Can this be true?

[catface34]

Greetings all! I have a question related to a long-standing problem. I was told by a doctor that one can have a chronic infection (his words were: some old virus that never went away), even though repeated and frequent bloodwork shows: low CRP (>1), low ESR, perfectly normal WBCs and normal general IgG, IgA, IgM. I do not agree with this; I know that infections can evade the immune system, but how is it possible that a chronic symptomatic infection would not be at least causing some inflammation? If an infection is causing a patients symptoms, then surely the infection is doing 'work' somewhere? The only immunological finding is very high leukocyte count in the urine and some blood, which could indicate a kidney infection. However, in order to make the patient feel crappy, the infection would have to be systemic, right? Apologies if my understanding of immunology is laughable, I'm really trying to learn about this stuff!

[CharonY]

First of all, none of the following should be taken as medical advice, just as basic microbiological info.

 

One should distinguish between bacteria and viruses as the infection processes are quite different. Viruses can be inactive and asymptomatic for a long time after infection. A common example is the Varicella zoster virus that causes chickenpox in children, then can stay dormant until it may result in shingle in the adult. In-between, there will not be any irregularities in the bloodwork. In order to detect it, you would have to search specifically for antibodies against that virus.

 

For bacteria this is rarer, but some have dormancy states or otherwise extremely slow turnover (prime example is Myxobacter tuberculosis) which may be present, but asymptomatic for a long time. But it is generally true in order to have symptoms, there must be an outbreak of sorts, which in these examples would be shingles or pneumonia, respectively.

 

In fact, there is a whole range of chronic infections which can be almost non-symptomatic and have various degrees of progression (or lack thereof).

 

A systemic infection is independent from the whole matter. I just means that it affects the whole body. Obviously serious local infections can also result in symptoms up and including organ failure.

 

What can happen is that chronic infections are the source for occasional breakouts. But again, it would require medical tests in order to sustain this and I would be very careful to use internet sources to self-diagnose.

Edited September 21, 2015 by CharonY

[catface34]

First of all, none of the following should be taken as medical advice, just as basic microbiological info.

 

One should distinguish between bacteria and viruses as the infection processes are quite different. Viruses can be inactive and asymptomatic for a long time after infection. A common example is the Varicella zoster virus that causes chickenpox in children, then can stay dormant until it may result in shingle in the adult. In-between, there will not be any irregularities in the bloodwork. In order to detect it, you would have to search specifically for antibodies against that virus.

 

For bacteria this is rarer, but some have dormancy states or otherwise extremely slow turnover (prime example is Myxobacter tuberculosis) which may be present, but asymptomatic for a long time. But it is generally true in order to have symptoms, there must be an outbreak of sorts, which in these examples would be shingles or pneumonia, respectively.

 

In fact, there is a whole range of chronic infections which can be almost non-symptomatic and have various degrees of progression (or lack thereof).

 

A systemic infection is independent from the whole matter. I just means that it affects the whole body. Obviously serious local infections can also result in symptoms up and including organ failure.

 

What can happen is that chronic infections are the source for occasional breakouts. But again, it would require medical tests in order to sustain this and I would be very careful to use internet sources to self-diagnose.

 

Hi CharonY, thanks for your reply. From what you have told me, it would be unlikely that an infectious process is causing a patients' symptoms if there is no biochemical evidence of infection during a flare up. Is this also true of fungal infections? From what I understand of systemic fungal infections, they are aggressive and don't have latent periods, or am I wrong (i.e. from what I've read, systemic fungal infections have no chill and go batshit lol!)?

[Xalatan]

Some infections can be latent. Some pathogens also have the ability to change surface antigens so to be undetected. Testing for wbc, igg etc only look at the immune side of the equation, it doesn't account for what the pathogen is doing to evade the immune system, nor if the person is immunocompromised. This is why you do tests like viral load, and HB surface core envelope antigens as well.

Edited December 25, 2015 by Xalatan