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Continuous low grade fever, rises in the evening, body and joint pains, breathing trouble, CBC shows neutrophilia, high ESR. Diagnosis?

My mother, 50, is experiencing fever for past two months - - The fever is usually low grade ranges between 99 - 100 - The fever rises in the evening after 4 PM. - She has body aches and joint pains - She sometimes experience trouble in breathing - Doctor gave her generic antibiotic for 7 days but it did not help - CBC shows neutrophilia and high ESR (Doctor says high ESR could be due to hypothyroidism and swelling in her ankles) - Liver function and kidney function are normal. Typhoid , malaria test negative - Her weight and appetitie is normal despite of fever since last 2 months
Asked On : Mon, 24 Sep 2012
Answers:  1 Views:  286
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Internal Medicine Specialist 's  Response
Welcome to HCM
Fever for more than 2 months itself is serious enough to find out cause for it some times such prexia of unknown origin is challenging task,as count is high a trial of antibiotic is warranted but as she is also suffering from hypothyroidism so some kind of autoimmune disorder should be considered .
It is beyond the scope to point out all the causes but advise would be to get a meticulous physical examination with detailed history.
A stepwise investigation should be planned
Or she may be hospitalized and investigated for the cause as waiting too long may be deleterious for her.
Many times atypical infectios,inflamatory diseases and hidden Tuberculosis and malignancies turns out to be the cause of unexplained fever.
Good Luck to her.
Answered: Mon, 24 Sep 2012
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