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Family Medicine (Expert Forum)
Can't find source of fever!
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
Can't find source of fever!
by kd0522, Jan 27, 2005 12:00AM
I'm worried. I became ill around Thanksgiving 2004 with what appeared to be a sinus infection (low-grade fever, slight blood in CLEAR mucous, headache behind eyes/in forehead, ear fullness/popping, chills, muscle aches). I have had various appointments with my doctor and been on a variety of medications (Augmentin XR - 3 wks., steroid shot, to name a few). Nothing seems to work. All 4 of the CBC tests have been "normal."
I saw an ENT last week and he doesn't really see anything wrong with my sinuses. He also gave me a steroid shot, ran a mono and cmv test (both negative) and sent me home to come back in a month.
I have tested negative for HIV (same partner for last 11 yrs) and don't have any swollen lymph nodes. I have lost about 10 pounds since this started and my mental health has suffered. I am an avid runner and teacher. My current symptoms include the above mentioned in addition to jaw pain and slight shakiness. My biggest concern is the fever, though. I run anywhere from 98.7 to 100.5 (higher on a few occasions). Obviously by body is fighting some infection somewhere, correct?
I have an appointment with an allergist next week and an infectious disease doctor the week after. Do you have any helpful advice for me? I'm beginning to go crazy! Thank you so much.
I saw an ENT last week and he doesn't really see anything wrong with my sinuses. He also gave me a steroid shot, ran a mono and cmv test (both negative) and sent me home to come back in a month.
I have tested negative for HIV (same partner for last 11 yrs) and don't have any swollen lymph nodes. I have lost about 10 pounds since this started and my mental health has suffered. I am an avid runner and teacher. My current symptoms include the above mentioned in addition to jaw pain and slight shakiness. My biggest concern is the fever, though. I run anywhere from 98.7 to 100.5 (higher on a few occasions). Obviously by body is fighting some infection somewhere, correct?
I have an appointment with an allergist next week and an infectious disease doctor the week after. Do you have any helpful advice for me? I'm beginning to go crazy! Thank you so much.
Doctor's Answer
by Kevin Pho, MD, Jan 27, 2005 12:00AM
, Jan 27, 2005 12:00AM
There has already been a comprehensive evaluation for the fever, ruling out the more common causes.
Before infection has been completely ruled out, you may want to consider several sets of blood cultures. Things like endocarditis (infection of the heart valves) can be an insidious cause of fever.
Non-infectious causes of fever can include things like lymphoma - and this can be considered if all the tests are negative thus far. You may want to consider imaging studies like a CT scan which can evaluate for this, and can look for a previously undiagnosed abscess, which can also cause a low grade fever.
These options should be brought up by the infectious disease referral.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Before infection has been completely ruled out, you may want to consider several sets of blood cultures. Things like endocarditis (infection of the heart valves) can be an insidious cause of fever.
Non-infectious causes of fever can include things like lymphoma - and this can be considered if all the tests are negative thus far. You may want to consider imaging studies like a CT scan which can evaluate for this, and can look for a previously undiagnosed abscess, which can also cause a low grade fever.
These options should be brought up by the infectious disease referral.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
I am looking for answers too. I am 27 yrs. old and use to be healthy. I have had a low grade fever on and off for over three months. Sometimes I get a slight sore throat. Some days I fell like myself and then it starts all over again. My CBC is normal, Lyme's was negative. Any other options out there? What are the chances of a person having lymphoma? I was perfectly healthy before I came down with a cold that just didn't go away. I am pretty tired and weak but my weight has stayed the same and actually increased a little since I am just sitting around. I am just so upset b/c I can't plan any activities b/c I don't know if it is going to be a good or bad day and I am barely working. I had a sinus CT scan that was normal.