Hello,

Thanks for your query.

Important aspects of your query are:
• 70 year old female
• complain of low grade fever in evening time for 6 months
• Known case of Osteoarthritis and Asthma
• Past history of knee replacement
• On Advair ( fluticasone and salmeterol) and Ibuprofen

In your case there are multiple possibilities came in my mind for cause of fever with current information like:
• Tuberculosis
• Chronic obstructive pulmonary disease (COPD)
• Osteoarthritis

All these possibilities need to be ruled out by detailed physical examination and laboratory investigation.

As you are old you are predisposed to several illnesses so possibilities of other findings cannot be ruled out during examination. So visit a Physician earliest.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.

Regards,

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Hello again,

I am sorry I do not mean to offend you. It is good that reports are normal.

Can you tell me about total leukocyte, differential leukocytes count and value of most commonly used marker of inflammation is C-reactive protein (CRP) as you already having osteoarthritis and in active phase it can lead to low grade fever.

If these investigations are normal than sputum examination is needed to rule out Tuberculosis as evening rise of temperature is very typical symptom of tuberculosis.

A small rise in temperature is expected with metabolic process that happen in every human. Even regular intake of medicines can increase the metabolic process and thus rise temperature.

Let me know if you have specific queries about this rise in temperature and I can clear them.

Regards.

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