question-icon

What causes high fever, nausea,lack of appetite and severe fatigue?

default
Posted on Mon, 12 May 2014
Question: Started really not feeling well 8 days ago. Monday 04/07,my mom was pushing it a bit with lifting and all and since my dad has been put on oxygen, her workload has increased. the next day, she slept all day and night, ate nothing, drank nothing, same the next day. When I saw her Thursday 4/10, she was completely pale and had a fever of 102.7. Didn't even realize she had a fever, she told me she didn't but I took it anyway. Her BP was very high a few days prior to all these symptoms beginning, bottom number being 108 and she is ON blood pressure medication. It has been spiking up, then spiking low. She finally went to the doctor Friday, 4/11. Predicted a virus based on her symptoms of high fever 102.9 at the doctors that day, nausea, lack of appetite & severe fatigue and her liver count was 51. 2 days after this appointment, her knees swelled up very badly, to the point she could barely get herself up and down and would limp while walking, again, all the same symptoms as before plus swelling in the knees, no where else, but not a severe fever. This was on Sunday 4/13. Monday 4/14, her hands and fingers began swelling but she said swelling decreased a bit in her knees but not completely. Dr asked if she has been exposed to fifth disease, in which mom said no she has not. Assuming its her arthritis / bursitis acting up. All I do know, is if anything, she is worse than last week not better. I would hope if was just a virus she would be improving by now. She looks frail, pale, no appetite which is NOT like her, she is far from herself, and extremly fatigue is almost and understatement. I have been considering taking her to ER. Last night she mentioned her urine has had a very bad foul smell and been dark for a few months, which caused me to once again be concerned there is something else going on here especially seeing protein was found in her urine. I noticed some of the bloodwork that is high and / or low represent or could represent more than just a virus. Is that normal for just a virus?? She mentioned last night she was put on evista, for her bones a few months back. Could this possibly be due to side effects? I just wanted to discuss the symptoms I have seen and have heard her tell me and my dad (she tells me she's fine normally so not to worry but dad calls to tell me what is going on). Any signs to look for of when should take her to ER at all? Heart problems run on mom's side of the family. With her sudden symptoms, history of blood pressure, current stress, etc, I just want to take extra precaution. Bloodwork: BUN: 13 BUN/CREAT Ratio: 16.7 Creatinine: 0.78 GFRA: >60 GFRC: >60 AGAP: 12 Chloride: 94 CO2: 27 Potassium: 3.6 Sodium Level: 133 ALT (SGPT): 13 AST (SGOT): 51 Abs Basos - Auto: 0.0 Abs Eos Auto 0.0 Abs Lymph - Auto: 0.8 Abs Mono - Auto:L 0.6 Abs PMN - Auto: 4.7 Basophil Auto: 0.4 Eos Auto: 0.4 Lymph Auto: 12.9 Mono Auto: 10.1 Neutro Auto: 76.3 Hct: 42.1 Hgb: 13.6 MCH: 29.8 MCHC: 32.4 MCV: 92 MPV: 10.3 Platelet: 117 RBC: 4.58 RDW: 12.5 WBC: 6.1 Urinalysis: Specific Gravity: 1010 pH: 6 Protein: 30, everything else negative. When I say worse than last week I guess I mean with additional symptoms. She doesn't have a fever as severe as 102. 100 or less.
doctor
Answered by Dr. Chakravarthy Mazumdar (19 hours later)
Brief Answer: Your mom should see at the ER Detailed Answer: Hi, At present the symptoms do concern me but not life threatening. I do not dismiss this patient and let her remain at home without proper diagnosis. They quickly go into a sepsis soon. The blood pressures, pulse and temperature to be monitored. I suggest to monitor temperatures and see at the Emergency if it raises over 103. So keep them monitoring. I am not sure when were these tests done. You had not mentioned units of the tests and reference range. They vary from lab to lab. What were raised in the above list? After her unusual work load the other day she fell sick this could have taken a toll on her overall health. After physical stress the germs and other microorganims take a chance to invade the human body and cause such symptoms. The joint swelling and other symptoms suggest generalized inflammation. Is the Evista a recent medication that she is taking? IF yes it could be a reason. So a bout of stress combined with viral infection is most likely cause. Viral infection can bother up to 3 weeks. Symptoms may add to the previous week. Dark and foul smelling urine could be dehydration coupled with medications. Hope you come back with units and reference values.
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
default
Follow up: Dr. Chakravarthy Mazumdar (41 hours later)
She has gone back to the doctor today. She still has a fever it was 100.00 while at the doctors. They took a chest xray since she's not completely better and hee lungs have fluid in it. They prescribed zithromax. Her blood work in some areas was better but worse in others. The swelling has gone down a little bit. Blood work as follows shows last weeks result / to the right of slash is this week's result: Ast/agot: 51/29 Lymph auto: 12.9/13.6 Alt/sgpt: 13/34 Nuetro: 76.3/75.4 Platelets: 117/292 Wbc: 6.1/9.1 Rbc: 4.58/3.98 Chloride: 94/98 BUN: 16.7/20.9 I posted the actual documents a couole of days ago of blood work from last week for your review
doctor
Answered by Dr. Chakravarthy Mazumdar (2 days later)
Brief Answer: Bacterial infection, azithromycin helps Detailed Answer: Hi, My earlier thoughts were correct. Infection and electrolyte disturbance. As I said there seems to be a septic focus somewhere. It is right for your mom's doc to work on to find where is it. The blood work says so. It could be urine, Lung or airways. The blood work seems improving this week. How is she otherwise feeling. I suggest to continue Azithromycin for a week. Keep monitoring her symptoms, temperature, blood pressure and pulse. It would be good if your doc can find out where the infection is from and the reason for the entry of organism. Hope this helps.
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
default
Follow up: Dr. Chakravarthy Mazumdar (7 hours later)
Thank you. Trying to get her into hospital today. She woke up with eye completely bloodshot very very red. Fever has gone down to 100 and feeling a little better however she's been on zithromax for 4 days now....any ideas on eye issue?
doctor
Answered by Dr. Chakravarthy Mazumdar (19 hours later)
Brief Answer: Sub conjunctival hemorrhage Detailed Answer: Hi, You seem to be describing about blood oozing in the conjunctival sac, called Sub conjunctival hemorrhage. There are other serious conditions described as well. Hence it is better checked up at the hospital today. SCH happens if the capillaries in the conjunctiva break open. This may be because of recurrent cough, injury and sometimes unknown reasons. However most of this blood gets absorbed on its own and rarely require any treatment. So you should see whiteness coming back in 48 hours as the blood gets absorbed. Hope this helps.
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
Answered by
Dr.
Dr. Chakravarthy Mazumdar

General & Family Physician

Practicing since :2004

Answered : 1779 Questions

premium_optimized

The User accepted the expert's answer

Share on
What causes high fever, nausea,lack of appetite and severe fatigue?

Brief Answer: Your mom should see at the ER Detailed Answer: Hi, At present the symptoms do concern me but not life threatening. I do not dismiss this patient and let her remain at home without proper diagnosis. They quickly go into a sepsis soon. The blood pressures, pulse and temperature to be monitored. I suggest to monitor temperatures and see at the Emergency if it raises over 103. So keep them monitoring. I am not sure when were these tests done. You had not mentioned units of the tests and reference range. They vary from lab to lab. What were raised in the above list? After her unusual work load the other day she fell sick this could have taken a toll on her overall health. After physical stress the germs and other microorganims take a chance to invade the human body and cause such symptoms. The joint swelling and other symptoms suggest generalized inflammation. Is the Evista a recent medication that she is taking? IF yes it could be a reason. So a bout of stress combined with viral infection is most likely cause. Viral infection can bother up to 3 weeks. Symptoms may add to the previous week. Dark and foul smelling urine could be dehydration coupled with medications. Hope you come back with units and reference values.