your reply ladybug. This indentation that I described has come back again (I actually noticed it this morning), but is smaller and is relatively in the same spot with light tension. After I made this original post on 10-29-2014, I had an ultrasound done of both legs for a comparison and I was told that nothing was found. I was curious on your thoughts of this again because I have a history of weird health problems like everyone else on here lol. I am 22 and I practice light yoga, and I am a healthy eater. When this first happened I was doing neither of those things. I haven't been in any accidents that I would think to cause this, or any strained muscles from the yoga that I recall.
    I posted another question yesterday that you responded to titled Eye pain from allergies? Or eye pain from underlying cause?

    I see that you make a lot of post on here and that you are very knowledgeable. Thank you for your help in advance.

    Last edited by Administrator; 01-04-2016 at 03:24 PM.

     
    Old 01-06-2016, 08:27 AM   #5
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    Re: Possible Mono Misdiagnosis?

    My thoughts on the skin indentations are the same as before- possible lupus panniculitis. The ultrasound would have likely have just shown thinning of the fat layer under the skin, something they might not even comment about. I always find it helpful to get an actual copy of the report, as there is often information in the report (clues) that are not told to the patient. When they say it was ok, they probably just meant nothing serious was found, but they don't take the time to go over details. You can get the report emailed or mailed to you, or pick up a copy at the Dr's office. You can also see pictures of panniculitis for comparison on the internet if you search panniculitis images, and see if they look similar to yours.

     
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    misdiagnosis, mononucleosis, muscle pain and knots, muscle spasms, thigh



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