I have a friend who just had surgery requiring anestesia put into her throat. Her cough seems to be progressing to one that is in the chest now, instead of just in throat. Is it ever possible to have a bacterial infection without fever as a presenting symptom or is fever always present except for bacterial meningitis?
In an otherwise healthy person, whose immune system is working well, it would be most unlikely to have a bacterial infection without fever and an elevation of the white blood cell count and that includes the diagnosis of bacterial meningitis. However, in the presence of overwhelming infection of the lungs or central nervous system, one's temperature may not rise and, if up, may fall, especially if culture of the blood is positive for bacteria.
If her cough is producing discolored phlegm, bacterial infection would be the most likely cause and would require antibiotic therapy. In that instance, her sputum should be sent to the laboratory for "culture and antibiotic sensitivity.
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