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elevated body temperature
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elevated body temperature

Hello!

I have problem that I never noticed before. Here is what have happened to me:

Before 1 of January 2010 I experienced stomach problems at night. After 4th of January, I got stomach pain and nausea late at night and I went at hospital and I lab test were made to me. I have only raised sedimentation (at about 45). After few days I noticed 37.2 celsius body temperature. Every other analysis were in normal range. I went on ultrasound of my abdomen and small inflammation of the gall bladder was noticed. After 1 week of nausea, I went again on hospital and I received infusion. After 1 week (diagnosed gastritis) I felt good, but when I started to go on faculty (before 2-3 weeks), after coming at home I noticed temperature of 37.3 - 37.4 celsius (I am measuring temperature on my armpit with digital thermometer). After relaxing 3-4 hours my temperature decreases at 36.3 - 36.5 celsius. Recently I made complete blood tests everything was OK, except one thing. The total billirubins (indirect + direct) were 50 (normal 20). I am puzzled. I made all test for bacteria and there isn't one.

I was very healty guy, this is something which is serious to me (which does not need to be). I don't know if the temperature is normal, and what could cause it. I am male, at age of 19.

Could you possible tell me is that normal temperature, and could you give me some idea what could cause elevated body temperature.

Thanks in advance.

Regards,
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17 Comments
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Avatar_m_tn
Help please
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875426_tn?1325532016
Armpit/axillary temperature is normally within a range of 96.6° (35.9° C) to 98° F (36.7° C). It is usually one degree lower than taking your temperature under your tongue.
Regarding sedimentation- are you referring to ESR?  If so, an elevated rate would indication generally that you have inflammation in your body.
Regarding elevated bilirubin & gallbladder symptoms- have you discussed getting a HIDA scan with your doctor?  Biliary colic can cause pain and an elevated bilirubin level can indicate a liver, gallbladder or bile ducts in distress.  A HIDA scan with gallbladder ejection fraction can sometimes pick up what's missed in an abdominal ultrasound when it comes to this issue.  Since you have a low grade fever, you should see your doctor immediately according to what I was looking at, given your symptoms.  See PM.
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Avatar_m_tn
Thank you very much for the help.

Yes, I refer to ESR. But, the last test show that I got only 4 ESR which means that I got no inflammation in my body.

My blood test show negative tests of hepatitis, and my last ultrasound showed dense material in my gall bladder (but actually no stones or sand). The ultrasound test showed that all organs are fine including the liver.

I don't know what HIDA scan is but I read something on wikipedia but I am afraid that its dangerous.

Thanks for the PM. Sometimes I experience nausea and my skin is yellow (I guess because of the raised level of billirubins).

If I am home all day my body temperature is no more than 36.7 C

But when I go to faculty and come back home (at 4 pm), my body temperature is 37.2-37.3 C

At 8 pm, my body temperature drops to 36.2 C, which is (in my opinion) very strange. The temperature falls without using any medications.

It is logical that it is not virus based problem, since my temperature drops at night (which is opposite when virus is in question).

I see various doctors (including specialist of infections, specialist in internal diseases), only I have not visited specialist of gastrointestinal diseases.

All of them are ignoring my body temperature, just the doctor on the ultrasound told me to go on specialist of gastrointestinal diseases.

I am really puzzled. I am not sure that even billirubins are causing rise of body temperature or there is something else which is separated from this problem.

Could you possible give me some advices that could help me find my way out?

Thanks in advance.
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875426_tn?1325532016
I had a HIDA scan done late last year on me.  If you are allergic to the dye/ tracer they use, it could be dangerous.  You might call your local radology office to inquire about the dangers versus benefits.  Besides going to a GI specialist, have you ruled out thyroiditis, mononucleosis, and CMV (cytomegalovirus)?
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Avatar_m_tn
I made hormone tests for thyroid gland and everything is fine. Only I have not tested mononucleosis and CMV.

But could that dense material in my gall bladder cause low fever (not constant)?
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875426_tn?1325532016
According to Merck's website fever is more likely to be associated with acute cholecystitis versus chronic.  If you were having acute attacks and were not always getting the blood work to see if your gallbladder was inflamed, then I would think it would be possible to have a normal ESR when you were in between attacks.  Since you don't want to do a HIDA scan, you might ask the doctor about getting a MRCP to check your bile duct work.
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Avatar_m_tn
Thanks for the advices.

And, could all those symptoms indicate virus in my body? When some human have virus in his body, does the increased body temperature is constant (i.e is not dropping without any medications).

I am asking this because when I went to the doctor, and she sow my throat she said I have some kind of infection somewhere but she do not know where. When she put me on other blood analysis there was no sign for bacteria in my blood. I've taken urine culture and still negative. She gave me HICONCIL capsules for my throat, but after a month has passed I still feel like my throat is hurting me. Also there is lump in my throat sometimes (I do not know whether stress could cause this). My blood tests showed no signs of any viruses in my body. Sometimes I feel like cold (my body "shakes" but I got no raised temperature).

Here are my blood tests (on the link):

http://i49.tinypic.com/301n67t.jpg

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875426_tn?1325532016
It looks like your link goes to a picture, so I'd rather if you could post your abnormal lab numbers on here, if you wouldn't mind.  

Did your doctor not do a swab culture of your throat then?  An inflamed looking throat can also come from acid reflux, and you might want to get a barium swallow to check this & to see if the lump feelings might be caused by food getting hung up.... also did the doc check your thyroid for lumps?  I believe a lump feeling can also come from anxiety.
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Avatar_m_tn
The abnormal values are:

Billirubin I+D........... 50.1 uMol/L,.....,referent value 3-20
Billirubin I................41.3 uMol/L,......,referent value <13.7
Billirubin D...............8.83 uMol/L,......,referent value <5.1

Middle .......0.1 ... 10^9 / L,..........,referent value 0.12-0.84
Middle-R ...1.9..... %....................,referent value 2-12

MCV.........82.1....fL................,referent  value 86.0-100.2

Before the blood results, I was being made a swab culture which showed no signs of bacteria. The throat lump sometimes appears, and sometimes not.

From yesterday I am sneezing, my throat hurts and I got headache.

I am also allergic to pollen and dust. My nose is choked but I do not know wheter is a virus or an allergy in question.

Could some virus stayed in my organism so long that it know shows symptoms?

I am asking this because my throat was "red" 1 month and I got know bacteria.

My mother checked my throad yesterday and she sow "red stave" (which I have it before 1 month).
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Avatar_m_tn
Sorry for reposting. Just to fix my sentences:

*Could some virus stayed in my organism so long that it shows symptoms now?

*I am asking this because my throat was "red" 1 month and I got no bacteria.
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875426_tn?1325532016
Are you taking any drugs known to increase bilirubin (from my book it looks like there are a number of them)?

If you don't want to get a HIDA scan with ejection fraction regarding your elevated bilirubin, can you ask your doctor about getting a MRCP (magnetic resonance cholangiopancreatography) to take a look at why your bilirubin is so high?    An elevated bilirubin level can indicate a liver, gallbladder or bile ducts in distress.  I'm not a doctor and I'm sorry, but I can't help you with what your very specific test readings indicate.  I hope you have a doctor you can call about these findings to discuss them in detail?

My Manual of Laboratory Diagnostic Tests second edition by Frances Fischbach says that decreased values of MCV can be caused by iron deficiency anemia, pernicious anemia, thalassemia, anemia of chronic blood loss, and chlorasis.  It looks like direct measurement rather than calculated value is the way to MCV tested for best reliablity & anemias characterized by abnormal erythrocyte shape will cause MCV testing be of doubtful value because of hematocrit not being reliable in such cases.

I can't really say if your very recent symptoms are virus, allergy a combo, or even some acid reflux thrown into the mix (GERD) or what.  But I think you really should take up the blood results with a qualified physician.  There are many potential reasons for recurring fever, but your already abnormal tests should not be overlooked by a doctor as you try to figure out why you're having those fevers.
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Avatar_m_tn
Thanks for the help.

After doing the tests for mononucleosis and CMV, I was positive on CMV IgG, all hepatitis test are negative, but still can't find connection with the reccurent fever. I did all possible tests. Now I got some kind of vertigo like I was taking alcohol for 1 week. This happened to me 4 weeks ago but it stopped after 2 weeks.
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875426_tn?1325532016
CMV is a cause for recurrent fever.  When you say vertigo, do you mean spinning or like the room was moving or do you mean feelings of light headedness or faintness or ?
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Avatar_m_tn
I do not have classical vertigo. When I move my head from one point to another point, my vision "lags". You know what I mean, like a night vision camera. Also sometimes I feel the pulses of my heart on my eyes (when I am concentrated).

I read from the Internet that CMV IgG are anti-bodies and that I have had CMV sometimes. I guess I have it before New Year, because after New Year I got stomach pain and bad nausea for 1 month. Now I am OK, except for this problem with diziness/vertigo.

Thanks.
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Avatar_m_tn
Also, when I lean down to take something on the floor, and then when I stand up I got severe vertigo (spinning) and I feel my head like heavy (like bowl).
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875426_tn?1325532016
You might go to an ear, nose & throat specialist and ask about getting a VNG test for your eye-tracking and vertigo to see if a vestibular problem or something else might be the culprit.  Are you standing up from leaning over quickly?
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Avatar_m_tn
Yes, maybe that causes me stronger vertigo. Also it is characteristic when I lean down with my head it hurts me (not strong pain) and when I stand up my head is ok. Today I had headache, but I take a nap of 2 hours and now my head is ok. This kind of verigo happened me maybe before 1 month, and I went to the ear and eyes doctor. The ear doctor made me quick check and said that everything is ok, except that I am very yellow (I didn't know then that I have raised level of billirubins). He said me to drink Bilobil for blood circulation in the brain, but I am denying to drink it, because I believe I am too young and it is strong medication (for head injuries, strokes etc.). The eye doctor checked me and said that I need to take <0.25mm goggles. At that point, I got headaches every day, and it was over after 2-3 weeks.

Also, it is symptomatic that when I close my eyes, I do not feel motion spinning or something. It could be something with my eyes, because I have no trouble walking.
The only concern that I have is that I am intoxicated with billirubins.

This vision "lagging" only happened to me when I drink alcohol (beer) before. I was not using alcohol often, just on parties (very rarely). Now for over a 3 months I have not been drinking alcohol. I only drink B6 vitamin (20mg) x 3 daily, B Complex 3 daily, and C vitamin 1000 mg once daily.

My doctor said that CMV that passed made damage to my metabolism and Hepar. She said that I need 2-3 years for full recovery. She said that I need to eat only healthy food and drink vitamin B6.

I am not sure if VNG test have in my country, but I will give it a try.

Thank you very much for the help.

Regards.
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