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    What causes low grade fever when diagnosed with peripheral neuropathy?

Posted on Thu, 3 Aug 2017 in Digestion and Bowels
Question: Male, Age 85, 165# (nude-consistent), 68". 10 days of level five pain in stomach/intestine., low grade fever (101F), BP normal 115/60. History of GERD and IBS, diagnosis of peripheral neuropathy (VA). Black feces, golden urine. Latest urine has 3 black 1-mm. solids in 200 ml. Persistent vertigo (VA cane provided, told can do nothing for me) . General discomfort in rib cage. Sleep for only 45 minutes at a time, sometimes as much as 2 hours. VA primary care, has scheduled consultation on 31 July. Self treatment with OTC naprosyn, omeprazole, ineffective.
Answered by Dr. Ramesh Kumar 3 hours later
Brief Answer:
Multiple morbidities.

Detailed Answer:
Thank you for choosing HealthcareMagic for your query.
Have gone through your query in detail and i appreciate your concerns.

Fistly before comming to your questions!

Naproxen is a nonsteroidal anti-inflammatory drug of the propionic acid class that relieves pain, fever, swelling, and stiffness. It is a nonselective COX inhibitor,. Naproxen poses an intermediate risk of stomach ulcers and can precipitate severe gastritis hence is contraindicated in patients with acid peptic disorders.
Stop taking naprosyn asap.

Pain in stomach area can be spasmodic in nature and is most likely due to spasms in smooth muscles.
Presence of low grade fever is suggestive of the fact that there is some ongoing infection in your body.Fever is an indicator of infection.

Black stool may be normal in some cases and caused by ingesting certain substances or medications, such as iron supplements. However, black stool can also be caused by a serious condition, such as bleeding in the digestive tract caused by a peptic ulcer.In a patient with history of reflux disorder with pain in abdomen mild bleeding from an ulcers can be considered.

Excessive yellow or golden color of pee can be due to presence of riboflavin in urine.Its a vitamin and can cause darkening of urine.

As off now i would suggest you two tests-
1)Stool for occult blood- to see if dark color of stool is due to blood.
2)Ultrasound abdomen to rule out possibility of diverticulitis organomegaly and other intestinal infection.
3)Tolal and differential leucocyte counts-To see nature of infection.

Till then
Take a proton pump inhibitor like Esomeprazole 40 mg twice daily along with a prokinetic drug (eg.Domperidone) for 3 days. This will provide you symptomatic relief from symptom.

Antacid like Pepto bismol can be taken for few days along with it.
Any over counter probiotic should be taken for few days to provide relief in symptoms of indigestion.
Take an anti inflammatory in combination with antispasmodic like Dicyclomine 10 mg thrice daily.
For fever take calpol sos.

As i am a gastroenterologist would you like to take a briefing about vertigo from me.
If yes please jusr write a follow up.

In case you have any specific query i would be happy to help!

Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Ramesh Kumar 2 hours later
VA hearing consultant states "I can't do anything for you." VA compensates for tinnitus. Exercises suggested to improve balance were not effective. Problem has persisted off and on almost fifty years. With no warning, may just collapse. I suggest origin was anoxia attendant to more than 1000 hours jet bomber service. Dizziness comes and goes, even when supine in bed, before or after sleep. Within domicile, I have to hold on or lean against something to to prevent falling. Walking is somewhat enhanced by broad stance. If it's dark, forget it. The house has night lights everywhere, but going outside after dark is not a common practice.
Answered by Dr. Ramesh Kumar 12 hours later
Brief Answer:
follow up

Detailed Answer:
Hi again,
See vestibular disorders can be central or peripheral.
Central involves brain while peripheral involves inner ear.
Tinnitus with severe disbalance is usually there in inner ear disorder.
Kindly attach reports of your audigram.
Caloric test MRI etc
As just by going through history its rather impossible to throw light on nature of problem.

It can be menieres disease or otolithic crisis.
Kindly attach all investigation and what is VA?

Above answer was peer-reviewed by : Dr. Kampana
Answered by
Dr. Ramesh Kumar


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