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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes mouth sores along with constant low grade fever and severe fatigue?

Answered by
Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2563 Questions

Posted on Wed, 16 May 2018 in Ear, Nose and Throat Problems
Question: 1. low-grade fever (99.3-100.4) for 5 weeks (since 3rd week of October). never goes away for 48 hours Drs. cannot explain it. They have said that they don't think the mouth sores are related to the fever. Typically it is WNL in the AM only to go up in the afternoon or evening or after exertion like goes to the grocery. fatigues easily....
2. "Shingles of the mouth Dx November 4th. fever noted at that time for the first time. I was surprised because other than my mouth, I felt fine. More than 30 canker sores in my mouth. 2 rounds of Antiviral meds x 12 days. Severe, deep tongue pain lingered and I was put on Gabapentin for 2 weeks, and The tongue is almost back to normal. I cannot elicit tongue pain even with extreme movement. Most of the mouth sores -80%- are gone. The ones that are left are the few large ones that I started with 3rd week of October.
Currently I am out of bed more today--hence this letter. I still cannot shake this fever.....
3. Incidentally I am getting over Tardive Dyskinesia from Stopping Abilify. My shrink put me back on Abilify and after 2 doses I am considerably better
4. all lab tests were WNL EBV showed convalescent Mono (1979 and 1995) but no acute illness.
5 CBC was completely normal--No rise in WBC and the differential completely normal x 2.. even extensive Vitamin labwork was done and all WNL. CMV was WNL. I have not been around anyone with the flu or TB. Both my PCP and the ENT are at a loss for the low-grade fever and fatigue...I have cut off social activities since no one can figure out the fever since Oct 30. Most of the time I feel OK in the AM, but by four I am exhausted and the temp is back up. I have eaten more ice cream in the last month than I have in the last year, and I've only gained 5 pounds...which is amazing. Usually I can just look at ice cream and I gain weight. After a day of severe mouth pain where I only ate ice cream all day, I lost 2 pounds the next day!
That is XXXXXXX I can think of at the moment; I hope you can figure this out because I am sick of being sick!! XXXXXXX V. Herbison
more info today...EBV negative CMV negative repeat CBC and diff all WNL
99.7 temp today after 3 doses of Augmentin. no sore throat all but the first canker
sore are gone. still tired..
Answered by Dr. Sumit Bhatti 2 days later
Brief Answer:
Rule out thyroiditis, autoimmune disorders.

Detailed Answer:

Thank you for your query.

1. The symptoms and signs mentioned by you may be due to subclinical thyroiditis.

2. Any low grade inflammation in the body such as multiple oral ulcers can cause low grade fever also.

3. Fatigue can also cause low grade fever.

4. Herpes outbreaks are usually seen in severe illnesses or when the immune system is depressed due to underlying problems.

5. A work up to rule out autoimmune disorders should be done, including an ANA blot test.

6. Tuberculosis and other mycobacterisl infections should be conclusively ruled out.

l hope that I have answered your query. If you have any further questions, I will be available to answer them.


Above answer was peer-reviewed by : Dr. Vaishalee Punj

The User accepted the expert's answer

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