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Suggest Treatment For Recurring Elevation Of Body Temperature In An Elderly Person

Posted on Sat, 13 Jun 2015

Question: My friend is 90 yrs old./male. His temperature goes from 98.5 to 102 within minutes, back down again & then up. He went to the emergency room last Sunday (3 days ago)..they did all kinds of test, chest x-ray, stomach scan & found nothing but slightly elevated liver enzymes. Everything else was ok. He came home yesterday (Tuesday, PM) and he was fine. Then, this morning it happened again. We called 911 (his temp was 102) and by the time he got to the hospital - 10 minutes away - his temperature was normal. He was just admitted to a floor room (from the emergency) & he will be there until ?? What causes this fluctuation and what can we do about it. Could lyme disease do this to someone (he has a dog & walks it on a metropolitan park.no meds were given until this afternoon (I think Tylenol but not sure). He threw that up, I understand. He is not hungry...very unusual for him as he eats 3 big meals every day!! Probably has not eaten since his breakfast this morning. Seems in good spirits, XXXX. Thank you.
Good Friend

Answered by Dr. Noble Zachariah (3 hours later)

Brief Answer:
Likely to be an infection

Detailed Answer:
Hello,
Welcome and thanks for your query.
Appreciate your concern for your friend.
The elevation of temperature and other symptoms are likely to be due to an infection which would be detected with the appropriate tests. There can be rarer causes affecting the thermoregulatory mechanism. His signs and symptoms do not suggest Lyme disease. One possibility and a common cause is a urinary infection which can occur without the classical symptoms in the elderly.
There is nothing to worry. As he is in the hospital, the cause will be detected soon and your friend will be fine soon. Till they know the cause requiring specific treatment, he will be on symptomatic treatment.
Do get back to me if you have more queries.
Wish your friend a quick recovery.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Noble Zachariah (10 hours later)

Dr. XXXXXXX ..thank you so much for your prompt response. I have requested the hospital take a urine sample ASAP. I so appreciate your response and this web site!! I will keep you posted.I just spoke to Bob's son. He said they took urinary samples both times he was admitted to the hospital (last Sunday & yesterday). This is a local, new hospital (3 - 4 years) that is having difficulty "being"!! Not the greatest I appreciate your input/help! treatment, I understand, but very convenient for "small" things. Not connected with the XXXXXXX Clinic but the other good hospital, University Hospital. Is it possible that a transfer to one of the bigger hospitals would be in order? Would they have better diagnostic departments or...does it all go to the "same" lab? Do you have other diagnostic possibilities of what it might be?

Answered by Dr. Noble Zachariah (2 hours later)

Brief Answer:
Welcome and thanks

Detailed Answer:
Thank you Marylin for your kind words.
How is your friend now?
If it is possible to get the test results, I shall be able to give my opinion on them? Give the hospital a couple of days unless he is getting worse and they should be able to sort it out.
Sorry for the delay in replying , as I was attending to my physical patients.
Best wishes,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Noble Zachariah (22 minutes later)

Thank you. I will wait & see what his son/daughter do. Being the girl friend is not so easy these days! I am afraid he is not walking in the halls as he should, if able. I have had 2 serious surgeries and know these things are important. Please stay tuned....!! I appreciate your offer/help!
I just talked to him and said:

- have XXXXXXX (son) bring your robe & slippers & even your p.js so you can walk the halls.
- he is not eating much, but was going to eat now the fresh turkey sandwich (on rye!) that I brought last night. They gave him heart tests this morning (he has a stent from 3-4 years ago) & a million other tests. He doesn't think they know what they are doing.

No need to reply to me...just wanted you to know the latest.

Answered by Dr. Noble Zachariah (3 days later)

Brief Answer:
Thanks for the update

Detailed Answer:
Hello Ms. XXXX,

Hope your boy friend is better now.
If there is any concern you want to discuss with me you are most welcome.
Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Noble Zachariah (25 minutes later)

Hello...
Well, XXXXXXX is home (came home on Friday) after I complained bitterly to the head supervisor in the hospital for the number of tests and the indecision they had after all of the other tests. His temperature ha been normal for 36 hours and he was not walking enough or feeling so great (tho he was ok). That morning they gave him a 2 HOUR stomach test with intravenous...why, I don't know. Anyhow...they did release him by 3:00 that afternoon. I think he would still be there if I hadn't quietly intervened. He is coming along great, now. He had an aide with him until today (Monday) and he sounds much stronger & is walking around the upper deck of our complex - 2x a day. He is eating & sleeping well and his temperature has been 97.5 for 4 days now (morning & night). I guess his fluctuations were just something that some times happens to older people! The doctor here never gave it a name!
Thanks again for your comforting words, tho. I appreciate it!!
XXXX

Answered by Dr. Noble Zachariah (14 hours later)

Brief Answer:
Welcome

Detailed Answer:
Thank you XXXX for the update.
I am glad that he is improving.
Wish you both good health and a great day.
Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Noble Zachariah (6 hours later)

Thank you and you, too.

Answered by Dr. Noble Zachariah (36 hours later)

Brief Answer:
You're welcome

Detailed Answer:
Wish you both good health and a great day.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar