Commonly Asked Questions / Doctors' Answers|
Fever of Unknown Origin (Internal Medicine)
I have a recurring high fever (100-104), severe chills, headache,
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.