My daughter, who has type�1 diabetes, has had a mystery illness for several weeks.She complains of constant headache, sore eyes with dislike of bright light, shortness of breath, chest and right sided tummy pain, lethargy and sore legs. Her blood glucose levels were quite high until last week, but they are now normal, and there were no ketones at any point.

Her general practitioner ordered chest x-ray, which was okay. She was then referred to a pediatrician who ordered a wide range of blood tests – NAD, but says virology indicated there may have been a virus ‘at some point.’ My daughter now complains of tingling in lower legs and arms and ringing and tingling in left ear. The medical team seems quite happy to call it an ongoing virus, but there are a lot of symptoms that show no signs of leaving. I hate seeing her like this — diabetes is enough!

It certainly is easy and attractive to ascribe her symptoms to “a virus.” While that may not be terribly satisfying, it is probably true. I personally don’t like the “waste-basket” terminology of ascribing unknowns to “it’s probably a virus: “polio” is caused by a virus, but so is the common cold. I am not suggesting that your child has polio, but I am suggesting that if this really is something serious, there will be more symptoms and non-resolution.

I don’t know what “NAD” means, but I take it that the evaluation thus far has not shown definite abnormalities. You describe a child with muscle weakness, chest and abdominal discomfort, aversion to bright light, (“photophobia”), and headache. I would think a possible diagnosis to consider is meningitis, an inflammation of the spinal canal and spinal fluid. There are serious, rapidly progressive forms of meningitis that are caused by bacteria (that can be fatal!) and more indolent, mild cases caused by certain viruses.

You might discuss a spinal tap with your daughter’s medical team, if that has not been done. As it has been several weeks, the result may not be as helpful, especially if she is getting better. Has she had any insect bites in the days preceding this illness? Perhaps your doctor has consulted with an infectious disease specialist.

DS