Have had low grade fever for over two months now

[jojo6751]

Has anyone ever experienced this before. I had surgery Nov.28,2008. TVT. I have had a low grade fever for over two months now. I did develop a hematoma. It is almost gone now. My doctor said the fever is not from this. I am generally not feeling well. Very tired and sometimes dizzy and light headed. I have been off work as well with this. Can anyone give me any suggestions on what would be wrong with me.
Thanks

[caregiver222]

I believe you should undergo a two part ultrasound screen for endocarditis. This involves an ultrasound scan of the back and swallowing a probe.

This is not the most likely of possibilities, but is an uncommon complication of surgery, and could result in the abnormal temperature.

You could also be suffering complications from an improper blood match if you recieved a transfusion.

[Dr. Kokil Mathur]

Hi
Thanks for writing to the forum!
Yes, flushed face and rise of temperature cannot be normal. You may have undergone a number of tests. I am enumerating the possible causes of prolonged fevers. Please go over the list to check if everything has been looked for.

Recurrent or chronic fever is seen in tuberculosis, SLE, rheumatoid arthritis, Polyarteritis nodosa (PAN) and other auto immune disorders, UTI, drug fever (if you are on any medication), glandular fever, HIV, STDs, endocarditis, parasitic infestations, fungal infections, lymphomas and other cancers etc.
In your case you must look at SLE as a possible cause. If you belong to the fairer sex, then even polycystic ovary, menopause, PID (pelvic inflammatory disease) should be investigated for.
Ofcourse, a number of times no diagnosis can be reached and the fever subsides on its own.
Hope this helps. I think you should discuss these possibilities with your doctor. It is difficult to comment beyond this without examining. 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!

[Fever4ever]

I am fne in the morning run low grade everyday all test are normal this has gone on for several years now. I did 18 months of 2 shots for ebbsteinbar no help. This flush face, low fever makes me so tired. This can not be normal...

[jojo6751]

Hi again,
I was just wondering how long it takes to see a hematologist?  Do you usually get in right away?
Thanks

[jojo6751]

Hi,
Thank you. I was really worried. According to my doctor both are very low. I just wanted to know is it possible to have leukemia with my white cells being normal. I think my red is a little low.
Thanks

[Dr. Kokil Mathur]

Hi
Thanks for keeping us posted!
Yes, it is possible to have fever. Many hemorrhagic fevers occur with low platelets and abnormal INR. It all depends on what your INR values and platelet counts. Your hematologist should be able to help you. Leukemia is possible but this will cause abnormal cells in the blood. So in your case it’s ruled out I guess.
Hope this helps. Take care!

[jojo6751]

sorry, forgot to let you know I am not on any medication.
Thanks

[jojo6751]

Thanks for the reply.
Is it normal for me to have a low grade fever with this. I have aches and pain all the time. I just dont feel well. I have a appetite and am still losing weight. With my platelets being low and the inr is it possible that it could be leukemia? I have all the symptoms except for the white cell counts. I have had the fever and pain for three months now. There is no infection.

Thanks

[Dr. Kokil Mathur]

Hi
Thanks for keeping the forum posted!
“The prothrombin time is the time it takes plasma to clot after addition of tissue factor (obtained from animals). This measures the quality of the extrinsic pathway (as well as the common pathway) of coagulation.
The speed of the extrinsic pathway is greatly affected by levels of factor VII in the body. Factor VII has a short half-life and its synthesis requires vitamin K. The prothrombin time can be prolonged as a result of deficiencies in vitamin K, which can be caused by warfarin, malabsorption, or lack of intestinal colonization by bacteria (such as in newborns). In addition, poor factor VII synthesis (due to liver disease) or increased consumption (in disseminated intravascular coagulation) may prolong the PT.
A high INR level such as INR=5 indicates that there is a high chance of bleeding, whereas if the INR=0.5 then there is a high chance of having a clot. Normal range for a healthy person is 0.9–1.3, and for people on warfarin therapy, 2.0–3.0, although the target INR may be higher in particular situations, such as mechanical heart valves.” Refer: http://en.wikipedia.org/wiki/Prothrombin_time

Along with low platelets this will result in increased risk for bleeding. Your doctor is right in sending you to a hematologist.This will not affect the red and white blood cells.

Hope this helps. Do let me know if there is any thing else and keep me posted. Take care!

[jojo6751]

Forgot to let you know, my white and red cell count is normal.
Thanks

[jojo6751]

I just came back from from my doctors app. The blood test show low platelets and abnormal inr. He is sending me to see a hematologist. I still have a low grade fever and lots of bone pain. What could it be.
Thanks

[jojo6751]

Thanks for your reply. I have been tested for vaginal infection and UTI. There was no infection. This is what concerns me. I guess I will have to wait for the next blood work to come back.
Thanks.

[Dr. Kokil Mathur]

Hi
Thanks for writing to the forum!
There are a few possibilities that come to my mind. One is vaginal infection, other is UTI and the third is infection in the veins where IV was given. All of them can cause low grade fever and a run down feeling and are common complications of surgery. A urine examination, a vaginal swab examination is surely required.
I have enumerated the possibilities that come to my mind right now. Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!

[Bhupinder Kaur, MD]

Hello,

It sounds like PUO(pyrexia of unknown origin).The common causes which need to be evaluated are infectious mononucleosis,typhoid ,liver disease,infections like tuberculosis,malignancies,SLE,lyme’s disease,polycythemia vera,cushing’s syndrome and addison’s disease.A complete blood profile is needed to confirm a diagnosis.Pls get yourself evaluated from a physician.

Hope it helps.Take care and regards.

[jojo6751]

My temp. is any where between 99.3 to 100.2. It goes up and down all day and I feel very tired and weak with it. I am very pale. Sometimes during the day it goes to normal but not for long. When they found the hematoma they admitted me. I was in the hospital for a week. They had me on antibiotics through IV . I was also on them for a week after I got out. This was in Jan. I have been seeing my doctor every two weeks since the end of Nov. I had more blood work done last week. My doctor called and said that my platelets and INR test came back abnormal. He said that I might have a blood disorder. He wants me to repeat the test again saying that if I was on advil that it could give false results. If it comes back positive the second time I have to see a hematologist.
Thanks for your reply.

[Encephalomalcia]

If you have a fever, you must have an infection somewhere.  What are you calling a low grade fever?  Some temp. run 99 in some people.  If it is a 100 or above, I would ask the doctor for an antibiotic.