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Continuous fever with fluctuations not reduced by ANTIBIOTICS.

Resolved Question:

Hello Doctor,

I am Shobhit Agarwal, residing in Pune, India. My father is residing in Lucknow, India.

He is having a countinuous fever from past 25-30 days, initially the temperature fluctuation was pretty high i.e. 100 - 103/104. This fever comes anytime in the day and remains for 2-3 hours with lot of sweating. We have counsulted doctors and conducted some testings as well which all resulted in FINE. Even though after some injection course of 10 injections and regular medication, his fever is not going above 101 but the fever still remains in the body. This fever is now fluctuating between 98-101 degrees.

Urine testing was also done which resulted FINE.

Attached are some other testing reports as well. Can you please suggest what we can do and what could be the possible problem here? Conducted almost all the testings and all testing results are fine. Also, we have now consulted another doctor yesterday and he suggested that because the body already has too many ANTIBIOTICS these testings could be wrong and suggested that first these ANTIBIOTICS needs to be removed from the body (in around 5-6 days) and after that fresh testing needs to be conducted.

Could you please suggest the next course of action.

Let me know if you need any other information.

Regards,
Shobhit Agarwal

Category: Internal Medicine Specialist

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Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
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 30 Doctors Online

Expert:  Dr. Jaydeep Tripathy
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Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
Your father is suffering from intermittent fever with chills and it's been there for the last 25-30 days. I can only typhoid has been ruled out and other blood tests has not been done.
Since, it's been there for a long time, I will advise a complete set of investigations for us to have a clue towards the diagnosis.
- CBC
- ESR
- LFT
- RFT with electrolytes
- Ultrasound Whole Abdomen
- Stool test.
- Malaria Antigen
This tests will give us a clue towards the diagnosis, you can go ahead irrespective of the diagnosis. I will advise you get the tests done at the earliest and share the reports with me. I will give you the diagnosis.
Hope this was helpful,
Regards.


Patient replied :

Thanks for your reply.
I will share the testing results ASAP.
Meanwhile doctors have told suggested a strong case of URINE INFECTION. For that they have asked for the injection course for 5 days (2 injection each day) named MONOCEF. First 3 days 2gm and next 2 days 1gm injection through the hand veins. Please suggest are we going in a right direction?
Also as you mentioned the above testings..can we start it right away? Because the doctors have said that because there is already a good amount of intake of ANTIBIOTICS in the body, it will be good if these testing could be done when these antibiotics move out of the body...for which they have asked to wait for 5 days until the body is fully out of ANTIBIOTICS. Please suggest!!
Regards,
Shobhit


Expert:  Dr. Jaydeep Tripathy
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Hello,
Can you share the urine test reports?
What are your urinary symptoms?
As I mentioned irrespective of the antibiotic usage, you should go ahead and get the tests done.
You said the urine reports are fine. What made the doctor suggest urine infection?
Regards.


Patient replied :

Hello Doctor,
Please can you check all the reports on the below site?
www.chandan.co.in
Username- IDC1-00159/15-16
Password- qdkomabu
Username- IDC1-00668/15-16
Password- lqilxlpf
Username- CALI-00676/15-16
Password- buutubio
Username- IDC1-00979/15-16
Password- igocvvix

One more Urine test was conducted yesterday for which the report will come day after tommorow (it takes 72 hours for that report). I will send that report as well as soon it will come to me.
Please check all the reports and let me know.
I will send you all th prescriptions also soon.
Regards,
Shobhit


Expert:  Dr. Jaydeep Tripathy
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Hello,
I have seen all the reports, and nothing is substantial except for his cholecystitis.
He has a calculus measuring 1.3 cms, and it mostly has to be removed.
I will request you to take him to a surgical gastroenterologist who can decide on whether it can be removed laparoscopically or can be manged medically. Since he has been having fever the doctor may decide to remove it laparoscopically.
Regards.


Patient replied :

Thanks a lot for your reply!!
I know that he is having a stone in his gallbladder. We asked the consulting doctors if this is the reason for his fever and they said that it is not the case.
But I personally thinks that this is because of the stone. 2 days back he had a severe stomach ache when this fever started.
He is currently getting the injections named MONOCEF. Shall we complete that course of 5 days first before going for Stone removal operation? Please suggest!!
Regards,
Shobhit


Expert:  Dr. Jaydeep Tripathy
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Hello,
There is no other explanation of his fever.
I also beg to differ with your doctor, that there is any urinary infection. In fact his urine is sterile, and there is no evidence of any UTI.
Please finish the course and I will advise you to consult a surgical gastro directly, who is best suited for your father.
Regards.

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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