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Unexplained Fever for 3 months
Hello,
My father 66 years in India is having for the past 3 months unexplained fever between 99-102.5 Dc.All possible tests like Malaria,Typhoid,TB,HIV,Hepatatis B & C , Bone Marrow ,Urinary infection , CSF Lumbar ,Thyroid FNAC,Leptospyrosis ,PCR taken and are Negative.Ultra sound scan of Liver,Chest,abdomen ,Pancreas,neck,Colonoscopy of lower intestine,Rectum and CT scan of abdomen,Head was all normal.He was given lot of antibiotics and paracetamol tabs and injecctions but of no use. 15 days back his Dr.gave NSAID tab (etrocoxib) and the fever stopped.But when he stopped the NSAID tablet fever has again come.He lost weight 6-7 kgs initially but now he maintains his weight.He has High BP and under went Thyroid operation 8 years back and he takes regular medication for both.He also had Cataract surgery on his left eye 6 months back. Can anyone please guide how to treat him for possible cure.
My father 66 years in India is having for the past 3 months unexplained fever between 99-102.5 Dc.All possible tests like Malaria,Typhoid,TB,HIV,Hepatatis B & C , Bone Marrow ,Urinary infection , CSF Lumbar ,Thyroid FNAC,Leptospyrosis ,PCR taken and are Negative.Ultra sound scan of Liver,Chest,abdomen ,Pancreas,neck,Colonoscopy of lower intestine,Rectum and CT scan of abdomen,Head was all normal.He was given lot of antibiotics and paracetamol tabs and injecctions but of no use. 15 days back his Dr.gave NSAID tab (etrocoxib) and the fever stopped.But when he stopped the NSAID tablet fever has again come.He lost weight 6-7 kgs initially but now he maintains his weight.He has High BP and under went Thyroid operation 8 years back and he takes regular medication for both.He also had Cataract surgery on his left eye 6 months back. Can anyone please guide how to treat him for possible cure.
Hi,
You should consult your doctor and get certain tests done immediately to come to a definite diagnosis , so that further management can be planned accordingly.
You would need to get a hemogram, blood culture sensitivity, urine routine microscopy and urine culture sensitivity; serum electrolytes - sodium, potassium; a CT scan of the head (keeping in view his symptoms and history of fall); serum eltroxin levels; thyroid function tests; kidney function tests, chest xray and also any other investigations your doctor might suggest.
Let us know the reports when they come in - it would help to short list a few possible causes of the symptoms he is having.
Let us know if you have any other doubts.
Regards.
You should consult your doctor and get certain tests done immediately to come to a definite diagnosis , so that further management can be planned accordingly.
You would need to get a hemogram, blood culture sensitivity, urine routine microscopy and urine culture sensitivity; serum electrolytes - sodium, potassium; a CT scan of the head (keeping in view his symptoms and history of fall); serum eltroxin levels; thyroid function tests; kidney function tests, chest xray and also any other investigations your doctor might suggest.
Let us know the reports when they come in - it would help to short list a few possible causes of the symptoms he is having.
Let us know if you have any other doubts.
Regards.
Dear Dr,
Many Thanks for ur immediate response.We had not done any test relating to Thalamus except Physical examination by a Neuro as he had symptomps of imbalance while walking or suddenly when he gets up from sleep.He had a fall during night time @ bathroom without knowing, At that time (45 days ago),he was very weak and fever was continually there and at times when the Temp.raises to 102-103 ,he will utter or say some thing during semi-sleep conditions and it will subside once his Temp.lowers.
Now he is taking Eltroxin for Thyroid and amlodypine 10 mg for BP daily in the morning.As per your views my father is taken care of well by all our family members and we think he doesnt have any unsatisfied / special needs at present. By the very look of his Face itself we feel that he is not allright and his eyes will become very dull and dim when he has temperature .Usually he will have a bright face and people who use to meet him regularly now when they see him they say immediately that he is not cured of his illness What are the tests we need to take again.Pls advise.
Thanks &Regards
Many Thanks for ur immediate response.We had not done any test relating to Thalamus except Physical examination by a Neuro as he had symptomps of imbalance while walking or suddenly when he gets up from sleep.He had a fall during night time @ bathroom without knowing, At that time (45 days ago),he was very weak and fever was continually there and at times when the Temp.raises to 102-103 ,he will utter or say some thing during semi-sleep conditions and it will subside once his Temp.lowers.
Now he is taking Eltroxin for Thyroid and amlodypine 10 mg for BP daily in the morning.As per your views my father is taken care of well by all our family members and we think he doesnt have any unsatisfied / special needs at present. By the very look of his Face itself we feel that he is not allright and his eyes will become very dull and dim when he has temperature .Usually he will have a bright face and people who use to meet him regularly now when they see him they say immediately that he is not cured of his illness What are the tests we need to take again.Pls advise.
Thanks &Regards
Hi,
Fever of Unexplained Origin or FUO is an entity which may be used to describe your fathers' condition. This entity is a combination of all possible reasons for a fever which has been undiagnosed.
Fever is a general symptom of the body. The body temperature is controlled by the thalamus, and it is called the thermostat of the bosy. Sometimes there may be abnormalities with the setting of this 'thermostat' which may lead to change in basal bosy temperature. This is common in a hot and humid place like India and it appears that this may be one possible reason which may not have been investigated by the doctors.
Also an analysis of the medication for thyroid and hypertension is required to understand the reasons in this case.
I think you may also have to run a few of those tests again, so as to completely rule out any developments which were not detected in the tests earlier.
People in the geriatric age group have special needs and requirments and it is importnat to find out if there are any special needs for your father here.
I think you have shown resolve and determination and love for your father through this illness. Please keep taking care of him, since sometimes it is more forensic work for the doctor to try and find the culprit, than a simply a healthcare provider.
Let us keep this is an interactive session and I encourage you to come back with more information and queries which I would be able to then answer and use in helping you
Fever of Unexplained Origin or FUO is an entity which may be used to describe your fathers' condition. This entity is a combination of all possible reasons for a fever which has been undiagnosed.
Fever is a general symptom of the body. The body temperature is controlled by the thalamus, and it is called the thermostat of the bosy. Sometimes there may be abnormalities with the setting of this 'thermostat' which may lead to change in basal bosy temperature. This is common in a hot and humid place like India and it appears that this may be one possible reason which may not have been investigated by the doctors.
Also an analysis of the medication for thyroid and hypertension is required to understand the reasons in this case.
I think you may also have to run a few of those tests again, so as to completely rule out any developments which were not detected in the tests earlier.
People in the geriatric age group have special needs and requirments and it is importnat to find out if there are any special needs for your father here.
I think you have shown resolve and determination and love for your father through this illness. Please keep taking care of him, since sometimes it is more forensic work for the doctor to try and find the culprit, than a simply a healthcare provider.
Let us keep this is an interactive session and I encourage you to come back with more information and queries which I would be able to then answer and use in helping you
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