recurrent fever more than 103

[Saintalbans1]

My nephew is 32 and has had problems with high fever of approximately 104 for the last 10+ years. He has always been treated with antibiotics that may or may not have been a help. It seems the fever lasts about 3-4 days and the other symptoms are swollen glands in his neck and being very tired. He has seen ENT that performed CT scan and  determined sinus was clear. He also was examined by infectious disease doctor that found no suspicious symptoms. He had decayed wisdom teeth extracted last year. He was in the ER again last night and yet again they cannot find anything wrong.
Has anyone had similar symptoms?

[mkh9]

Well, it is a good start. I would definitely look into the LLMD type doctor because a lot regular doctors won't listen to you about lyme disease unless you have a "target" rash and only a small percentage of people get that. So then you can become chronic and they miss diagnose people. So it is good to get these things checked out. If it isn't lyme, the co-infections are possible. If not we can go from there.
take care,
mkh9

[Saintalbans1]

By the way there is no rashes or discoloration.  He was in an accident about ten years ago and received third degree burns on 40% of his body so his skin of course does not look "normal"as such at any time.

[Saintalbans1]

Thank you very much for the information regarding parasites. Real possibility as he is outside quite a bit. When he was a teenager he had a job clearing brush and weed eating. He says the only other symptoms other than fever are swollen glands in the neck but no other lymph glands, also extreme fatigue all the time but much worse during fevers. I'll pass along information regarding blood work and hope he can find a doctor that will listen.

[mkh9]

Hi, there is the website:

go to:    ILADS.org and email them and ask for an LLMD

There are some inherited or genetic disorders that can cause fevers so maybe this is why they referred you to a rheumatologist. I would check for the lyme and babesia first. If he doesn't have a rash then it probably isn't rocky moutain spotted fever. Lets go from the lab work forward. It is just a thought or start.
take care,
mkh9

[mkh9]

Yes some infectious disease doctors are jerks and some are good. I worked for one that was excellent but I went to one that was terrible. Don't give up. Even a good family practice doctor that is willing to work with you can order lab tests.  The fact that the fevers are cycling is what made me think of malaria. I can look of some of the unusual relapsing fevers as I don't recall the cycles of how often the fever are. Do you recall him getting bitten by a tick or going hiking in the mountains? I have to see about rickettsia and rocky mountain spotted fever. Has he had any rashes or anything like that? Babesia is another malaria like parasite you get from a tick bite too. You may just want to get him to a Lyme Literate doctor I'll get the website and see if there is one near you and they can get you some tests to rule out these odd organisms. They need to do PCR (molecular test) not serology. There is a lab that specializes in this that is much more sensitive and specific that the usual ones that give false negatives. It is called IgeneX. You can look up their website too. I don't if he has symptoms of lyme rather that the co-infections that you get from being bitten by the Ixodes tick. They are small and you often don't see them. I'm not saying this for sure just that it is very usual to have a fever that long and the fact that it is cycling means something to me.
mkh9

[Saintalbans1]

Thanks for the suggestions,. He did see an infectious disease doctor and the jerk basically said if he was not sick enough to be admitted to the hospital he couldn't help him. He gave him a prescription for ten Z pak which he has already used. His last trip to ER they told him to see a rheumatologist. Not sure about the malaria issue but eill check.  Thanks again.

[mkh9]

One thing that comes to mind is malaria and other similar parasites. They have a cyclic fever that lasts a few days and then goes away for a few days and comes back. Has he ever been tested for this? It is not impossible for someone in the U.S. to get malaria. Have you traveled outside the U.S. it would be more likely but they still do have some cases. Also there are some tick borne disease and relapsing fevers that may be the cause. Like relapsing fever, and rickettsia and maybe Lyme. I would have an infectious disease doctor do a panel of tests on him.
Hope this helps.