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Cough, Low Grade Fever, Joint Pain, Feet Swelling. No Phlegm. Taking Ibuprofen. No Medical History Or Allergies To Medicine

Posted on Sat, 7 Jul 2012

Question: My wife has a mild cough for 4 weeks and a low grade fever around 101 F for last 2 weeks. Of late she has developed joint pains and mild swelling in the feet. Her chest x XXXXXXX came clear. She has no past adverse medical history and no allergies to medicine. The cough did not produce any phlegm except for very little in initial few days but now it is mostly dry. She has taken 2 course of antibiotics within these 4 weeks. She is currently taking ibu profen for fever and joint pain. I appreciate your help.

Answered by Dr. Pavan Kumar Gupta (55 minutes later)

Hello and thanks for the query.
I understand your concern and will try to address your concern
I need few informations from you before being able to narrow down the possobi.ity and answer your query.
Is this fever continuous through out the day or does it fluctuate?
Does it ever become normal?
Is this fever associated with any chills and rigors?
Is there any burning during urination?
Is there any associated diarrhea with this fever?
Is there any associated pain in abdomen?
Is there any history of travel to any country recently?
Has any simple investigations like complete blood count,peripheral blood smear,malaria antigen,urine and blood cultures done?
Has she been subjected to any gynecological procedure lately?
There is no point taking antibiotics irrationally without evidence of any infection?
Till the cause of fever is established continue ibuprofen or paracetamol

Please supply these informations do that we can take our discussion ahead.
Thanks
Waiting for your reply.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pavan Kumar Gupta (18 hours later)

Is this fever continuous through out the day or does it fluctuate?
Not continuous but comes up in the evening with chills
Does it ever become normal?
Yes it does, I have a feeling that it might be because of joint pains she is facing.
Is this fever associated with any chills and rigors?
Yes it starts with a chill
Is there any burning during urination?
No
Is there any associated diarrhea with this fever?
No
Is there any associated pain in abdomen?
No
Is there any history of travel to any country recently?
4 months back visited India
Has any simple investigations like complete blood count,peripheral blood
smear,malaria antigen,urine and blood cultures done?
Yesterday her blood tests were done and doctor told everything is normal including white blood cells count.
Has she been subjected to any gynecological procedure lately?
No

The main problem is with her joints. It is painting awfully. The mild dry cough is not really an issue. Appreciate your help.

Answered by Dr. Pavan Kumar Gupta (1 hour later)

Hello
Whenever fever is there associated with joint pains the most likely causes are infective and then autoimmune diseases
Infective causes include viral,bacterial and fungal infections.
In our clinical practice most of the patients of fever with joint pains are viral in nature followed by bacterial and fungal.
The commonest causes of viral infection are japanese encephalitis,chickengunia ,hepatitis B,HIV infection etc.
Bacterial infections can be staphylococcal ,streptococcal,lyme disease,gonorrhea,tuberculosis etc
In autoimmune disease post streptococcal rheumatic fever,systemic lupus erythemetosus etc

Malaria can also cause the fever with joint pains.
Since white blood cells are normal,the suspicion is on malaria although she requires further investigations for the diagnosis .
Have you got the malaria a tiger test done ?
What are different tests you have got done till date?
Please send all reports to me so that I can see them and discuss with you the further plan of action.
Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pavan Kumar Gupta (2 hours later)

Hello Doctor,

Regarding malaria, the place where I am in, it is almost non existent. Also she is not accompanied by too high a continuous fever, it is, as I said, only later in the day.
Regarding the tests done, chest x XXXXXXX blood tests, urine, everything is like a healthy individual, as per the doctor.
Just some update of last days, her fever seem to be going down, yesterday she did not had the fever. But there is no let up in joint pain and also mild swelling is there in her wrist, knee and ankle.
Is this something that is left behind after an infection. Some post infectious arthritis kind of thing.
Regarding some viral infections you specified, she did not have the kind of exposure thos kind of infections needs. Also as you know, her white bold cell count is normal.
I am sorry, I do not know how to attach her test results, but as per the doctor there is nothing they could make out of that report. Also those reports are in different language.
I appreciate your help.

Answered by Dr. Pavan Kumar Gupta (54 minutes later)

Hello
As far as malaria is concerned you can have the fever even after many months or years of malaria infection.This is important due to the fact that you travelled to India 4 months back.
Mild swelling in joints can remain for few weeks after a viral infection.
If fever has stopped coming,then you simply wait and watch and give ibuprofen for the pain.Gradually this pain should should cease.
Best of luck to you and your wife.
If any further query,you can revert to me.
Thanks
Regards

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar