HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Causes Fever With Body Chills?

Posted on Wed, 30 Apr 2014

Question: Hi dr I had a baby on march 13 2013 2 EPIDURALS then a csection 3 weeks later I came down with a cold lifted my head the hole room was spinning I could feel it in my breathe the hole bed would move double vision stiff neck severe back pain once that stopped every time I stood up I became extremely lightheaded naueas sweating extreme weakness in arms an legs heart racing then I got dimentia after that all stopped now my balance is so gone I feel like I am swaying on a boat every time I move my head am lightheaded constantly. The dr decided to see if it was a spinal leak so they did a blood patch the back went away but now I have a fever from 99.9 to 100.5 with the chills I have a baby an need help thank u

Answered by Dr. Lohit K (1 hour later)

Brief Answer: Antibiotic + NSAID. Blood patch helps you Detailed Answer: Hi, I went through your query and understood your concerns. Now, since you are suffering from fever with the chills, this suggests infection. The most common causes for the above said symptoms are UTI (urinary tract infection) and any abscess anywhere in body. - What ever the cause this needs antibiotic treatment and if abscess, needs to be drained. So kindly check for the procedure site (only inspection, don't touch bare hand) for any abscess or inflammatiory signs. If inflammation local treatment is required with antiseptic lotion and ointment. - For my patients, with abscess I prescribe ampicillin + cloxacillin (better action in abscess) or ofloxacin + ornidazole antibiotic as the combination act on both aerobe and anaerobes. As antibiotic is a prescription drugs you need to contact your doctor for prescription and he may choose other antibiotic based on examination. With this you need to take NSAID like acetaminophen/diclofenac for fever and chills. These will relieve from your current symptoms. - Blood patch is done to relieve post dural puncture. Here the blood clot after procedure "patches" the meningeal leak. This patch will relieve all the symptoms if it was due to spinal leak. You should take complete bed rest for 2-3 days minimum and gradually the symptoms will subside. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you and your family a very good health. Regards

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

Follow up: Dr. Lohit K (38 minutes later)

Hi dr do u think the first cold an vertigo an blurred vision all came from the first epidural? Because that started 3 weeks after pregnancy a year later I still suffer from all of it but now swaying all day blurred vision. But the fever an chills this time started after the blood patch which I just had at the end of march but the fever started low then progressively went up. I do not see any Abcess on the outside if there is am Abcess on the inside how can they see that? I sorry I have been like this for a year until they decided to try the blood patch, my balance has gotten worse Sorry just wanting to see if a cat scan or something would show an Abcess inside I am so afraid after all I have been through to do a spinal tap I do not want them to touch my spinal fluid. They blew me off for several months of vomiting even ended up in the ER with 105 fever 2 months ago with severe leg pain an vomiting an they just sent me home I want to get better for my baby thank u

Answered by Dr. Lohit K (1 hour later)

Brief Answer: relax. continue NSAID & OTHER PRESCRIBED DRUGS. Detailed Answer: Hi, I really feel sorry for your illness during lactation time. The illness due to CSF leak may start after a week of spinal anesthesia. Since that started after cold there may be trigger due to virus for your illness. All the symptoms you mentioned suggested CSF leak or problem in brain. I hope you have been evaluated with MRI brain to ruleout the pathology in brain. Also check for prolactin and growth hormone levels once. Even with inner ear problem these symptoms can appear. For now since no visible inflammatory signs in the site of patch the chance of abscess is less. Since during procedure strict aseptic precautions will be maintained and will be done only after complete blood work the chance of internal abscess will be less. So no need to be anxiou. But if fever and chills persists even after taking NSAID then needs blood work and a scan (USG/CT) will help in diagnosis of abscess. Now be relaxed and continue NSAID. If you were not evaluated for the above said then discuss with your doctor for evaluation. I hope this information relieves your anxiety and helpful to you. If you have any queries or concerns feel free to discuss with me. I wish you a very fast recovery and good health. Regards

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

Follow up: Dr. Lohit K (13 hours later)

Thank you so much doctor. I have had brain neck an spine MRI it all looked good it am trying to relax but being this sick for a year without 1 doctor knowing why is starting to make me very anxious I have been to an ent they found nothing. After the blood patch I still have the constant swaying as if on a boat all day brain fog an blurred vision. Are there any infections from the epidural from childbirth that would cause this? It's like my nervous system went twang after the csection then came the cold last year vertigo an it all got worse from there so that's why a year later on march 24 2014 they decided to try the blood patch if it was a delayed leak for a year who knows what it COUld of done to my body

Answered by Dr. Lohit K (22 hours later)

Brief Answer: repeat MRI . RETINOSCOPY. continue helpful drug Detailed Answer: Hi, I can understand your problem. The CSF leak is one of the problem to cause the symptoms you have mentioned. Usually symptoms are less due to epidural and this will not stay for many months if any leak.. No need to worry for chronic leak and its effects as it is not confirmed cause and is very rare. Since the symptoms started after cold 3 weeks post delivery, there are 2 possibilities I can think without your examination. 1. CSF leak. 2. Viral infection (cold trigger) that has affected your cerebellum or inner ear or other part of brain. More than CSF leak the diagnosis points towards infection or injury to brain. If your MRI brain was taken within short span of onset of symptoms then repeating it again may also help in your diagnosis due to established problem. Check for pituitary enzymes like prolactin, growth hormone levels as very rarely due to pregnancy the gland and its surrounding areas can be affected.Also get checked for your retina with retinoscopy which may lead us for diagnosis. Sometimes anti histamines or anticholinergic or corticosteroids drugs may help in preventing the symptoms. Continue the drugs that are helpful. But we need to diagnose the problem as removing the trigger will lead to complete cure. I hope this information helps you. Feel free to ask for any further queries. Wish you faster recovery. Regards

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

Follow up: Dr. Lohit K (1 hour later)

Thank you so much dr I have been to so many doctors all my CBC levels are even showing normal but wouldn't they be elevated if there was an infection? If meningitus would there be a high fever constant every day? I am going to do what you said an get into a obgyn ASAP. Are u in Orange County? Or do you KNIW any good doctors here in my area? What concerns me is 1 week prior to my period the brain fog lightheaded racing heart gets worse I never had any if this prior to the pregnancy. What would be the best test for them to see if there is an infection? Since it has been a year of this ? I do not want to do a spinal tap after all I have been through Can you guide me to what blood test need to be done to see if there is an infection since that is how all this started? I did see an ophthalmologist she said my right optic nerve did not look good here thought was a csf leak this was in January but since the blood patch I got a fever again:( an chills. I am so sorry the doctors here are horrible an I have had no change but got worse after the blood patch I am so sorry one more question if my blood was already infected an they did the blood patch could that bring back all of the infection again is this why I might be getting worse

Answered by Dr. Lohit K (20 hours later)

Brief Answer: mri brain, hormonal levels. anti inflammatory drug Detailed Answer: Hi, I can understand your problem and concerns. 1. If infection any where in body there will be inflammatory signs. Fever is one of them and this will present in meningitis but with other typical signs like neck rigidity, irritability, behavioural changes and other central nervous system manifestation. So with your features meningities is unlikely. 2. Yes with infected blood used for patch the chance of infection is there but before conducting the procedure blood tests will be done to rule out any pathology and only after confirming the procedure will be done. SO no need to worry for spreading infection and also you don't have any features suggestive of brain or menings involvement. 3. More than blood test check for scanning brain and hormonal levels. Check for the reason for optic nerve involvement. Since the menstrual cycle is controlled by the hormones and also you suffer during last 10days of menstrual cycle kindly get evaluated for that with hormanal levels of FSH, LH. Your obgyn will assist you. 4. For infection CBC will be sufficient. CSF analysis will help to know if any problem in meninges or brain, reason for infection and any other pathology. But you CBC is normal with no signs of meningeal involvement /Infection. 5.your fever with chills should subside with in 2-3 days of anti inflammatory drugs like Ibuprofen or aceclofenac. If persists then needs other tests like urine examination, haemogram,internal organ function tests depending on the examination. 6. Am not staying in orange county. Since I don't no the doctors personally staying at your place I personally cant recommend any doctors. But if you want me to check for review and to select doctors then I can help you. For now continue anti inflammatory drugs with antibiotics(if prescribed) and get investigated as explained above. The management of your problem should go step wise so without the investigations its very difficult to decide next steps. Feel free to ask if any further queries. I will be glad to help you. wish you faster recovery and good health. Regards

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

Follow up: Dr. Lohit K (3 days later)

Hi dr so I had my eyes dialated and she did not see any fluid in the brain or anything pressing on the optic nerves. I went back to the dr that did the blood patch but he blew me off an did not seem concerned with the fever said if I had menegitis I would be much more sick. I really need help my period came about 1 week before it comes the swaying the lightheaded the vision all gets worse.i started this morning am when I lift my head the back where the brain stem is hurts an I feel stiff an pressure an lightheaded when I stand up I get weak start shaking heart racing feel like I am going to pass out. I went to the obgyn he has no clue an said I might have to live this way:( please do u have any other clues or doctors in my area hunting beach ca or Orange County I am desperate I can't take care of my baby like this I was so healthy before the pregnancy Hi dr sorry I am also getting these very odd migranes it's like pressure in my forehead an in my eyes an in the back of my neck a neurologist gave me depakote but it made me very very sick I am so afraid to get off the lexapro thinking the full spinning will come back not sure if it's helping or creating more mood issues an brain fog:( also they gave me beta histamine said that sometimes the blood flow goes twang after pregnancy an the blood forgets to go back to the ear but I have been afraid to take it I have never been on pills I just want to feel normal again i thought after a year it would change

Answered by Dr. Lohit K (2 hours later)

Brief Answer: postural hypotension, drug adverse reaction,glauco Detailed Answer: Hi, I went through your query. Based on the explanation you have given I like to give you differential diagnosis for evaluation. 1. Swaying, lightheaded, vision getting worse, lightheaded when you stand up and getting weak with shaking heart racingall may be due to postural hypotension or anaemia. In postural hypotension the blood supply to brain and also to heart reduce on sudden raising from bed or while changing posture. So get checked your BP at different posture (sleeping, sitting and 2 min after standing from supine position) and also get checked for complete hemogram to rule out any problem in blood. 2. You haven't mentioned about your current drugs anywhere before. Lexapro is an antidepressant and it usually lack side effects compared to other typical ones. But the chance of perepheral vasodilatation and hence postural hypotension may be present. You need to discuss with your doctor regarding this and can dechallenge the drug with his guidance. 3. Check for glaucoma using tonometer as that can also presents similar to migraine. 4. A CT scan brain may be required to find if any brain lesion. I could not understand the sentence " blood flow goes twang after pregnancy an the blood forgets to go back to the ear " Kindly explain it. Hope this helps you.Wish you faster recovery and good health. Regards

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

Follow up: Dr. Lohit K (3 hours later)

Hi dr yes I saw a cardiologist who said I have post Pardum pots syndrome. But would that cause constant swaying as if on a boat all day long? When my period comes it all gets worse the shaking lightheaded racing heart an severe pressure migranes brain fog . But this all started before I got on the lexapro. The nervous system goes twang when after a pregnancy the blood flow can forget to go back to the ears heart brain which the ENT said he prescribed beta histamine it's like serc 16 but I have been to scared to I Itry it. The eye dr said I have early stages of glaucoma in my right eye she says that would not cause these symptoms? Your thoughts on that. The cardiologist can't give me a beta blocker because blood pressure is to low. I had a MRI of the brain showing no lesion I have tried compression socks salt water nothing is helping;( do u do phone calls? If so how much? Or any doctors that you think can help in my area. Should I do a cat scan with contrast because they said my brain was perfect in the MRI. I was going to try osteopath dr for cranial therapy I heard it can help pots I had a bad accident trauma to my head in 2007 so it could be coming from my neck Also would pots syndrome make you loose your balance like this? The ent is saying silent migrane

Answered by Dr. Lohit K (11 hours later)

Brief Answer: POTS syndrome. Detailed Answer: Hi, Thanks for follow up query and more information. 1. Yes, POTS syndrome is possible as I told before as orthostatic hypotension. Majority of POTS patients are female and of the menstruating age. Some women develop POTS symptoms during or after pregnancy and usually see milder improvement and can be plagued with their condition for life. So these symptoms may improve over years. Since more problem (POTS) avoid beta blocker. Yes POTS syndrome can make you loose your balance. If POTS you need to do few lifestyle modifications like frequent small quantity carbohydrate rich food, more of salt intake and regular exercises. 2. I don't do phone calls and don't know doctors personally in CA, United States. If you want I can inquire and can help in selecting the doctor. 3. Since your retina and fundus of eye are normal with previous normal scan, the present brain scan may be normal. 4. I think its beta betahistine, an antivertigo drug. It is commonly prescribed to patients with balance disorders. So you can take this as this may help you. 5. Silent migraine: I don't think it is silent migraine as your symptoms is not towards it. So the most probable cause is POTS syndrome. You can continue management with your cardiologist. Hope this helps you. Feel free to ask for any clarification and any query. I like to help you. Wish you faster recovery. Regards

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

Follow up: Dr. Lohit K (5 hours later)

Thank you I am really sad I hope this pots does not last forever I do get severe migranes now on the left side an pressure in my ears;( especially when my period comes then my vision am swaying get worse. Yes can you assist me with a doctor what do I need to do for you to help me with that? I am really scared this pots is ruining my life I can't be in the sun or even go out with my friends;(Yes they gave me beta betahistine 10 mg will this make the pots worse? Any side effects? My bp is anywhere between 80/60 to 97/60 then standing heart rate sitting 90 can go all they from 110 standing to 140:( I am so scared this is never going to stop they said they could put me on medication to raise my bp bit will this raise my heart rate?

Answered by Dr. Lohit K (12 hours later)

Brief Answer: Can take betahistine. Fludrocortisone or midodrine Detailed Answer: Hi, 1. Betahistine acts more specifically at the inner ear and also hense it usually won't worsen POTS. Side effects depends on individual person. There may be head ache or gastric side effects or may be allergic reaction. 2. Fludrocortisone or midodrine are the drugs given to raise BP. They wont raise your heart rate. But regular monitoring of BP is required initially to maintain the dose and timings. Also take Vit B12 supplements as this may help in few patients. These will help your symptoms and once BP is maintained you can enjoy your life as before. 3. Here let me give some references (cardiologists) who may help you. XXXXXXX XXXXXXX MD, FACS 360 San XXXXXXX Dr, Newport Beach, CA 92660 (949) 759-9551 Dr. Majed Chane, 18800 Main St. Suite 103, Huntington Beach, CA 92648. (714) 842-8100 But better to continue with the same doctor who diagnosed as POTS and is willing to start drug to increase BP. As adherent to one doctor will help in stepwise complete recovery. I hope this information helps you. I wish you faster recovery and good health. Regards

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

Follow up: Dr. Lohit K (12 hours later)

Thank you so much doctor at least i know there is hope to have my life back thank u;)))

Answered by Dr. Lohit K (10 hours later)

Brief Answer: Wish you happy life Detailed Answer: Hi, I wish you very happy life and faster recovery. If you are satisfied then please close the query and write a review as well. If and additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

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