Question

My age is 27, weight 82 kg, unmarried. I was in uttar pradesh. I came to my home on 21st march and from 23rd I was feeling light increase of temp in head i.e was 99f. Then on 27 march you got sore throat (like something stuck in throat) and also my sternum sides are paining on body movement. U went to government hospital many times and they did xray and xray was normal and also took antibiotics for sore throat but still not resolved. On 29 may I got high fever 104f for 3 days and was having burning in penis after urination and also pain at tip of penis ,it was continued for 3 days and fever was not coming down with paracetamol. My urine report on 1 june was pus cell 18-25, rbc 10-12, bacteria 1+,albumin 1+ and blood report on 1st june was lymphocyte 10%, platelet 1.25thou/cumm (range 1.5 to 4, tlc was 4.then doctor gave me mefenamic acid and some antibiotics like nitrofurantoin and ofloxacin for 15 days. But after that I was feeling like shooting pain radiating from penis to rectum. On 1 july I visited urologist again, there junior resident ordered usg abdomen and it shows normal study and prostate size 21 cc. Then he sent to me general surgeon to check piles but it was normal as they checked with metal probe .on 7 july and 13 july I got bleeding in semen. Semen was fully mixed with blood. And I was also having hips pain, hips connecting to femur point pain, femur pain, thighs pain and legs pain, feet frontal part pain and hands frontal part pain, leg pain and also getting chills many times. On 14 aug, my vitamin d was 75 (range 74 to 215) but it is same since 2015. And blood report show lymphocyte 26%,platelet 2.34lakh and tlc 5 (range 5 to 10. On 14 aug 2020, my serum psa came 2.06 ng/ml but in 2016, it was 0.77 ng/ml. Within 4 years it has increased 3 times. On 26august I went to urologist but my maine issues were to go to him to interrelated the cause of my bones pain as I saw blood in semen as first sign of problem. He did semen analysis showing 10-12 pus cell, and trus prostate showing "prostate volume 14. 8 cc. The prostate is normal in size, shape and shows ill defined parenchymal areas if increased echogenicity mainly limited to the anterior stromal zone and transitional zone of the prostate. The echogenic areas are seen extending and surrounding the opening of ejaculatory ducts on both side and there is preserved zonal differentiation noted in both lobes elsewhere" possibility of chronic prostatitis needs to be ruled out" I also had trus prostate in 2017, at that time prostate was normal having 13. 5 cc size (it was done in 2016 due to frequent urination problem. He gave me antibiotics for 21 days i.e oflox 400 mg (bd), alfuzosin 10 mg (od. 8 days after taking these antibiotics again I got blood in semen on 2 sep and 3 sep. My mai problem is that my whole body bones are paining i.e hips bone ,femur bone ,back of hips where it connect to femur near rectum, thighs pain, legs pain, feet pain (not able to walk properly, rib cage pain, chest frontal part pain ,teeth pain, having too much weakness in thighs and legs ,shoulder joints also started to pain since 6 days, hands pain above elbow, I get chills sometimes in these hot summer at back of lungs. My weakness intensity increasing on daily basis. Withing these two months pain acquired my whole body. My feet are paining too much and having weakness in hands too like somebody get tired after too much work. My sore throat (like something stuck in throat) not going even after showing to ent 2 or 3 times, they are saying it might be due to acid reflux without checking anything, they are not seeing properly. I do not feel they I have that much acid reflux to cause problem. With the intensity of increasing problem and sudden onset of whole body bone pain and burning sensation and specially too much weakness in femur and bone pain in hips bone connecting point, I assumed that I became prostate cancer patient though it is very rare at this age but I am not getting any solution to my problem even after showing to good urologist. One homeopathy doctor was asking me to get typhoid test done. Can typhoid survive for 8 months. I am getting chills and bony pain increasing day by day and having problem on walking on feet and having feet arch pain. Neither my sore throat resolving. I am in too much problem. Please guide me sir what to do?

General Physician•Bangalore

Hello lybrate-user, I have gone through your detailed report. To keep the long story short. Looks like you have pyrexia of unknown origin. You need to take few first line tests for confirmation of what is causing the puo.
Complete hemogram with esr tsh
calcium hiv elisa
urine routine and micro urine for acid fast bacilli (tb)
urine culture sensitivity
widal test for typhoid mp spear for malaria blood c's if possible. These are the first line of tests and depending on these in...more

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Dr.Emmanuel Mj · Accepted Answer

Hello lybrate-user, I have gone through your detailed report. To keep the long story short. Looks like you have pyrexia of unknown origin. You need to take few first line tests for confirmation of what is causing the puo.
Complete hemogram with esr tsh
calcium hiv elisa
urine routine and micro urine for acid fast bacilli (tb)
urine culture sensitivity
widal test for typhoid mp spear for malaria blood c's if possible. These are the first line of tests and depending on these investigation I shall advice you on the further process.
Revert back to me with the following details ,you can test me or call me anytime.
Hope it helped.

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