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Got high fever, headache and eye pain with watery motion and mouth ulcer. Giving crocin. Suggest?

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General & Family Physician
Practicing since : 1969
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Hi Doctor My Husband got Fever 3 times .Every time he gets fever it goes to arroun 104c.First time(From XXXXXXX 22nd till XXXXXXX 30th) he got admitted to the hospital..First time he got fever he had headache and Eye pain ,he didnt have any other symptoms.2nd time he got arroun 24th of july again fever was arroun 104c ,body ache and no other symtoms (july 24th till august 8th have attached his report which we took 2nd time, report1.pdf).3rd time he got fever arround 22nd august and again 104c and tillnow he has fever with no other symtoms ( have attached his report report2.pdf).Every time he gets fever he motion is watery and he gets mouth ulcer some time during the fever and sometimes after fever.And even after giving crocin and dodlo 650 fever dosent comes to normal, it decreases from 104 to arroun 100c to 101 and it goes up again for next 5-6 days then it gradually decreases to normal.
Posted Wed, 18 Sep 2013 in General Health
Answered by Dr. Ramesh M.Vachharajani 3 hours later
Brief Answer:
Pyerxia of unknown origin, Widal test etc advised.

Detailed Answer:

Thanks for posting query.

I think we are dealing with P.U.O. (Pyrexia of Unknown Origin). This is an entity every physician has to deal with numerous times. Here, despite numerous investigations, we do not find any clue for having fever.

Your husbands condition seem be this PUO. His all reports are normal, in 2-3 reports there are some minor deviation from normal, but I think it has no significance. That being said, it is surprising that there is no Widal test is done for typhoid as typhoid is most common and he is having some gastric symptoms as well. Similarly thick smear for malarial parasite will be helpful.

You need to visit your nearest physician and discuss about this clinical condition and this investigation records. He/she can plan further tests as WIDAL, smear for malarial parasites along with X-ray chest and ultrasound of abdomen. They might provide the missing clues to understand the cause of fever and to treat it.

In the interim give him plenty of fluids and a plain-light diet. Give some B complex and other supportive supplements.

I hope, I answered to your query. If you have further query or clarification, please ask.

Wishing for speedy recovery of your husband.
Above answer was peer-reviewed by
Follow-up: Got high fever, headache and eye pain with watery motion and mouth ulcer. Giving crocin. Suggest? 26 hours later
Hello Doctor

WIDAL ,X-ray chest and ultrasound of abdomen tests has been done when he got fever 2nd time .I have attached the report with this (scanningrep1.pdf & typrep1.PDF).smear for malarial parasites is also done this time ,it is in the report report2.pdf which i have attached.

He gets fever arround same date each month and he gets 5-6 days high fever of 104c then from 7th day it reduces many times it goes to 101c and without paracetamol it comes to normal and after few days it goes off. every time he gets fever he gets loosemotion, and boils in the mouth. i read somewhere about periodic fever .are these symtomos of periodic fever ?will adults get periodic fever ?if yes is there any medication for that.Loose motion has something to do with it? (though stool test is -ive in report2.pdf)

If it is Pyerxia of unknown origin are there no medicine for this.

Thanks in advance

Answered by Dr. Ramesh M.Vachharajani 4 hours later
Brief Answer:
PUO, blood culture advised

Detailed Answer:

Thanks for posting query again.

I am glad you sent me all other reports this time. All reports are normal; but on ultra sound examination there is moderate enlarge spleen.

Again there are many diseases where there is spleen is enlarged. However looking at the pattern of fever, chronic malaria is likely where spleen enlargement is there. I have seen many cases of fever where blood report do not show malarial parasites. You can go for Qbc test for malaria especially at the time of fever. Discuss about this possibility with his treating doctor and go for full anti-malarial treatment if not given earlier.

Beside malaria testing, in this situation when spleen is enlarged I advice Blood Culture to my patients to rule out septicemia.

As far as periodic fever is concerned, it is generally found among children.

Have full faith in your treating Physician, he may discuss this case with his/her XXXXXXX colleagues and will take steps accordingly. Follow up regularly with your physician. I wish him speedy recovery.

Let me know if you need clarifications.


Above answer was peer-reviewed by
Follow-up: Got high fever, headache and eye pain with watery motion and mouth ulcer. Giving crocin. Suggest? 46 hours later
Hello Doctor

Our physician asked to get the CRP and LFT done and i have attache the report (nayak.pdf).In the report crp is positive and sgot and sgpt are high can you tell me what it indicates .

Thanks in advance

Answered by Dr. Ramesh M.Vachharajani 1 hour later
Brief Answer:
Infection in gastro-intestinal tract with liver

Detailed Answer:
Hi, Shwethaji,
I read these reports.
High SGOT and SGPT shows damage in liver cells and the values are significant. Since the ultrasound of liver is normal so any acute infection in liver should be suspected. I would look for jaundice in this case especially Hepatitis since CRP is also positive. Intestine,stomach,pancreas,spleen should be checked.
Gall stones should be looked as well. If not visible endoscopy will give some clue.
So go for endoscopy as advised by your doctor.
Positive C-reactive protein again indicates infection.
Wish for a faster recovery.
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