Low grade fever

[sourav_ghosh]

My sister, age of 24, is suffering from low grade fever (99 to 100 usually) for 3 months. Fever comes only at evening (from 6 p.m. to till go to bed). But at the morning she has no fever. She has no more symptoms. After a months ago we consult with a M.D. doctor. At that time she had some more symptoms like- nausea, vomiting, headache, caugh etc. He suggest all types of test like- Blood tests for re/me, thyroid,bilirubin, liver function, Xray of chest, USG of upper and lower abdomen. All the reports are normal exept liver and spleen is slightly enlarged. At that time doctor prescribed some medicine like- R-Clinex, Combutol, Rabifast-DSR, Nukast etc. At that time she was well but now for a week she had facing same problem(low grade fever). We are very much about it. Please help us. Is she suffering from cancer or any uncurable disease? please write some test if she needed.

[Dr. Kokil Mathur]

Hi! Your sister probably has anemia and the cause for it such as poor diet, occult blood in stool, heavy periods etc should be looked into. Further tests for serum iron etc should be done. Please follow up with your doctor for prescription of iron supplements.
Anemia too can cause low grade fever.
Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!

[sourav_ghosh]

Thank you for ur response. After 1 week our home physician told us that he also can't understand why my sister's body temp becomes 99-99.6 F. So he reffered another doctor.
He said that 99.4 is not fever. Although he suggested to do some blood test like TC/DC/ESR/HAEMOGLOBIN, HBsAg, anti HCV, IGE, C. reactive Protien. The blood test report is like the followings:-
Haemoglobin: 9.7 G/dl
Total Leucocyte count: 13,600/cu. mm.
neutrophils: 67%
Lymphocytes: 28%
Monocytes 2%
Eosinophils: 3%
Basophils: 0%
RBC: Hypochromic microcytic & normochromic normocytic. A few are normochromic
         macrocytic
Platelets: Adequate
ESR: 55 mm(at the end of 1 st hour)
IGE: 763.70I.U/ml.
C.REACTIVE PROTEIN: 1.24 mg/dl
HBsAg: Non Reactive(0.0 IU/ml)
Anti HCV: Non Reactive(0.07)
Is there anything which is dangerous for her. We don't consult our doctor yet. Pls Help me.

[sourav_ghosh]

Thank you doctor. I shall consult with my doctor.

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
Evening rise in temperature is generally due to anemia, diabetes, hypothyroid states, overwork, stress and fatigue. It is also seen in diseases like tuberculosis.
If your sister’s stomach too feels queasy, there is a chance that she has inflammation of the bowels as seen in IBS, colitis or maybe even gluten or lactose intolerance. Discuss this with your doctor and try and get investigated. Even polycystic ovary and PID (pelvic inflammatory disease) should be investigated for. Dehydration is a frequent cause of low grade fever with malaise. So she should drink plenty of fluids and see.
Most labs have a fever panel to rule out most diseases that can cause persistent low grade fever.
Hope this helps. It is difficult to comment beyond this at this stage. Do consult your doctor. Please let me know if there is any thing else and do keep me posted. Take care!