identify the mystery illness!

March 18, 2009 12:47 AM

a week ago i started growing an ulcer (or canker sore) on the inside of my lip. i didn't think much of it, although it was growing quite large and white and i hadn't had one like that before. a week later i woke up very bone sore for no apparent reason, and while out and about....

... i started feeling more tired and could feel the pressure on my head, especially when turning my neck too fast.

i slept in until midday the next day, which is unusual for me. although i could not detect a fever, i was feeling extremely cold on a 37°C day, and my limbs ached not unlike the flu. i also experienced sore throat, swollen gums, and large swollen bumps behind my teeth, though i have not gone out of my way to scratch the inside of my mouth.

the aching was alleviated with paracetamol, the tiredness has been a bit harder. i've slept in until 1pm on my day off, and had to go to sleep at 10pm on a work night. i haven't had the energy to get anything done at all. in the morning i just don't feel like i can cope with a day's work, though it seems to get better gradually as the day progresses, and at least i do most of my work in front of a computer.

i can barely eat due to the sores inside my mouth, though at least the sore throat has died down. but what worries me is that there has been more pressure on my lymph nodes, and this morning it felt like it was squashing my neck and jaw in. my tongue is whitish and spotty, but i've also seen this connected with thrush, and hell no, i don't think that's where this is going.

btw, i've scheduled a doctor's appointment tomorrow, but until then... i'm a bit worried it might be glandular fever, or what you guys commonly call mono. the swollen gums don't seem consistent with its symptoms though...

posted by sardonicsmile to health & fitness (16 comments total)

It's herpangina.
posted by runcibleshaw at 1:05 AM on March 18

The mayo clinic website (first hit for canker sores) lists almost exactly those symptoms as symptoms of … canker sores. A bad case but still within the norm. Clearly you should see your doc, but I'm putting my bet on it being just plain canker sores.
posted by hattifattener at 1:09 AM on March 18

This really doesn't help your overall sickness issues, but back when I had braces, the only thing that would give any relief to the sores was Zilactin. It's got some soothing chemical stuff that will help heal the sore, but most importantly, it creates a sort of bandaid-like thing over the sore and keeps it from rubbing, itching, and getting worse. (Tastes like absolute crap, though, but oh man, it was the ONLY thing that kept me from grabbing the pliers some days.) Maybe once your sickness is gone it'll help with the mouth issues. I hope things go well at the doc and you start feeling better soon.
posted by phunniemee at 1:09 AM on March 18

Baking soda applied directly to the sore stings like hell, but then pleasant relief. Also helps dry them out and heal them.
posted by Meatbomb at 1:14 AM on March 18

...it felt like it was squashing my neck and jaw in...

Unlike some of the previous answerers I have no idea what is going on. But then again I am a physician, so what do I know? However, as someone experienced in airway issues, I would suggest that any difficulty breathing or swallowing merits a trip to the ER (or whatever the antipodean equivalent is). There are a number of conditions that can cause swelling of the neck sufficient to compromise your airway and you owe it to yourself to make sure that you are not afflicted by one of them.
posted by TedW at 2:13 AM on March 18 [6 favorites has favorites]

When I get cold sores, I am bone tired for several days and often get a cold -- generally, if my immune system has tanked enough for me to get a cold sore in the first place, it means I'm pretty susceptible to anything once I have it and my immune system is even weaker. The trouble breathing is unusual, though, at least for me, and the white spots on your tongue really sound more like thrush or something.

You could certainly have mono. I've had that as well and depending on the extent to which you are tired and achey, you could have that and the cold sore at the same time. I didn't have the spotty white tongue when I had it, though.

I'm not sure what help we can be. You're already going to the doctor tomorrow, don't sweat it for now.
posted by Nattie at 5:01 AM on March 18

I am not a doctor, of course. But listen to the one upthread and get thee to the ER. Some of those symptoms, on an individual basis, would have sent me there if it were me.
posted by azpenguin at 5:51 AM on March 18

I get horrible, horrible canker sores, like they get huge, my nodes swell, and I can't stand to eat for a week. However, I have not had all of these odder symptoms you describe.
I don't know how it works in Australia, but do they have some sort of urgent care/minor emergency facilities you can go to if you can't get an appointment soon enough with your regular doctor, but it's not really a full-blown emergency?
posted by fructose at 8:02 AM on March 18

While a doctor is always more of an authority than a mefi or google, Hand, Foot and Mouth disease could be a candidate. This affected a 38 year old colleague of mine recently and some of the "odder" symptoms reminded me of him. But please get to a Dr. sooner rather than later... I would.
posted by sundri at 9:00 AM on March 18

I have no idea about the other symptoms but I have found that taking lysine pills help (almost immediately) for cold sores. I'm not sure that this is on topic but maybe it will help someone.
posted by notned at 9:07 AM on March 18

This is a case for a dentist, alas, and not a physician. IAAD.
what we do, upon examining you and your mouth, is called differential diagnosis; and while herpangina might be one of the conditions you have, it may also be one of several others.
Onset of symptoms; duration of the ulcers; appearance, location and abundance of the lesions are all factors that a quick look on the internet will not provide answers for, with all respect to pithy answers like runcible's.
treating the symptoms is not inappropriate. bring down the fever, topical anesthetic for the ulcers, nsaid for the lymph pain. many of these conditions have no fixed cause ('etiology unknown' in the parlance of our times), but having a diagnosis may shed light on a broader problem, or help refine a solution that will give you speedy resolution of the symptoms, and may help you to avoid or mitigate future episodes.
may you feel better soon.
posted by OHenryPacey at 12:13 PM on March 18

It's herpangina.
posted by runcibleshaw at 1:05 AM on March 18 [+] [!]

This is utterly irresponsible. Despite years of medical training, I wouldn't posit an internet diagnosis so bluntly, so why should you? I mean seriously. For what it's worth herpangina is associated with coxsackie A infections, which typically occurs in children and usually during the summer months. While perhaps a possibility in this case, it's far from certain.

This is a case for a dentist, alas, and not a physician. IAAD.

Huh? Do you say the same thing about strep throat and oral herpes? I'm guessing I managed more cases of these during just my residency than the average dentist deals with in an entire career.

OP, I wouldn't even hazard a guess as to what this is. The list of possibilities may be quite long, though in most cases I suspect symptoms like yours are attributed to a viral infection. For what it's worth, except for the subset of patients with HIV, mono typically does not lead to oral uclers. Try to get some rest, drink plenty of fluids, continue taking over-the-counter drugs for your symptoms if they are helpful, and definitely see your doctor by tomorrow.
posted by drpynchon at 1:50 PM on March 18 [2 favorites has favorites]

Dr. Pynch, no disrespect intended, but i've been seeing and treating oral lesions for 20 yrs and I've seen and heard enough blatantly lazy and wrong diagnoses from ER docs, PA's and nurses to fill a journal. Most folks will go to one provider only, so for oral lesions my call is to recommend going to someone who sees oral lesions day in and day out. I routinely send patients to physicians and specialists if i suspect a systemic tie in, but often see patients weeks or months after they've been misdiagnosed by a physician with nary a mention of 'follow up with your dentist if symptoms persist'.
In no why do i want to start a flame war over the relative merits or one field over the other, each has a valuable place. Yes you've probably managed your share of strep, but as to seeing more oral herpes, i doubt it.
posted by OHenryPacey at 3:30 PM on March 18

It's good that you're going to a doctor soon. There are explanations that aren't necessarily dire. Literally every canker sore (or cluster) that I get is a signal that within days I'll start feeling extremely fatigued, often with other symptoms of flu or a cold. The fatigue, etc., last about a week and a half. My doctor doesn't think it's odd at all. It happens once or twice a year -- sometimes mild, sometimes severe.
posted by wryly at 4:00 PM on March 18

the swollen gums don't seem consistent with its symptoms though

This sounds like what I had with mono - gingivostomatitis. It's really painful and makes eating a nightmare. (Unfortunately, I had ulcers almost all the way down to my esophageal sphincter, and ended up on IV fluids. I very much hope you fare better than I did.)
posted by elizardbits at 5:21 PM on March 18

@drpynchon Oh, sorry. Let me rephrase... I am not a medical doctor and have absolutely no medical training whatsoever, but my first guess as a layperson is herpangina. The reason I thought of it was that the only person I ever knew who had it, had very similar symptoms* to the OP and was in his early twenties. Oh and it was winter too.

As far as being irresponsible, the guy already said he's going to the doctor. I didn't give him any medical advice or tell him to do something specific to treat the illness. It was a guess... trying to "identify the mystery illness". My user name doesn't have "Dr" in it, so there's no reason for the OP to consider my opinion anything other than that... an opinion. No one else in this thread really knows what it is either. So we're all just guessing, although some of the guesses are more educated than others.

*though he didn't have swollen gums.
posted by runcibleshaw at 6:53 PM on March 18