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What Causes Recurring Fever Despite Having Normal Urine, Widal And Hepatitis Tests?

Posted on Mon, 6 Jul 2015

Question: Hi I am suffering from intermittent fever since 2 months and the fever is observed every week for at least 3 days and upon taking dolo/crocin it subsides until next few days n strikes again. Along with this I have anemia complaint my HB levels are decreasing . I had been admitted to hospital once when HB level reduced very much to 5 and having fever . in the hospital they have conducted good number of tests like endoscopy, ultrasound scan of abdomen , LFT, ANA , Urine tests, widal, malaria, HIV , Hepatitis b and c ; and finally bone marrow biopsy aswel. And all of the reports were non reactive . and they discharged me from the hospital after 3 packs of RBC transfusion. But soon after a week I am having this fever observed in the same fashion as it used to be intermittent every week 3 days and also HB levels started decreasing again . pls advice .

Answered by Dr. Hardik Sanghvi (1 hour later)

Brief Answer:
You should go for blood culture test.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
You may have some infection. Your all tests are normal so there may be some hidden infection or flu like illness.
You should go for blood culture once.
Please send me your bone marrow report also to search the cause of anemia. Your anemia may be related to your chronic infection.
Please send me your reports so that I can help you further.
Hope I have answered your question, if you have doubt then I will be happy to answer.
Thanks for using health care magic.

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

Follow up: Dr. Hardik Sanghvi (49 minutes later)

Hi Doctor, I have attached my bone marrow biopsy report please have a look at it. If its not accessible do let me know , and also pls let me know what are the other reports that you would essentially like to see , it would be easier for me to attach those few important ones as I have gone through numerous tests.
And I see that I Dont have blood culture test yet done. But I have few other tests related to blood like CBP , hemogram etc which I will attach it .

Answered by Dr. Hardik Sanghvi (7 hours later)

Brief Answer:
You should go for blood culture test.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern. Your bone marrow report suggest either vitamin B12 deficiency, folate deficiency or PNH, but all three test suggest normal results. So we can't get any conclusion from that test. Your anemia may be due to some chronic infection. But your serological test and test for all kinds of fever are normal so you should go for blood culture test once. If that report is all normal then it could be some viral infection.

Till you get conclusion you should take symptomatic treatment like paracetamol.

Please go for blood culture test once.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj