What causes profuse night sweats, chills and body pain?
a viral infection probably
your case sounds a lot like viral infection although no diagnosis is possible from afar. You haven't mentioned C-reactive protein. Did you do this test too? A low value at least a couple of days after the initiation of symptoms usually means a viral infection. The normal CBC (although I haven't seen the report) is usually against bacterial etiology.
Some findings or symptoms that may indicate a more serious infection include the following:
- severe headache that won't go away even when the fever is gone
- faintness and low blood pressure
- rigor (uncontrollable tremor with the chills with rattling teeth, etc)
- any new symptom for example urinary tract symptoms like flank pain, urgency or frequency.
I don't believe it's your ears because a middle ear infection usually presents with pain and hearing deficits. Besides that such infections are much more likely to occur in young children. Adults do not usually have middle ear infections.
I hope you find my comments helpful!
If you'd like to provide additional details or require any clarification please use your follow-up questions to ask.
if they've excluded a UTI then a viral etiology is likely
The difference between rigor and chills is the uncontrollable element of rigor. Rattling teeth is characteristic and is almost always present. Rigor usually means more serious infection although common infections like influenza may present with rigor too.
If the doctors have excluded a urinary tract infection (negative urinalysis) then the most likely cause is a virus. Viral infections cannot be treated (except herpes and influenza but treatment is not indicated for all patients). That's what I can contribute to your case. I'll be glad to give you more information if you provide additional details...
If things are not better after a couple of days then reassessment might be necessary.
Best wishes for a speedy recovery!
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I see. Although both a negative urinalysis and a negative flu swab do not exclude a UTI or influenza (unless PCR was done), they're very indicative that you don't have these disorders.
It's normal for the symptoms of rigor to stop after the temperature rises. It's neither a positive nor a negative event. Besides that having rigor (particularly when it's the sixth day since the infection presented) is concerning. The negative CBC does not always say the complete truth. Sometimes the white blood cells count may be normal or even low with very serious infections. Other indicators in the CBC may provide additional clues, so if you can upload the reports it may help me to have a better understanding of your condition.
So, if your condition continues to be unchanged reassessment is indicated. If you've seen any kind of improvement then perhaps you can wait a bit. A good indicator might be the maximum temperature. For example if you had 102.5F in the first 2-3 days then it started to decline then this lowering might indicate improvement.
White Blood Cells 4.2 K/UL 3.8 - 11.0 K/UL
Red Blood Cells 5.05 M/UL 4.20 - 5.70 M/UL
Hemoglobin 14.3 GM/DL 13.2 - 17.0 GM/DL
Hematocrit 43.1 % 39.0 - 50.0 %
MCV 85.3 FL 80.0 - 100.0 FL
MCH 28.3 PG 27.0 - 34.0 PG
MCHC 33.2 GM/DL 32.0 - 37.0 GM/DL
RDW 13.1 % 11.0 - 15.5 %
Platelets 207 K/UL 150 - 400 K/UL
Differential Type Automated
Neutrophils % 72.4 % 40.0 - 75.0 %
Immature Granulocytes % 0.2 % 0.0 - 1.0 %
Lymphocytes % 17.3 % 15.0 - 48.0 %
Monocytes % 9.9 % 0.0 - 12.0 %
Eosinophils % 0.0 % 0.0 - 7.0 %
Basophils % 0.2 % 0.0 - 2.0 %
Neutrophils,Absolute 3.00 K/UL 1.90 - 7.40 K/UL
Immature Granulocytes Absolute 0.01 K/UL 0.00 - 0.05 K/UL
Lymphocytes, Absolute 0.72 K/UL 1.00 - 3.90 K/UL
Monocytes,Absolute 0.41 K/UL 0.00 - 0.80 K/UL
Eosinophils, Absolute 0.00 K/UL 0.00 - 0.50 K/UL
Basophils, Absolute 0.01 K/UL 0.00 - 0.10 K/UL
The CBC would have been almost normal without the immature granulocytes. These cells are normally absent from peripheral blood. Although their number (and percentage) is very low and they do not fulfill the criteria of SIRS or sepsis, they do raise some concern.
So in conclusion, if you've seen substantial improvement, you can wait it out for a couple of days more. Otherwise reassessment would be required.
New blood work done today.
Sed rate- 55 up from 43
CBC unchanged from previous draw
Added on CMV pending
ASO titer - equivocal “higher than 200 less than 400”
Also will receive ultrasound of my neck in the morning for the pulsatile tinnitus in my right ear.
viral infection more likely
Being afebrile for 12 hours does not mean much because in most cases ibuprofen and similar drugs may 'hide' the fever until their effects wear off. If you remained afebrile for a complete 24 hour period without ibuprofen then this would have been something.
The low CRP (3.6 whether it's mg/dL or mg/L it's low - if it's neither then please let me know) is against bacterial infection so a viral etiology is the most likely scenario. ASO is not useful in acute infections. The elevated ESR may just mean a prolonged infection - it's not sky high nor is it normal, it's somewhere between.
If you have any other symptom besides the ones you've mentioned or other clinically useful information (like a recent bite, travel abroad, pain, rash or anything that might seem relevant) please let me know. In cases with protracted undiagnosed fever and no sign of improvement radiological testing might be the next best step. Chest X-ray and abdominal ultrasound scan are two useful and easy to do tests.
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