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What causes persistent fever with normal blood culture?

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Posted on Mon, 15 Sep 2014
Question: My mother is 58 years old. She is diabetic. She is having high fever for the last 16 days. She has been admitted to hospital last 8 days. At the time of admission her tlc count in blood was found 16000 and CRP in blood 138.2 with no MOD, sugar level 203, high pulse rate as per Doctor. At the time of admission she was having fever of 104 degree F. All the other tests like blood culture, urine culture, malaria, dengue, typhoid came negative. Her sugar level 138 mg/dl and pulse rate came back to normal. Doctor is still unable to find the source of infection. My mother is having fever still which is rising to 102 degree F at times though she is in continuous antibiotics and IV. Doctor is giving her paracetamol also. Todays tlc in blood is 12100 but fever is 101 degree F. Doctor started giving broad spectrum antibiotics from yesterday. He is calling it as a case of Septicimia. Please help.
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Answered by Dr. T Shobha Deepak (1 hour later)
Brief Answer:
To consider Autoimmune disorders

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day,

From the description given it qualifies as Pyrexia of Unknown Origin(PUO) with evidence of systemic inflammatory response syndrome(SIRS).

Infection or Infection leading to septicaemia is just one of the cause for PUO.
I would also suggest you to consider the possibility of other disorder like

1. Auti-immune disorder
2. Temporal Arteritis
3. Subphrenic abscess

These could be the cause of fever.

I would also suggest the following investigation to be done

1. Ultrasound of abdomen and chest
2. Lumbar puncture
3. Autoimmune workup

I would suggest you to discuss this with your treating Physician.

Do keep me updated about the progress.
Awaiting your response

Take Care

Best Regards
Dr T Shobha Deepak
MBBS,MD
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Answered by
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Dr. T Shobha Deepak

General & Family Physician

Practicing since :2005

Answered : 1774 Questions

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What causes persistent fever with normal blood culture?

Brief Answer: To consider Autoimmune disorders Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day, From the description given it qualifies as Pyrexia of Unknown Origin(PUO) with evidence of systemic inflammatory response syndrome(SIRS). Infection or Infection leading to septicaemia is just one of the cause for PUO. I would also suggest you to consider the possibility of other disorder like 1. Auti-immune disorder 2. Temporal Arteritis 3. Subphrenic abscess These could be the cause of fever. I would also suggest the following investigation to be done 1. Ultrasound of abdomen and chest 2. Lumbar puncture 3. Autoimmune workup I would suggest you to discuss this with your treating Physician. Do keep me updated about the progress. Awaiting your response Take Care Best Regards Dr T Shobha Deepak MBBS,MD