Question: Hi,
My wife has recurrent low grad fever for last 3 months.
Following is the history of her illness and tretment done so far:

1. 26th March: Severe Abdominal Pain: Ultrasound and other tests done. Ultrasound also detected kidney stone and suspected appendicitis.

2. 27th March: During operation appenidx was found normal and instead rupture of Ovarian Cyst was seen, hence the cyst was operated with assistance from a Gynechologist.

3. 29th : Discharged from Hospital. Was on medication till next 7 days. Also took 10 Gentamicin injection due to urin infection reported in urin culture report.

4. 4th April: Doctors review suggested normal recovery. Antibotics stopped

5. 9th April: Some problem of stomach ache, loose motion, and fever (upto 102 degress reported). Ultrasound and CBC done done but were normal(other than the Kidney stone reported), Antibiotics: OfloxTz given.
Pain subsided and fever gone

6. 17th April: Re-review showed normal recovery.

7. Low grade Fever (< 99.5 degrees) persisted since then. Also, patient reported discomfort in the operation wound. Seemed like it didn't heal completly.

8. Upon reference from other doctor started taking Zifi-200 for 10 days. Fever subsided after stopping medicine intake for 4-5 days. Fever agains re-surfaced with temp ranging betwen 98-99.4 degrees.

9. On 27th May, CBC, Throid, Liver Profile, Lipid and Kidney profile, Urin routine. Everthing normal except for Urin pus cells=20-25

10. 2nd June: On doctors advice, Urin culture was done, less dense E-coli culture were seen but, doctor anticipated UTI and advised 14 amicacin injections.

11. 9th XXXXXXX : Injections were over. Fever not seen till the injections were given

12. 17th June: Fever (< 99.4) was again seen randomly ranging between 98.0-99.4 degrees.

13 Since 17th June: Fever is continously ranging between 98-99.4. While in morning its <98.6 but, > 98.6 any other time

14. July 1st Fever gone. Tmepretur is now ranging between 97.5-98.6

15. July 15th Fever reoccured and is ranging between 98-98.6 (in morning) to 98.7-99.3(in evening)

The tempreture chart in each occurence is something like

Morning Afternon Evening Night
98.0-98.6 98.4-99.1 98.7-99.3 98.7-99.3
There are no other symptoms. So far, I havent seen tempreture going above 99.4
Blood test shows high ESR (38), however other things are normal.
Ultrasound says normal except for a small kidney stone
There are no visible lumps or tumours visible in lymph node areas.
No weight loss till now (only .5 kg)
I have got her examined by two general physicians as well.
I am really scared of something serous happening.

Thanks a lot for the reply doctor.
This is also explained by other Physicially who saw her.

But, my concern is that she is doing the same work under same conditions all the time, but for 9-10 days the tempreture is less than 98.6 (or very few times > 98.6 but <99.0). Also, on those days, the morning tempreture is also normal like 97.5-97.9

Now a days again the morning tempreture is always > 98.0, but limited to 98.6. Earlier, she always had subnormal tempreture ranging between 97-98.6 (rarely would go upto 99), but, now she has almost 99.0-99.3 tempreture through out the day (with intermittent dips upto 98.7) before going to bed. When she goes to the bed in an airconditioned room the tempreture goes down upto 98.5 after 10-15 mins.
In the same conditions my tempreture is always normal.
For instance when she had 99.1 degree temp and at the same time in same conditions, I had 97.9. Can this be explained by difference in body metabolism. We both weren't doing anything at that time. I can confirm that in past she always had lesser body tempreture than mine.

So, I am wondering :
1. What has went wrong that elevated her normal tempreture.
2. Could that be related to some malignant behavior in the body.
3. Could that be auto immune disease due to high dose of antibiotics during her hospital stay and then after due to UTI.
4. She also has cervical spondilitis, which is disturbing her in daily life. Could that be a cause. However, I have read that this doesn't have any relation with the fever occurrence
5. She also has pain in her legs for last 1-2 year. Doctors say that it is due to varicose vein.

Best Regards

Hi Doctor,
Thanks for the reply.
I also thought the same that Convalescent body temperature is a bit more variable than normal one due to the inflammatory cascade but, I am worried as its continuing for more than 3-4 months now.
Shouldn't that have subsided in 1-2 months.

What does inflammatory cascade mean. Does it imply, inflammatory conditions spreading over different parts or something else?
Does it elevate the ESR value as happened in this case?
What could be the duration or life cycle of this inflammation?
What kind of inflammation it could be?
What part of the body usually suffer from inflammation?
Any other test that can confirm these facts?

Sorry for all these kinds of queries but, I just want to clear out any kind of doubts sooner than later. I hope you understand

Best Regards

Just few more questions:
1. I am still worried as its continuing for more than 3-4 months now.
Had there been some inflammation then shouldn't that have subsided XXXXXXX in 1-2 months if it is something not severe.? Usually, we have arthritis inflammation etc but, it goes away after some time or by medication. In my case, it isn't seem to happening.
2. Could this be due to multiple occurences?
3. Can there be `not so severe` inflammations lasting for several months post laproscopy?

Best regards