Female | 52 years old
Complaint duration: 26/10/18
Conditions: Low grade fever
I'm not sure what medication you are referring to which helps with the fevers but that could indicate the underlying issue. Sometimes antibiotics help with symptoms but don't resolve the problem if there is an underlying infection of a foreign object or fluid collection such as an abscess or pleural(lung) fluid collection. Some patients suffer from an inherited condition called familial mediterranean fever which is typically one of the last resort screening tests ordered.
Hope this helps,
Jack Stephens, MD
IF all these common and easily diagnosed and treated diseases have been ruled out, then you need to look for the 3 main causes of FUO: infection< tumor, collagen vascular DZ.
1) INFECTION: TB, AIDS, ENDOCARDITIS (infection of heart valve) and abdominal/liver/lung/kidney abscess/infection needs to be looked for (IF the patient is from out of the country, malaria, typhoid, and TB may need to be ruled out depending on what country the patient is coming from).
2) TUMOR: Usually meaning LYMPHOMA/LEUKEMIA, but other solid tumors -- lung, liver, kidney, breast, colon, pancreatic, etc. -- can rarely do this, too, and may need to looked for, depending on the clinical scenario and whether the patient has any focal symptoms that may be a clue to the source of the problem.
3) CVD: like lupus, rheumatoid arthritis, vasculitis (like giant cell arteritis, polymyalgia rheumatica, polyarteritis, ANCA vasculitis)
Depending on the results of the preliminary tests and the clinical context -- blood tests, blood cultures, sed rate, CXR, urine cultures, and maybe abdominal imaging -- these all need to be considered. If one knew what drug appears to be suppressing the fever, like an antibiotic, NSAID/Tylenol, or steroids, this might clue one in to the source of the problem. If an antibiotic seems to be suppressing the fever, then there probably is an infection going on and blood cultures (OFF ANTIBIOTICS), urine cultures, CXR -- all need to be done. Imaging studies like CT or MRI may be indicated if there are focal symptoms or history or physical exam (or a blood test) suggests where the source is.