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my partner is severely unwell and in need of a diagnosis ASAP. We are currently awaiting results of an upper addominal ultrasound done last Tues but assume that the lack of news means no further clues. I am hopeful someone may be able to read a history of SHane and advise whether you think we are on the right track so far as he has very risky history healthwise and I am worried about delaying tests for any length of time but don't know what to do next.
We have been together for over 10yrs..he always been healthy( ie. Has never got sick easily and always recovered quickly) except for a history of an extreme alcohol/drug problem over a period of 22yrs from age 13 to age 35. Binge drinking resulting in incontinence, vomiting blood and pancreatitis. Drug use was mainly marijuana with daily use of this as well as cigarette smoking.Occasional heavier drug use but not habitual. Around 2yrs ago he was given a clean bill of health when given a full medical for the purpose of obtaining his drivers license back.( included full physical and blood tests.)We were surprised at this as after bouts of drinking he had been suffering excrutiating pain in the middle back region- believed to be due to the acute pancreatitis.
He has now been alcohol free for just over 2yrs( he is 37yrs old) , but still a cigarette smoker and daily marijuana user( in fact, ironically, he finds this is now his only relief from his symptoms.)About 18mths ago he developed excrutiatingly itchy feet- lasted about 15mths -groin lymph nodes enlarged during this time( not painful though)- (this cleared up around the same time his other symptoms took over towards the end of last year.)
13mths ago- developed a severe case of cellulitis on knee. No known cause- ended in hospitilisation and IV antibiotics. Found to be anaemic and treated with iron replacement therapy. No further investigation done.Over past year began to notice he was slow to heal ( cuts etc) and was feeling less than 100% all the time. Went downhill very quickly this year culminating in diagnosis of anaemia and re-activation of cytomegalovirus( which they have confirmed he had been infected with at some unknown earlier date as he showed both antibodies so it is not a new infection.)He has been very ill and unable to work since Feb 05.

Been treated with iron therapy finishing about six weeks ago.

Recent/Current symptoms include:

Fevers

Drenching night sweats

Nausea ( especially bad in the mornings but constant and worsening in severity)

Severe Weight loss- especially as he has always been on the lean side ( gone from 64kg to 55kg- he is 1.65cm tall )

Extreme fatigue

Breathlessness

Chronic mid abdominal pain radiating to back ( same pain as he suffered when drinking, but now permanent, varies in degrees of severity but never goes away completely- worse when lying down)

Complete loss of appetite, now forcing himself to eat

Feeling of fullness/bloated abdomen( this comes and goes)

Irritability

Difficulty sleeping due to being uncomfortable + sweating

-No persitant diarrhoea or constipation and no noticible blood in stools.Bowel habits regular.

-No sign of jaundice or pain/blood on urination.

He has so far only had blood tests in Feb and March this year, which resulted in diagnosing the anaemia ( RBCS normochromic normocytic, low low iron stores and iron saturation, but normal ferritin TIBC levels) suggested anemia of chronic disease and the re-activation of the CMV was also discovered at this time.The doctor was prepared to accept this as the cause of all his problems/symptoms. Other results were normal including liver function ( except albumin was a bit high also suggesting slight dehydration)C-reactive protein levels were normal at 2 mg/L on 4th March. This was over two months ago but he has not improved- instead he is slowly worsening - he likens it to a feeling of being 'poisoned' from within. We have gone to a new doctor and he arranged for a chest x-ray which we have not heard the results of yet and he has also arranged for an upper abdominal ultrasound in 2 wks . He also found with palpitating the upper abdomen ( first time any physical examinations have been done) that there were tender areas in the liver or region. What would your thoughts be in this situation? I am extremely worried as he is fading away in front of me and only a shadow of his usual self.

Can anyone suggest any tests that might help???





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