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What causes persistent low grade fever when blood test reports are normal?

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Neurologist, Surgical
Practicing since : 2004
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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.
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. 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 can think of at the moment; I hope you can figure this out because I am sick of being sick!! XXXXXXX V. Herbison
Mon, 7 May 2018 in Headache and Migraines
 
 
Answered by Dr. Erion Spaho 5 hours later
Brief Answer:
Other infections to consider.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

In my opinion, an infection should be evaluated as the most likely cause of your issues.

Lower respiratory tract infections or TBC are among the most common causes that may cause symptoms like yours.

Imaging studies such CT scan of the lungs
etc. are necessary to evaluate more correctly this possibility.

Other conditions to consider also include brucellosis, etc.

Brucellosis as a possible condition is evaluated by the appropriate blood tests that may confirm or exclude it.

Discuss with your Doctor about these issues and further tests.

Hope you found the answer helpful.

Let me know if I can assist you further.

Take care.
Above answer was peer-reviewed by
 
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