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Diagnosing symptoms over the computer
Sep 14, 1998

Thanks for the great site! I've got a serious concern, but want some advice on what kind of testing to undergo, as I am concerned about my health, but have no idea what it may be. I had oral and vaginal sex with a sex-worker overseas two and a half months ago, and came up with fairly severe pharyngitis, chills running about every ten minutes, and chronic low-grade fever (99.5-100.5) starting two days after the incident. After about a month, my throat got better with a week and a half course of antibiotics, but the chills and fever have not stopped. In fact, I think the last week or two have been worse, especially as far as the chills/ sweats are concerned. I got antibody and PCR tests for HIV, which were negative, so I know its not that. I think the doctor did a WBC and some liver enzyme tests which were normal. But I'm very concerned about what I may have. My fever/ chills are not a dream - they are very tangible and bothersome. For instance, right now I'm at 101, sweating in strange little bursts, and feel 'waves' every so often. What tests can I ask for to rule things out, and find out what is disrupting me? A syphillis, gonorrhea (not oral, though), and chlamydia test were negative. Might malaria give me this? I was in the city, though. I would really appreciate your opinion on differential diagnoses. I do not have much money, and so would like to know more before I see a doctor again. Thanks a lot! - concerned in CO

Response from Mr. Sowadsky

Thank you for your question. I frequently get questions from people asking me what illnesses may be the cause of their symptoms. The fact is, nobody can diagnose your symptoms over the computer or over the phone. And nobody online or over the phone can give you a list of what possible illnesses may be the cause of your symptoms, nor what tests you need to have. This is for several reasons:

1) If you are having any growths, lesions, rashes, etc., nobody can tell you what these may be without seeing these symptoms in-person. And nobody can tell you if you have infections like thrush without examining you in-person. No matter how much detail you go into describing your symptoms, this is not enough to make a diagnosis. A doctor would have to see your symptoms in-person, to see exactly what your symptoms look like. Likewise, to determine if you have swollen lymph glands or not, a doctor would have to feel your lymph glands themselves. If necessary, a doctor would have to do lab tests to determine the possible causes of anything unusual.

2) Determining the possible causes of many symptoms can often be done only through laboratory tests. You cannot do lab tests over the computer or over the phone. In addition, in order to correctly interpret your lab results, a doctor would have to read the lab report itself.

3) Symptoms like fevers, fatigue, flu-like symptoms, swollen glands, etc. can have numerous possible causes. In order to determine the cause of non-specific and vague symptoms such as these, a doctor would have to do various lab tests.

4) In order to determine which lab tests are best for you, a doctor would need to know more than just your symptoms. They would also need to know your entire medical history, your family medical history, your international travel history, and your disease risk history (your sexual practices, smoking history, drug abuse history, your diet, etc.). Finally lab tests are determined by what your doctor sees when they give you a physical exam.

In summary:

There are a lot of things that we can do on the Internet, but there are also a lot of things that we cannot do on the Internet. Diagnosing a persons symptoms, or listing possible causes of a persons symptoms, is one of the things that we cannot do. It is important to remember that your computer cannot be used to diagnose any symptoms you are having. Your computer is not a substitute for seeing a doctor in-person. You cannot diagnose yourself with any illness, based on what you see or read on the Internet. Please see your doctor in-person regarding any symptoms you are having.

For more information on this issue, read the posting, Medical Information vs. Medical Advice.

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).



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