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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Has Headaches, High Fever, Bad Chills, Shaking Violently. Is It Meningitis Or Silent Pneumonia ?

My husband is presenting with headaches, high fever of 39 degrees celcius, chills so bad he is shaking violently. His blood work has come back negative, urine negative, ultrasound negative. He has had 2 chest xrays and they think there might be something but are not sure. He has been in hospital for 3 days now and on saline and antibiotics for the 3 days.
He was feeling better but now seems to be feeling more tired and just unwell. The headaches, fever and chills seem to be held off with tylenol but after about 6 hrs after taking it the symptoms come back especially the headaches and fever.
He had sore neck but not stiff, they do not think it is menengitis....possible silent pneumonia.
He is past Hodgkins Lymphoma cancer patient and had stem cell transplant 1.5 yrs ago with his own stem cells. Is in remission since Jan/13 and in good health since.
Has had no reimmunizations since sct in Nov/11.
Had Giardia Intestinalis in summer 2011.

The hospital is at a loss right now as to what he could have, most things coming back negative but still unwell. Want to keep him until he is fever free for 24 hrs.

We have contacted his oncologist to see if this should be a concern for him what is happening right now, cancer wise.

Any advise?

Thank you
AAAA
Wed, 31 Jul 2013
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,

Fever with chills is commonly associated with bacterial infections and malaria.
The most common bacterial infections causing these symptoms are pneumonia, meningitis, cholangitis, urinary tract infection to name a few.
Since, the blood workup and urine workup is negative, the possibility of bacterial infections is ruled out.
A test for malaria should also be done.
Oncology point of view, cancers and lymphomas are associated with fever and malaise.
There could be re-activation of the disease again.
An enlargement of any lymph node and / or lymphoid organ should be looked for.
Consult your oncologist for further work up.

Thanks and take care
Dr Shailja P Wahal
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Has Headaches, High Fever, Bad Chills, Shaking Violently. Is It Meningitis Or Silent Pneumonia ?

Hello and welcome to HCM, Fever with chills is commonly associated with bacterial infections and malaria. The most common bacterial infections causing these symptoms are pneumonia, meningitis, cholangitis, urinary tract infection to name a few. Since, the blood workup and urine workup is negative, the possibility of bacterial infections is ruled out. A test for malaria should also be done. Oncology point of view, cancers and lymphomas are associated with fever and malaise. There could be re-activation of the disease again. An enlargement of any lymph node and / or lymphoid organ should be looked for. Consult your oncologist for further work up. Thanks and take care Dr Shailja P Wahal