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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Chronic Low Grade Fever?

My wife, aged 53 years, was diagnosed with the subject ailment after Widal Test +ve (TO 1/160, TH 1/80 ) on 13.07.2012. She was hospitalised and administered with medicines Powercef 1.2 gms I/V 12 hourly for 8 days and Levofloxacin 750 for 8 days. She was released from hospital as she recovered and had no fever.

But few days after coming home she started having temperature after midday till midnight up to maximum 99 degree and occasionally up to 99.5 degree. We again consulted the doctor on 09.08.2012 and Widal Test was repeated and found +ve (TO 1/160, TH 1/80). The doctor then prescribed a fresh dose of antibiotic (Augmentin Duo 625 twice daily for 10 days with other accompanying medicines like Bifilac HP) which she had completed on last 18-08-2012. All these days, she continued to have the same low grade temperature during day time with maximum range of 99.5 degree and getting normal after 10 p.m or so. When she gets up in the morning she does have the normal temperature of 98.6 degree or less sometimes.She has no other complication and has reasonable appetite and is on diet of less spicy and oily veg dishes/fish curry (no meat) and dal.and occasionally boiled egg and milk. She has had no problem of loose motion at all.
She has also undergone various other blood tests in order to eliminate and ascertain the causes of fever like MSU, MT(1:1000), MP and for Jaundice which were all -ve.
And it is about now more than two months now and she still does have that temperature from after getting up in the morning and has that till late in the night.
We live in a remote place of Assam and has not much scope to consult other doctors and therefore request you to please advise whether her having this low grade fever is normal and will get over it in due course or whether she will be required to continue with further dose of antibiotics again

Wed, 24 Dec 2014
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Infectious Diseases Specialist 's  Response
Thanks for your query at HCM!
I went through your query!

Well first episode was Typhoid which was treated fine.
Antibodies persist for weeks to months so cannot guide the cause second time.
According to me she is suffering from tuberculois.
Get ESR, Chest X-ray and sputum ZN/culture done for Mycobacterium TB.
If positive she will be started on ATT. You can visit a physician/pulmonologist and get evaluated.
Other causes can be evaluated later if TB is negative (malignancy, autoimmune diseases which are unlikely).
What are her other symptoms?
Happy to take more queries! You can also write a review for me.
Take care!
Dr. Sheetal Verma
Infectious Disease Specialist
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What Causes Chronic Low Grade Fever?

Thanks for your query at HCM! I went through your query! Well first episode was Typhoid which was treated fine. Antibodies persist for weeks to months so cannot guide the cause second time. According to me she is suffering from tuberculois. Get ESR, Chest X-ray and sputum ZN/culture done for Mycobacterium TB. If positive she will be started on ATT. You can visit a physician/pulmonologist and get evaluated. Other causes can be evaluated later if TB is negative (malignancy, autoimmune diseases which are unlikely). What are her other symptoms? Happy to take more queries! You can also write a review for me. Take care! Dr. Sheetal Verma Infectious Disease Specialist