Inconsistent CT Scan Results
A 49-year-old male, measuring 5'9" and weighing 180 pounds, underwent a series of CT scans aimed at diagnosing the cause of a persistent fever lasting approximately five weeks. Additionally, he presented with an elevated white blood cell and neutrophil count. Tests ruled out several conditions, including Lyme disease, Rocky Mountain spotted fever, infectious mononucleosis, autoimmune disorders, HIV, tuberculosis, and cytomegalovirus (CMV), based on normal results from the respective examinations and urinalysis. The first CT scan, which focused on the chest, abdomen, and pelvis, was conducted last Wednesday. It revealed the presence of granulomas in the right lung and what appeared to be older granulomas in the spleen, likely remnants from a past case of mononucleosis. However, a subsequent CT scan performed on Saturday, both involving contrast material, yielded a starkly different outcome—no abnormalities were detected in either the spleen or lung, but it did identify renal cysts and a severely thickened bladder with signs of cystitis. This discrepancy raises questions about how two CT scans, conducted in such close succession, can provide entirely divergent results, with neither scan corroborating the findings of the other.
Answers (1)
7/28/2025, 11:10:48 PM
OpenHealth AI
The discrepancies between your two CT scans and your ongoing fever symptoms are understandably concerning. While it's common for imaging studies to have variances, particularly in complex cases, it's essential to approach this systematically.
Key Points:
- Inconsistent CT Scan Results: Differences in findings can occur for several reasons, including imaging techniques, patient movement, or changes in body positioning.
- Current Concerns: Your persistent fever and elevated white blood cell counts suggest an underlying infection or inflammatory process that needs to be identified.
Explanation:
- Granulomas on the first scan may indicate a past or present inflammatory process, while the absence of these in the second scan may suggest that they were not present at the time of that imaging, or that they were missed due to the technical variations in how the scans were interpreted.
- Cystitis and renal cysts noted in the second scan could be relevant, particularly if they are contributing to your fever or overall symptoms.
Actionable Steps:
- Symptom Monitoring: Keep a detailed diary of your fever patterns, associated symptoms (like any pain, urinary changes, or respiratory issues), and any other new developments.
- Hydration and Comfort: Make sure to stay well-hydrated and consider over-the-counter analgesics, like acetaminophen or ibuprofen, to manage fever and discomfort unless contraindicated.
- Follow-Up Testing: Consider discussing with your healthcare provider about the possibility of further imaging or targeted tests, such as an MRI, ultrasound, or specific blood tests focused on inflammatory markers or infections.
- Investigate Cystitis: Given the findings of a thickened bladder, it may be worthwhile to explore causes of cystitis, such as urinary tract infections, and address any urinary symptoms you might have.
If your symptoms worsen or you develop new severe symptoms (like persistent pain, significant changes in urination, or respiratory issues), it is important to seek immediate medical advice. Feel free to reach out if you need further clarification or support!
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