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What Causes Intermittent Headache, Fever And Chills?

Posted on Fri, 20 Nov 2015

Question: Hi, I am a non-alcoholic. I had a fever(about 103-104) with headache, shivers and sweat 20 days ago. My doc said it was sinusitis and prescribed me with antibiotics and Tylenol. After 5 days shivers, headache and chills subsided. Did not get the fever down. So he increased the dosage and gave a shot too. Took them for 5 days, had severe diarrhea and heartburn at that time. And my AST and ALT went up to 69 and 81. Albumin was 3.9. Then he asked me to stop taking the antibiotics. Next day my AST and ALT levels went up to 86 and 100. 2 days ago they were 140 and 186. But the fever is getting down. Now I have between 99-100. All the tests for Hepatitis, Cirrhosis, fatty liver, HIV and CT, Chest X-ray, Ultrasound are negative. Not sure what the cause is. Please let me know what could be it and how long does it take for my AST and ALT levels to come down to normal?

Answered by Dr. Abhijit Deshmukh (33 minutes later)

Brief Answer:
probably viral infection that is settling down..

Detailed Answer:
Welcome to HCM
Thank you for the query
I understand your concern
Looks like you had some infection most probably viral and is settling down as the fever is responding now.
The amount of sgot and sgpt abnormalities you have is fairly common with infections and they tend to settle with time and usually not a concern
Need to monitor them once in 5 days, avoid taking unnecessary pain killers and Tylenol.
Also get yourself checked for dengue, leptospirosis and scrub typhus if fever recurs and if your doctor suggests depending upon the endemicity of these infections in your area.

Likely that they will improve within two weeks.
Avoid alcohol if any till you completely recover.

Hope this answers your query.
Wish you a speedy recovery.
Happy to help.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Abhijit Deshmukh (1 hour later)

Hello Doctor,

Thank you sommuch for the very
Prompt response. That sounds a bit relaxing to me. But is it normal to havr fever for 20 days? And have you got a chamve to look at the reports? I have uploaded them sometime after I posted the question .

Answered by Dr. Abhijit Deshmukh (13 hours later)

Brief Answer:
Hello

Detailed Answer:
Hi
I went through your reports, well they all look ok except presence of toxic granules and atypical lymphocytes in your bloodstream.
They need to be recheck.
20 days of fever needs to be extensively evaluated including a bone marrow examination and echo study.
Also other odd infections like malarial antigen, leptospirosis, scrub typhus and sos bone marrow examination needs to be done if fever recurrs or you have persistent abnormal liver function tests
Hope this answers your query
Wish you a speedy recovery

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Abhijit Deshmukh (24 hours later)

Hi Dr. Abhijith Deshmukh,

My doctor did a blood test again on Oct 29. AST went down from 140-138 and ALT went up from 186-201. There are some abnormal values of Ferritin, Cerrulopla and Alph 1 Ant. Dengue test came back negative. I have attached the reports.

Thanks

Answered by Dr. Abhijit Deshmukh (20 hours later)

Brief Answer:
Hello

Detailed Answer:
Hi
Thank you for the query
Can consider doing esr, crp, angitensin converting enzymes levels, Ldh levels and alkaline phosphate levels repeat.
May need to consider liver biopsy if elevation persists
Let me know
Sorry for delayed reply
Best wishes

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Above answer was peer-reviewed by : Dr. Raju A.T