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Welcome, eCureMe.com medical contents search May 9, 2013
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Commonly Asked Questions / Doctors' Answers
Fever of Unknown Origin (Internal Medicine)




Question

I have a recurring high fever (100-104), severe chills, headache, and sweats.

Usually I have to stay in bed until the fever breaks. It occurs for a couple of weeks every few months for a few years now. I have been to an emergency room and visited couple of doctors but nothing has been found. I had Pneumonia as a child. I have not traveled out of the country. I am not taking any medications nor have I had any surgeries. I am a heterosexual male, age 23 and have no known allergies. I usually take Tylenol, Aleve, or Advil but had not really brought the fever down. Only other recurring symptoms are irregular bowels and I have a hard time functioning during these times





eCureMe's Advice 1

Hello - thanks for asking your question. There are many causes for chronic fever. More common causes include TB, abscess, malignancy, endocarditis, collagen vascular disease, and medication. You may want to consider the following tests for full evaluation. Discuss these with your personal physician:

A. Complete blood count, including differential and platelet count, Erythrocyte sedimentation rate
B. Routine blood chemistries, including liver enzymes, bilirubin, and lactate dehydrogenases
C. Urine analysis, including microscopic examination, and
D. Chest radiograph, Routine blood cultures (times three) off antibiotics, Tuberculin skin test with control(s), HIV antibody assay, Antinuclear antibodies, Rheumatoid factor or CT scan of abdomen.

Follow-up with your personal physician.




eCureMe's Advice 2

I am concerned about this problem--we generally refer to this as a "Fever of Unknown Origin"--a medical dilemma for which books are written. There are a number of different causes--some are infections, some inflammatory diseases, like lupus or rheumatoid arthritis, and sometimes, some cancers can present this way. You must go to your primary doctor and pursue a workup--blood work including CBC, liver chemistries, and sed rate. Possibly stool studies, like stool cultures and ova/parasite tests. I presume that a chest X-ray was done at some point already. If those are negative, I would have no hesitancy to undergo imaging tests like CT or gallium scans. Best of luck!



eCureMe's Advice 3

This may classify as a fever of unknown origin for which there is a specific protocol to be followed. Travel history, drug and toxin history, any level of immunocompromised state, and localizing symptoms must be discovered. Possible causes include: infection, drug reaction, cancer, or connective tissue diseases must be taken into consideration. I would advise seeing your primary care doctor again, or an internist with the specific words fever of unknown origin workup as something you'd like to look into. Good luck.



eCureMe's Advice 4

Chronic recurring fevers can be due to a number of reasons. Infection is usually the most common reason and blood, urine, and stool, need to be checked. If those tests are negative, more invasive testing will be needed i.e.: echocardiogram, CT scans, and possibly cerotic scan. There is also possibility of cancer, which would require a bone marrow test. As you can see, this can be a very complex medical problem and you need to see a qualified internist to help you find out what is causing this fever.






 
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