Persistent decomposed body

Specialty: General.

• chronic body discomfort
• prolonged systemic breakdown
• persistent feeling of illness

Why it occurs

• Atypical persistent chronic infections (extrapulmonary tuberculosis, chronic mycoplasmosis, refractory cat scratch disease)
• Continuous exposure to household mold or low-intensity industrial allergens (which cause chronic systemic inflammation and constant cytokine secretion)
• Indolent autoimmune disorders (primary Sjögren's syndrome, systemic lupus erythematosus without major organ involvement)
• Chronic post-infection fatigue syndrome with a fluctuating course (perpetuation of mitochondrial and autonomic dysfunction after a severe infection)
• Combined marginal or subclinical endocrine disorders (mild hypothyroidism associated with moderate ovarian or testicular insufficiency).

Initial workup

Complete blood count with manual smear, erythrocyte sedimentation rate (ESR), quantitative C-reactive protein (CRP), antinuclear antibodies (ANA), rheumatoid factor, thyroid profile, general metabolic profile, serology for HIV, hepatitis B and C, and chest x-ray.

Standard management

• Paracetamol — 500 mg orally every 8 hours for short periods for relief of myalgia and generalized body discomfort
• Ibuprofen — 400 mg orally every 12 hours administered with food, if there is suspicion of an evident systemic inflammatory component
• Adaptogenic supplementation with Rhodiola rosea root extract (200 to 400 mg per day orally to improve the response to general physical stress).