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Need URGENT help
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Need URGENT help

Hi All,

My father has the developed a slight fever (between 99-100 F). The temperature is normal in the early hours of the day but after abt mid day it starts rising and reached up to 100 F maximum. His Hb dropped to 7.9. However, his history is as follows:

1) CABG (3 artery) bypass 1 year ago. Released at Hb 9.3
2) Developed chest infection 2 montths ago leading to high Fever. Was treated with tablet antibiotics such as Ceclor/Brufen which led to stomach disorder and vomitting after 1 day. Then he was asked to take a course of injections. After 6 days, the temperature was normal. It stayed like that for about 6-8 days and then he developed this low fever. Its been almost 2 weeks now.
3) Severe diet issues over the last month. He doesnt feel he can eat and feels that his stomache is full.

The following tests were done:

1) LFTs normal
2) CBC mostly normal....slight drop in RBCs....WBC and platelets normal .....HCT slight less and MCV normal
3) Endoscopy revealed slight gasteritis
4) Typhoid negative
5) ESR initailly was 140...after blood transfusion it dropped to 115
6) Chest Xrays normal
7) Abdominal ultrasound normal
8) history of Hytal Hernia
9) Serum PSA normal

Please help in the diagnosis.....I'm really worried.
Tags: urgent, esr, hb
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4 Comments Post a Comment
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Avatar_n_tn
Just to add.....when he developed the low fever (after the 6-8 day break, his coughing (w flem (phlegm)) increased.

He is currenlt taking Losic 40mg per day for stomache issues. The doctors are concerned about the drop in Hb and increased esr.
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Avatar_f_tn
Hi,

There are various causes for low grade fever: Some cancers (specially leukemias and lymphomas), SLE, Sjogren's syndrome, rheumatoid arthritis, pernicious anemia, tuberculosis, sarcoidosis. Most of these can also have anemia, loss of appetite, elevated ESR.

Please ask your doctor if all the above have been ruled out.

Do keep me posted
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351246_tn?1379685732
Hi
Thanks for writing to the forum!

Since your father has a history of bypass surgery endocarditis and nosocomial infection has to be ruled out. Stomach issues could be due to hiatal hernia. You would need to consult a gastroenterologist for this.
Recurrent or chronic fever is seen in tuberculosis, SLE, rheumatoid arthritis, Polyarteritis nodosa (PAN) and other auto immune disorders, UTI, drug fever, glandular fever, endocarditis, parasitic infestations, fungal infections, lymphomas and other cancers etc.

A comprehensive investigation is required keeping all the points in mind. Please let me know if there is any thing else and do keep me posted. Take care!

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Avatar_n_tn
Hi,

Was the problem ever solved? I am in a very similar situation.

I had a fever, belching, nausea, etc after eating or even drinking a glass of water. It turns out that I had a pyloric ulcer and severe gastritis, but these problems have been treated successfully, and I still get a fever and a lot of belching after eating. I occassionally have clay colored stools and I constipated.

An ultrasound was normal.

An endoscopy taken after the treatment of the ulcer was normal.
Bilrubin is is normal
No urinary infection
All liver stuff is normal
Lactatdehydrogenase is high, but has been for at least a couple of years.
Other gall bladder blood test were normal
Colonoscopy was normal except for
My blood count is hard to interpret becasue I have Thrombocytosis and take Hydrea, a form of chemo therapy that lowers the level of all types of blood cells. A few months ago, I had to increase the dose of Hydrea becasue my platelet count was rising. In the next following months, my platelet count has fallen, but my whites have risen.

After the ulcer and gastritis were treated, my white fell slightly, but are still really elevated in relation to my platelet count and the high dose of hydrea I take.
I've lost 10 lbs in the last tw oand a half months.
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