What can cause acute generalized weakness with a normal white blood cell (WBC) count and hyperpyrexia (fever)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 30, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Acute Generalized Weakness with Normal White Blood Cell Count and Fever of 103 Degrees

  • Single Most Likely Diagnosis
    • Guillain-Barré Syndrome: This is an autoimmune disorder that can cause acute generalized weakness, often following a minor infection. The normal white blood cell count and high fever are consistent with this diagnosis, as Guillain-Barré Syndrome is not typically associated with an elevated white blood cell count.
  • Other Likely Diagnoses
    • Viral Myositis: Certain viral infections, such as influenza or coxsackievirus, can cause myositis, which is inflammation of the muscles. This can lead to acute generalized weakness and fever.
    • Viral Meningitis or Encephalitis: Although the white blood cell count is normal, some cases of viral meningitis or encephalitis may not have an elevated white blood cell count, especially early in the course of the illness.
    • Toxic or Metabolic Disorders: Certain toxic or metabolic disorders, such as hypokalemia or hypophosphatemia, can cause acute generalized weakness.
  • Do Not Miss Diagnoses
    • Spinal Epidural Abscess: This is a serious and potentially life-threatening condition that can cause acute generalized weakness, fever, and back pain. Although it is not the most likely diagnosis, it is crucial to consider and rule out due to its high morbidity and mortality.
    • Botulism: This is a rare but potentially deadly condition that can cause acute generalized weakness, fever, and other symptoms such as blurred vision and difficulty swallowing.
    • Tick-Borne Illnesses: Certain tick-borne illnesses, such as tick paralysis, can cause acute generalized weakness and fever.
  • Rare Diagnoses
    • Mitochondrial Myopathies: These are a group of rare genetic disorders that can cause muscle weakness and other symptoms.
    • Periodic Paralysis: This is a rare genetic disorder that can cause episodic muscle weakness, often triggered by certain factors such as fever or stress.
    • Inflammatory Myopathies: These are a group of rare autoimmune disorders that can cause muscle inflammation and weakness.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.