[38F] With persistent headache, fever, and gastrointestinal symptoms

Patient Description

A 38-year-old female has been experiencing a range of symptoms since late July. These include a throbbing headache located at the back of the head, rated as 10 out of 10 in severity. The headache comes on gradually and occurs off and on, lasting a few hours until relieved by ibuprofen (500 mg, three times a day) and sleep. There are no changes in vision or other neurological symptoms during these episodes. The patient also reports a fever with a temperature of 101.9°F, aching body pain of moderate severity, vomiting, a sore throat, loose and more frequent bowel movements without blood, and sharp, crampy abdominal pain accompanied by nausea. The patient has tested negative for COVID-19, strep, and influenza. There are no recent injuries, accidents, travel, or exposure to sick individuals. The patient has no pre-existing conditions or chronic illnesses and is not taking any other medications, supplements, or herbal remedies besides ibuprofen. There are no known medication allergies.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  • Viral Infection: Given your fever, sore throat, body aches, and gastrointestinal symptoms, a viral infection could be a likely cause. Common viruses like the flu or other respiratory viruses can cause these symptoms. Even though you tested negative for COVID-19, strep, and influenza, other viruses could still be responsible.

    • Treatment: Viral infections typically resolve on their own. Treatment focuses on symptom relief, such as rest, hydration, and over-the-counter medications like ibuprofen for pain and fever.
  • Gastroenteritis: This is an inflammation of the stomach and intestines, often caused by a viral or bacterial infection. Symptoms include diarrhea, vomiting, abdominal pain, and fever.

    • Treatment: Staying hydrated is crucial. Oral rehydration solutions can help. Over-the-counter medications may relieve symptoms, but it's best to consult a healthcare provider for specific advice.
  • Migraine or Tension Headache: Your severe, throbbing headache could be a migraine or tension headache, especially since it improves with sleep and ibuprofen.

    • Treatment: Over-the-counter pain relievers like ibuprofen can help. Avoiding known triggers, staying hydrated, and maintaining a regular sleep schedule can also be beneficial.

What you can do

While it's important to consult a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Stay Hydrated: Drink plenty of fluids, especially if you're experiencing vomiting and diarrhea. Oral rehydration solutions can be helpful.
  2. Rest: Ensure you get plenty of rest to help your body recover.
  3. Over-the-Counter Medications: Continue taking ibuprofen as directed for pain and fever relief. Follow the dosage instructions carefully.
  4. Monitor Symptoms: Keep track of your symptoms, including any changes or new symptoms. This information will be helpful for your healthcare provider.
  5. Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, get insights, and share longitudinal medical notes with your provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Worsening Symptoms: If your symptoms worsen or do not improve with over-the-counter treatments.
  • Severe Abdominal Pain: If you develop severe or persistent abdominal pain.
  • Dehydration: Signs of dehydration include dry mouth, decreased urination, dizziness, and fatigue.
  • High Fever: If your fever persists or rises above 103°F.
  • Neurological Symptoms: If you experience confusion, difficulty speaking, or weakness in any part of your body.

Remember, while I can provide information and suggestions, it's important to consult a healthcare provider for a formal diagnosis and appropriate treatment. If you have any more questions or need further assistance, feel free to ask.

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3 mo ago


People Also Ask


What could be causing my severe headache at the back of my head?

Your severe headache could be a migraine or tension headache, especially since it improves with sleep and ibuprofen. These types of headaches can be triggered by stress, dehydration, or other factors.


How can I manage my symptoms of fever, body aches, and gastrointestinal issues?

To manage your symptoms, focus on staying hydrated, getting plenty of rest, and using over-the-counter medications like ibuprofen for pain and fever relief. Oral rehydration solutions can help if you're experiencing vomiting and diarrhea.


What should I do if my symptoms worsen or new symptoms appear?

If your symptoms worsen or new symptoms appear, such as severe abdominal pain, signs of dehydration, or neurological symptoms, seek medical attention promptly. Monitoring your symptoms and consulting a healthcare provider is important.


Why did I test negative for COVID-19, strep, and influenza but still feel sick?

Even though you tested negative for COVID-19, strep, and influenza, other viral infections could still be responsible for your symptoms. Many viruses can cause similar symptoms, and some may not be included in standard testing panels.


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