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What Causes Night Time Fever With Severe Back Pain?

Posted on Sat, 8 Nov 2014

Question: Hi!

I have been having night time fever with severe back pain and extreme fatigue/ill feeling for over 3 weeks.

Diagnosed UTI then took 7 days of Cipro with no improvment. Long standing undiagnosed chronic illness.

Answered by Dr. Naval Mendiratta (1 hour later)

Brief Answer:
cause of fever

Detailed Answer:
Good evening XXXXXXX

Thanks for writing on health care magic

Well you seem to be having fever of unknown origin. We do need to figure out the cause. I would like to ask you a few questions to help me reach at a diagnosis

1. Fever is only present during night times,or during the day also? Is it accompanied with night sweats?

2. How high is the fever ?

3. Any rashes which accompany fever

4. Any history of consuming uncooked milk

5. Could you describe the nature of back pain. Is it present on activity or is it present at rest? Any particular point you can localize.

6. Is your back pain worse in the mornings or is it better

Do let me know these queries. Considering your pattern of fever I would wanna rule out any infection. You may need some blood tests and xrays of the spine to get to the diagnosis. If you have done some blood tests,kindly attach them too

Regards
Dr naval

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Naval Mendiratta (4 hours later)

Fever occurs only at night. Back pain is worse and very stiff in the morning, it gets a bit better as the day goes by, but never goes away. Pain is mid to low back. I can't bend over or put my socks on, its very stiff and the pain is very intense. Limits movements and changes the way i walk. Temp gets to 37.9-38-2 I do get night sweats and also sweat profusely during the day with minimal effort or activity. No presence of a rash and I have never ingested raw or unpasterized milk products. I have been sick this way before but usually lasts less than a week and goes away with just rest. But this time it is going on a month. Visited ER twice and no sign of infection according to them. I have a positive ANA, idiopathic polyneuropathy in both feet and oedema in my spinal bone marrow in the thoracic ares. Arside from that doctors have not found anything after various tests and say there is nothing to worry about. Mean while this illness has caused me to abandon my career and is impacting my life immensley.

Thanks for taking the time to look at this.
XXXX

Answered by Dr. Naval Mendiratta (14 minutes later)

Brief Answer:
low back pain

Detailed Answer:
Good evening XXXXXXX

The symptoms you are saying does fit into one of the arthritis I feel. I still would want to look into the detail reports of MRI along with ESR and crp and hla b 27 if you have done

Do look up on net for the disease called spondyloarthopathy. See if your symptoms fit into it. I will give you more details about it if you think it coincides with your problem
.

Waiting for your further queries

Regards
Dr naval

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Naval Mendiratta (23 hours later)

That has been suggested before by a rheumstologist but never diagnosed. I think all gge synmtoms align except it doesn't seem to cause extreme dibilitating fatigue like i also get.

I don't have my transcripts or medical results in hand as that has to be requested in Canada, but i can obtain.

If it was spondyloarthritis, are there tests you recommend to confirm? Or is it a hard diagnosis based on elimination and history?

Thanks again for your time.

XXXX

Answered by Dr. Naval Mendiratta (6 hours later)

Brief Answer:
Is it arthritis

Detailed Answer:
Good evening XXXXXXX

Well maybe that rheumatologist was right. You don't need to have fatigue to be diagnosed as spondyloarthopathy. To diagnose the disease main thing is the patient history. If history is suggestive then we do the following supporting tests

1. ESR and CRP to look for inflammation
2. HLA B 27 (by pcr)
3. X ray pelvis to look for sacroiliac joints
4. MRI of the sacroiliac joints to look for bone marrow edema

If MRI or X ray shows changes or if HLA b 27 is positive it normally fits into the disease.

It is mostly a disease of the males. It can happen in females too but is not severe and disabling as in males. Its major symptoms are pain and stiffness and acts as a nuisance value. But it will respond well to anti inflammatory and exercises.

What I would suggest is to look into these tests. If you have done it already, you can let me know about them as well. I would want to rule it out before labeling anything as depression related.

Do let me know about your other queries as well. Would be happy to help you reach a diagnosis.

Regards
Dr naval

Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari