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Had fever, bilirubin level high, wbc normal. Can it be jaundice?

I had fever 2 weeks back and was diagnosed and felt good for a week
Now, I have fever again in such a short span of time. I am not sure what the problem could be and so are the doctors.
My blood reports look inconclsive as per the doc. The bilirubin level is higher than normal. Over 2 but docs are not convinced about jaundice. My wbc is lower than normal and the only symptoms of my illness is fluctuating fever in the range of normal - 101F
Asked On : Sun, 14 Apr 2013
Answers:  2 Views:  52
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,

A history of fever and high bilirubin levels indicated hepatitis leading to jaundice.
The further management will depend on which type of bilirubin is raised.
There are two types of bilirubin- direct and indirect.
They are increased in different disease processes.
Direct bilirubin is increased in diseases of biliary tract e.g. obstruction of the biliary tract, damage to liver cells by infections, inflammations etc.
Indirect bilirubin is raised in conditions where there is increased breakdown of RBCs.

So, after determining which type is raised the further management can be planned.

Consult your doctor for further relevant investigations and management.

Thanks and take care.
Dr Shailja P Wahal
Answered: Mon, 15 Apr 2013
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General Surgeon Dr. Grzegorz Stanko's  Response

Thank you for the query.

Fever usually indicates an infection (sometimes it appears with cancer). Bilirubin over 2 is a jaundice indeed. Fever and jaundice can appear due to liver viral infection. Low WBC level can sometimes indicate blood diseases like leukemia. So there are some things that should force your doctor to find out what is wrong.

I suggest you to have blood smear test, liver tests (AST,ALT,GGTP,AP), direct and indirect bilirubin levels, HBsAg, Anti-HCV checked. Abdominal ultrasound should be also performed. If any doubts, hematologist consult is advisable.

Hope this will help.
Answered: Mon, 15 Apr 2013
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