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Running low grade fever. Having fatigue, no appetite and feelin fuzzy. Took doxicycline. What to do?

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General & Family Physician
Practicing since : 2003
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Hi, I travel back and forth to central africa for work... I have been running a low grade fever that comes at night and sometimes leaves in the morning. I have had extensive lab work ups including malaria and bilhazia tests all of which appear to be normal. But I am having extreme fatigue and just not feeling right. I have had p falciparum malaria 18 times from separate incidents in the last 6 years. This doesn't seem to be that. This low grade fever has been going on for about a year, I have little to no appetite, feel fuzzy headed and just have to push myself through my day. I was on a 10 day course of doxicycline and had no fever but as soon as I came off it, the fever returned. I really need to find some answers... Thank you.
Posted Mon, 29 Jul 2013 in Infections
Answered by Dr. Vaishalee Punj 2 hours later

Thanks for posting your query on XXXXXXX

As I was reading your query a few possibilities came to mind. The possibilities including diseases like malaria, giardia, tuberculosis, urinary infection, empyema etc. Since it got better with doxycycline, it suggests a bacterial infection. You will definitely need more tests to figure out the cause. I am not aware which tests you have already gotten done. If you can upload your reports, I will be better able to advise you.

Till then I will advise you the following:

1. Take some time off the medicines and give your own immunity a chance to work. Consult your physician before you discontinue any medicine.

2. Keep a record of your fever and the days it is recurring. Also record your weight and diet. Also note down any other symptoms that you may be having.

3. Since you have been taking antibiotics you may have developed resistance to some. You may need blood culture and urine culture along with the sensitivities. Chest x-ray and lymph node biopsy of any swollen lymph nodes is also indicated. Since typhoid fever may be endemic in the region that you are travelling, get a Widal test done to rule it out. These tests are usually not routinely prescribed in USA. We need to provide the doctors a history of travelling to get these done.

4. While travelling, take precautions to avoid mosquito bites with mosquito repellants, protective nets along with the medicines for prophylaxis for malaria.

5. Take hygienic food and pure drinking water to avoid recurrent gut infections. Reverse osmosis technique produces purest water and is available as bottled water in USA. Drinks lots of water to flush out toxins being produced by the unknown infection that you may be having.

6. Take multivitamin regularly. Take nutritional supplements like ensure, etc for any weight concerns or weakness you may be having.

Let me know if I can assist you further.

Dr Vaishalee
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