Night sweats, or excessive sweating at night, can often be a cause for concern. While they can be a result of various factors, one possible cause of night sweats is an infection. Infections, ranging from common colds to more serious conditions, can potentially lead to night sweats in some individuals.
So, how exactly can an infection cause night sweats? When the body is fighting off an infection, the immune system goes into overdrive to defend against the invading pathogens. This response can cause a rise in body temperature, leading to sweating as a way to cool down. Night sweats occur when this excessive sweating happens during sleep, making the individual wake up drenched in sweat.
It is important to note that not all infections will result in night sweats, and night sweats alone are not indicative of a particular type of infection. However, night sweats can be a symptom of certain infections, such as tuberculosis, HIV/AIDS, and certain types of cancers.
In conclusion, while night sweats can be caused by a variety of factors, including hormonal changes and certain medications, infections can also be a potential cause. If you are experiencing persistent night sweats or are concerned about your symptoms, it is advisable to consult with a healthcare professional for a proper diagnosis and appropriate treatment.
Infection and Night Sweats: What’s the Connection?
Infection is a common cause of night sweats. When the body is fighting off an infection, it can often lead to episodes of excessive sweating during the night. This is because the immune system is working overtime to fight off the invading pathogens, resulting in an increase in body temperature.
One of the most common infections associated with night sweats is tuberculosis. This infectious disease affects the lungs and can result in symptoms such as coughing, fever, and night sweats. The night sweats experienced by individuals with tuberculosis are often severe and can soak through clothing and bed sheets.
Other infections that can cause night sweats include HIV/AIDS, endocarditis (infection of the heart valves), and certain types of cancers such as lymphoma. These infections can disrupt the body’s natural temperature regulation, leading to excessive sweating during sleep.
In some cases, the night sweats may be a result of medication used to treat the infection. Certain antibiotics, antipyretics, and antiretroviral drugs can cause sweating as a side effect. It is important to discuss any symptoms or side effects with a healthcare provider to determine the underlying cause and appropriate treatment.
If you are experiencing night sweats, especially in conjunction with other symptoms of infection, it is important to seek medical attention. A healthcare provider can perform tests to determine the underlying cause of the sweats and develop a treatment plan accordingly. Proper diagnosis and treatment of the underlying infection can help alleviate night sweats and promote overall health and well-being.
Understanding Night Sweats
Night sweats can be a bothersome symptom that many people experience. It is a condition where a person sweats excessively during the night, often soaking through their clothes and sheets. While night sweats can be caused by a variety of factors, one possible cause is infection.
Causes of Night Sweats
Night sweats can be caused by a range of conditions, and it is important to determine the underlying cause in order to effectively treat the symptom. Infections, such as bacterial, viral, or fungal infections, can trigger night sweats. This is because infections often lead to an increase in body temperature, which can result in sweating during the night.
Other possible causes of night sweats include hormonal changes, medications, anxiety, menopause, certain cancers, and neurological conditions. In some cases, night sweats may be a symptom of a serious underlying medical condition, so it is important to seek medical advice if they persist or are accompanied by other concerning symptoms.
How Infections Can Cause Night Sweats
Infections can cause night sweats due to the body’s immune response to the invading pathogens. When the body detects an infection, it activates the immune system, which releases chemicals called cytokines. Cytokines help regulate the immune response, but they can also affect the body’s thermostat and lead to an increase in body temperature. This rise in temperature can result in sweating and night sweats.
In addition, some infections can directly affect the body’s ability to regulate temperature. For example, certain bacterial infections can release toxins that interfere with the body’s thermoregulatory system, leading to increased sweating and night sweats.
Seeking Treatment
If you are experiencing night sweats, particularly if they are persistent or accompanied by other symptoms, it is important to consult with a healthcare professional. They can help determine the underlying cause of your night sweats and recommend appropriate treatment options based on your specific situation.
- Make note of any additional symptoms you are experiencing.
- Provide information on any recent infections or illnesses you have had.
- Be prepared to discuss any medications or lifestyle factors that may be contributing to your night sweats.
- Follow your healthcare professional’s recommendations for treatment and management of your night sweats.
By understanding the possible causes of night sweats, particularly how infections can contribute to this symptom, you can take proactive steps to address the issue and improve your overall well-being.
Common Infections That Can Cause Night Sweats
Night sweats, also known as nocturnal hyperhidrosis, can be caused by various infections. Infections can trigger an immune response in the body, leading to symptoms such as fever and sweating.
Some common infections that can cause night sweats include:
Infection | Cause |
Flu | The influenza virus can cause fever and night sweats as the body fights off the infection. |
Tuberculosis | People with active tuberculosis can experience night sweats as a symptom of the disease. |
HIV/AIDS | Night sweats are a common symptom in people with advanced HIV/AIDS. |
Endocarditis | Infection of the heart valves can lead to night sweats as the body tries to regulate its temperature. |
Brucellosis | This bacterial infection can cause night sweats and other flu-like symptoms. |
COVID-19 | The novel coronavirus can cause night sweats as part of its symptom profile. |
If you are experiencing night sweats along with other concerning symptoms, it is important to seek medical attention to determine the underlying cause and receive appropriate treatment.
How Infections Can Trigger Night Sweats
Night sweats, or excessive sweating during the night, can be caused by various factors, including infections. Infections can disrupt the body’s normal temperature regulation and lead to night sweats as a result.
When the body detects an infection, it responds by increasing its production of white blood cells and releasing certain chemicals to help fight off the invading pathogens. This immune response can cause a rise in body temperature, leading to night sweats.
Infections such as tuberculosis, endocarditis, HIV/AIDS, and certain types of cancers, like lymphoma, can all be associated with night sweats. These conditions trigger an inflammatory response in the body, which can contribute to excessive sweating, particularly at night.
Additionally, some infections can directly affect the hypothalamus, the part of the brain responsible for regulating body temperature. This disruption in the hypothalamus can result in night sweats as the body struggles to maintain a balanced internal temperature.
Infections can also cause other symptoms alongside night sweats, such as fever, fatigue, and weight loss. If you are experiencing persistent night sweats along with these symptoms, it is important to seek medical attention to identify and treat the underlying infection.
Overall, infections can be a potential cause of night sweats. The body’s response to an infection, the inflammatory process, and direct effects on the hypothalamus can all contribute to excessive sweating during the night. If you are concerned about your night sweats, it is best to consult with a healthcare professional for proper evaluation and treatment.
Types of Infections That May Lead to Night Sweats
There are several types of infections that can cause night sweats. These include:
- Bacterial infections: Bacterial infections like tuberculosis, endocarditis, and osteomyelitis can lead to night sweats. These infections can cause the body to have an elevated temperature, leading to excessive sweating during sleep.
- Viral infections: Viral infections such as HIV/AIDS, influenza, and hepatitis can also cause night sweats. These infections can affect the body’s immune system and cause symptoms like fever and sweating.
- Fungal infections: Fungal infections like histoplasmosis and coccidioidomycosis can lead to night sweats. These infections can affect the lungs and other organs, causing sweating as a symptom.
- Parasitic infections: Certain parasitic infections, such as malaria and babesiosis, can cause night sweats. These infections are typically transmitted through mosquito bites and can cause symptoms like fever and sweating.
- Other infections: Other types of infections, like certain types of cancers and certain autoimmune diseases, can also cause night sweats. These infections can affect the body’s normal functioning and lead to excessive sweating during sleep.
If you are experiencing night sweats and suspect that it may be due to an infection, it is important to consult with a healthcare professional for a proper diagnosis and appropriate treatment.
Identifying the Symptoms of Infection-Induced Night Sweats
Infection can cause night sweats, and it is important to be able to recognize the symptoms associated with this condition. Night sweats are excessive sweating that occurs during sleep, and they can be a sign of an underlying infection in the body.
Common Symptoms
When night sweats are caused by an infection, there are several common symptoms that may accompany this condition. These symptoms may include:
Symptom | Description |
---|---|
Fever | Elevated body temperature above the normal range. |
Fatigue | Feeling tired and lacking energy. |
Weakening of the immune system | An infection can weaken the immune system, making it harder for the body to fight off infections. |
Chills | A sensation of coldness or shivering. |
Body aches | Pain or discomfort in the muscles and joints. |
Nausea | A feeling of sickness in the stomach, often accompanied by an urge to vomit. |
When to Seek Medical Attention
If you are experiencing night sweats along with one or more of these symptoms, it is important to consult with a healthcare professional. They can help determine the underlying cause of the infection and provide appropriate treatment.
Furthermore, if the night sweats are severe, persistent, or accompanied by other concerning symptoms, such as unexplained weight loss or a change in appetite, it is crucial to seek immediate medical attention. These could be signs of a more serious infection or underlying medical condition.
In conclusion, identifying the symptoms of infection-induced night sweats is essential for seeking timely medical care and addressing any underlying health issues.
When to Seek Medical Help for Night Sweats and Infection
Night sweats can be a symptom of an underlying infection, so it is important to pay attention to any additional signs or symptoms that may indicate a more serious condition.
If you experience night sweats accompanied by a fever, chills, persistent cough, shortness of breath, unexplained weight loss, or swollen lymph nodes, it is recommended to seek medical help.
These symptoms can be indicative of a bacterial or viral infection, such as tuberculosis, HIV, or pneumonia, which may require medical treatment.
Additionally, if your night sweats are interfering with your quality of life and causing significant distress, it is advisable to consult a healthcare professional.
A healthcare provider will be able to evaluate your symptoms, perform any necessary diagnostic tests, and provide appropriate treatment options.
If you are unsure whether your night sweats are related to an infection or if they persist for an extended period of time, it is best to err on the side of caution and seek medical advice.
Remember, early detection and treatment of infections can help prevent complications and promote a faster recovery.
Diagnosing Infection-Related Night Sweats
Night sweats can be caused by various factors, including infections. Determining whether night sweats are related to an infection requires a thorough medical evaluation. A healthcare professional will consider several factors while diagnosing infection-related night sweats.
Medical History
The first step in diagnosing infection-related night sweats is obtaining a detailed medical history. The healthcare professional will ask the patient about their symptoms, medical conditions, medications, and any recent illnesses. This information will help identify any potential underlying infections that may be causing the night sweats.
Physical Examination
After taking the medical history, a physical examination will be conducted. The healthcare professional will check for any signs of infection, such as enlarged lymph nodes, inflammation, or fever. They may also listen to the patient’s lungs and heart to rule out any respiratory infections.
In some cases, additional tests may be ordered to further investigate the presence of an infection. These tests may include blood tests, urine tests, imaging studies, or cultures of body fluids or tissues.
Once the infection is identified, appropriate treatment can be initiated to address both the infection and the accompanying night sweats. It is essential to follow the healthcare professional’s recommendations and complete the prescribed course of treatment to recover fully.
In conclusion, if night sweats are persistent or accompanied by other symptoms of infection, it is crucial to seek medical attention. A proper diagnosis is necessary to determine the underlying cause and ensure appropriate treatment.
Treatment Options for Night Sweats Caused by Infection
If you are experiencing night sweats due to an infection, it is important to seek medical treatment to address the underlying cause and alleviate your symptoms. Here are some treatment options that may be recommended by your healthcare provider:
- Antibiotics: If your night sweats are caused by a bacterial infection, your doctor may prescribe antibiotics to eliminate the infection.
- Antiviral medication: If your night sweats are caused by a viral infection, antiviral medications may be prescribed to help target the virus and reduce symptoms.
- Antifungal medication: In cases where a fungal infection is responsible for night sweats, antifungal medication may be prescribed to treat the infection and alleviate symptoms.
- Hydration: It is important to stay hydrated when dealing with an infection, as this can help regulate your body temperature and reduce sweating. Drink plenty of water throughout the day.
- Over-the-counter pain relievers: If you are experiencing discomfort or pain along with your night sweats, over-the-counter pain relievers such as acetaminophen or ibuprofen may provide some relief.
- Rest and relaxation: Getting plenty of rest and practicing relaxation techniques, such as deep breathing or meditation, can help your body recover from the infection and reduce night sweats.
Remember, it is important to consult with a healthcare professional for an accurate diagnosis and treatment plan tailored to your specific condition. They can provide guidance on the best course of action to address your infection and help alleviate your night sweats.
Preventing Infection and Night Sweats
Infection can cause night sweats in some cases. To reduce the risk of infection and night sweats, it is important to take preventative measures. Here are some tips:
- Practice good hygiene by washing your hands regularly with soap and water.
- Avoid close contact with people who are sick or showing symptoms of infection.
- Get vaccinated against common infections to strengthen your immune system.
- Take steps to boost your immune system, such as eating a healthy diet, exercising regularly, and getting enough sleep.
- Avoid touching your face, especially your eyes, nose, and mouth, as this can transfer germs to your body.
- Clean and disinfect frequently-touched objects and surfaces to prevent the spread of infection.
If you experience night sweats and suspect it may be due to an infection, it is important to consult with a healthcare professional for proper diagnosis and treatment. They can provide guidance on managing symptoms and addressing the underlying cause of the infection.
Tips for Managing Night Sweats During Infection
Night sweats can be a bothersome symptom of an infection. While they can be uncomfortable and disruptive to your sleep, there are several strategies you can try to manage this symptom and improve your quality of sleep.
1. Keep Your Bedroom Cool
One of the key ways to manage night sweats is by keeping your bedroom cool. Lowering the temperature of your room can help regulate your body temperature and prevent excessive sweating. Consider using a fan or opening a window to promote air circulation.
2. Wear Breathable Fabrics
The type of clothing you wear to bed can also make a difference in managing night sweats. Choose lightweight and breathable fabrics such as cotton or moisture-wicking materials that can help absorb sweat and keep you dry throughout the night.
3. Use Moisture-Wicking Bedding
Investing in moisture-wicking bedding can help keep you cool and dry during the night. Look for sheets, pillowcases, and mattress covers made from materials specifically designed to absorb and evaporate moisture, such as bamboo or microfiber.
4. Stay Hydrated
Drink plenty of water throughout the day to stay hydrated. When your body is well-hydrated, it can regulate its temperature more effectively and reduce the likelihood of excessive sweating during the night.
5. Avoid Triggers
Identify any triggers that may exacerbate your night sweats and try to avoid them. Common triggers include spicy foods, caffeine, alcohol, and high-stress situations. By eliminating or reducing exposure to these triggers, you may be able to manage your night sweats more effectively.
6. Practice Relaxation Techniques
Engaging in relaxation techniques such as deep breathing, meditation, or yoga before bed can help reduce stress and promote better sleep. Stress can contribute to night sweats, so finding ways to relax and unwind before sleep may help alleviate this symptom.
- Keep your bedroom cool
- Wear breathable fabrics
- Use moisture-wicking bedding
- Stay hydrated
- Avoid triggers
- Practice relaxation techniques
By implementing these tips, you can better manage night sweats during an infection and improve your overall sleep quality. However, if your night sweats persist or worsen, it is recommended to consult a healthcare professional for further evaluation and guidance.
Complications of Infection-Induced Night Sweats
While night sweats may be a common symptom of infection, it is important to recognize that they can sometimes indicate a more serious underlying condition. The following are potential complications that can arise from infection-induced night sweats:
- Poor sleep quality: Frequent episodes of night sweats can disrupt regular sleep patterns, leading to insomnia and daytime drowsiness. This can negatively impact overall quality of life and productivity.
- Dehydration: Excessive sweating during the night can cause dehydration, especially if fluids are not replenished adequately. Dehydration can result in symptoms such as dry mouth, fatigue, and dizziness.
- Electrolyte imbalance: Night sweats can also lead to an imbalance of electrolytes in the body, particularly sodium and potassium. Electrolyte imbalances can cause muscle cramps, weakness, and irregular heartbeat.
- Weight loss: Persistent night sweats can contribute to unintentional weight loss, as the body loses fluids and nutrients. Sustained weight loss can weaken the immune system and affect overall health.
- Increased risk of infection: If the underlying infection responsible for night sweats is not properly treated, there is a risk of it spreading or becoming chronic. This can lead to more severe symptoms and complications.
If you are experiencing night sweats as a result of an infection, it is important to consult a healthcare professional for an accurate diagnosis and appropriate treatment. They can help determine the cause of the night sweats and address any potential complications.
Seeking Support for Infection-Related Night Sweats
Experiencing night sweats can be alarming and uncomfortable. While there are various causes for night sweats, infections can be one of the culprits. If you are dealing with infection-related night sweats, seeking support is crucial to ensure proper diagnosis and treatment.
When an infection is present in the body, it can cause the body temperature to rise, leading to night sweats. This can happen as the immune system fights off the infection, resulting in increased sweating during sleep.
If you are consistently experiencing night sweats and suspect an infection as the cause, it is essential to consult with a healthcare professional. They can perform a thorough examination, conduct necessary tests, and provide appropriate treatment options.
Support groups and online forums can also be valuable resources for individuals dealing with infection-related night sweats. Connecting with others who have experienced similar symptoms can provide emotional support, practical advice, and a sense of community.
Support Options:
- Online forums dedicated to night sweats and infections
- Local support groups for individuals struggling with night sweats
- Seeking guidance from healthcare professionals specialized in infectious diseases
- Participating in support groups for specific types of infections
Remember, seeking support is not only important for finding the root cause of your night sweats but also for managing any underlying infections effectively. Do not hesitate to reach out and leverage the resources available to you.
Alternative Remedies for Infection-Induced Night Sweats
If you are experiencing night sweats due to an infection, there are several alternative remedies that may help alleviate this uncomfortable symptom. While it is important to consult with a healthcare professional to determine the underlying cause of your night sweats and receive appropriate medical treatment, these remedies can be used in conjunction with standard medical care.
1. Stay Hydrated
Drinking plenty of fluids throughout the day can help prevent dehydration caused by night sweats. Opt for water, herbal teas, and clear broths to replenish lost fluids and electrolytes. Avoid consuming excessive caffeine, alcohol, and sugary drinks as they can exacerbate night sweats.
2. Practice Good Sleep Hygiene
Creating a comfortable sleeping environment and establishing a regular sleep routine can help minimize night sweats. Keep your bedroom cool, use breathable bedding, and wear lightweight, moisture-wicking sleepwear. Stick to a consistent sleep schedule and avoid stimulating activities close to bedtime.
3. Try Natural Remedies
Some natural remedies have been suggested to potentially reduce night sweats. These include:
- Herbal supplements such as black cohosh, sage, and red clover
- Essential oils like clary sage, lavender, and peppermint
- Acupuncture or acupressure
- Yoga or meditation to manage stress and promote relaxation
It is important to note that scientific evidence supporting the effectiveness of these remedies is limited. Speak to a healthcare professional before trying any natural remedies to ensure they will not interfere with your medical treatment.
4. Manage Stress
Stress can worsen night sweats, so finding stress-reduction techniques can be helpful. Engage in activities that help you relax and unwind, such as deep breathing exercises, listening to calming music, or practicing mindfulness. Consider seeking support from a therapist or counselor to develop coping strategies for managing stress.
While these alternative remedies may provide some relief from infection-induced night sweats, it is crucial to address the underlying infection with appropriate medical treatment. Consult a healthcare professional for a comprehensive evaluation and treatment plan.
Lifestyle Changes to Reduce the Severity of Infection-Related Night Sweats
While infections can cause night sweats, there are several lifestyle changes that can help reduce the severity of these sweats and improve your overall sleep quality:
Avoid triggers: | Avoiding triggers such as spicy foods, caffeine, alcohol, and intense exercise before bedtime can help reduce the frequency and severity of night sweats. |
Maintain a cool sleeping environment: | Keeping your bedroom cool and well-ventilated can help regulate your body temperature and prevent excessive sweating during the night. Consider using a fan, opening windows, or using air conditioning. |
Choose breathable sleepwear: | Opt for lightweight and moisture-wicking sleepwear made from natural fabrics like cotton or bamboo. These materials can help keep your body cool and dry, reducing the discomfort of night sweats. |
Keep well-hydrated: | Drinking plenty of water throughout the day can help regulate your body temperature and prevent dehydration, which can exacerbate night sweats caused by infection. |
Practice stress-reducing techniques: | Stress can worsen night sweats, so finding effective stress-management techniques like deep breathing, meditation, or yoga can help reduce their intensity and frequency. |
Ensure good sleep hygiene: | Establishing a regular sleep schedule, avoiding screen time before bed, and creating a relaxing bedtime routine can help promote better sleep and minimize the impact of infection-related night sweats. |
By incorporating these lifestyle changes into your daily routine, you can significantly reduce the severity of infection-related night sweats and improve your overall sleep quality. However, if your night sweats persist or worsen, it’s important to consult with a healthcare professional to rule out any underlying medical conditions.
Impact of Infection on Overall Health
An infection can cause a variety of symptoms and have a significant impact on overall health. Night sweats, for example, can be one of the effects of an infection. When the body is fighting off an infection, it can cause an increase in body temperature, leading to excessive sweating during sleep.
Infections can also weaken the immune system, making it more difficult for the body to fend off other illnesses and infections. This can result in a cycle of recurring infections, further impacting overall health. Additionally, infections can cause fatigue, loss of appetite, and weight loss, further contributing to a decline in overall well-being.
It is important to seek medical attention if you experience recurrent or persistent night sweats or other symptoms of infection. Treating the underlying infection and managing its symptoms can help restore overall health and well-being.
Understanding the Link Between Infection and Night Sweats
Infections are known to cause a variety of symptoms in the body, including night sweats. Night sweats refer to excessive sweating that occurs during sleep and can leave the individual waking up with damp or wet sheets and clothing. While night sweats can be caused by a range of factors, infections have been identified as a potential cause.
Various types of infections, including bacterial, viral, and fungal infections, can lead to night sweats. When the body is fighting off an infection, it can trigger the release of chemicals that stimulate the sweat glands, resulting in night sweats. In some cases, the body’s immune response to an infection can also cause fluctuations in body temperature, leading to night sweats.
One common infection that is known to cause night sweats is tuberculosis (TB), a contagious disease caused by the bacterium Mycobacterium tuberculosis. TB primarily affects the lungs but can also spread to other parts of the body. Night sweats are a common symptom of TB and often occur alongside other symptoms such as coughing, weight loss, and fatigue.
In addition to TB, other infections such as HIV/AIDS, certain types of cancer, and bacterial endocarditis can also cause night sweats. It is important to note that while night sweats can be a symptom of an underlying infection, they can also be caused by other factors such as medication side effects, hormonal changes, or anxiety.
To determine if an infection is causing night sweats, it is important to consult with a healthcare professional. They will be able to assess the individual’s symptoms, perform diagnostic tests if necessary, and provide appropriate treatment for the underlying infection. Treating the infection effectively can help alleviate the night sweats and other associated symptoms.
Conclusion
Infections can indeed cause night sweats. When the body is fighting off an infection, it can trigger the release of chemicals that stimulate the sweat glands, resulting in excessive sweating during sleep. Common infections such as tuberculosis, HIV/AIDS, and certain types of cancer have been found to be associated with night sweats. If experiencing night sweats, it is important to consult with a healthcare professional to determine the underlying cause and receive appropriate treatment.
Question and answer:
Can an infection cause night sweats?
Yes, an infection can cause night sweats. When the body is fighting off an infection, it can raise its temperature, resulting in night sweats.
What types of infections can cause night sweats?
Various types of infections can cause night sweats, including bacterial, viral, and fungal infections. Some examples include tuberculosis, HIV/AIDS, influenza, and endocarditis.
How do night sweats caused by infections differ from those caused by menopause?
Night sweats caused by infections are typically accompanied by other symptoms such as fever, chills, cough, and fatigue, while night sweats caused by menopause are usually associated with hormonal changes and are not accompanied by other symptoms.
What should I do if I experience night sweats due to an infection?
If you experience night sweats along with other symptoms of an infection, it is important to see a doctor. They will be able to diagnose the underlying cause of the infection and provide appropriate treatment.
Are night sweats always a sign of an infection?
No, night sweats can have various causes, including infections, hormonal changes, medication side effects, and even certain medical conditions such as cancer. It is best to consult a healthcare professional to determine the cause of your night sweats.
What are night sweats?
Night sweats are episodes of excessive sweating that occur during sleep. They can cause you to wake up with damp or wet clothes and bedding.
Can infection cause night sweats?
Yes, infection can cause night sweats. Certain infections, such as tuberculosis, endocarditis, and HIV/AIDS, are known to cause night sweats as a symptom. Night sweats can also be a side effect of certain medications used to treat infections.
What are some other causes of night sweats?
Aside from infection, night sweats can also be caused by menopause, hormonal imbalances, certain medications, anxiety, and certain medical conditions such as cancer. It’s important to speak with a healthcare professional if you’re experiencing night sweats in order to determine the underlying cause.
How can I treat night sweats caused by infection?
The treatment for night sweats caused by an infection will depend on the specific infection. It’s important to see a healthcare professional for a proper diagnosis and treatment plan. In some cases, treating the underlying infection will help alleviate the night sweats. In other cases, medications may be prescribed to help manage the symptoms.