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What Causes Prolonged Fever With Pain In Neck?
Question: Patient (my mother) has been suffering from fever repeatedly occurring for the last more than 16 days. Had felt little stretch & pain while touching from out side of the neck and had been getting Bulgum.
AND she had local MBBS doctor's prescription a normal anti-biotic and paracitamol.
After that went to ENT specialist, he told there is nothing as such in throat.
When its been 9-10 days. we went for complete blood & urine tests CPC / Widal / MP etc....
everything was normal BUT ESR was arround TLC 12000 and ESR 78.
On 15th day she got TLC 16100.
Administered a drip of anti-biotic and paracitamol. she remained with normal fever for almost 8 hours yesterday nigh she again felt fever.
Blood & urine culture is awaited. ALSO doctor has been waiting to get right amount of saliva / bulgum to be tested in lab.
REASON of the fever is still not traceable. Yes 1 thing little stretch & little pain on touching neck nerves from outside is still there.
kindly give your expertise opinion.
thanks.
AND she had local MBBS doctor's prescription a normal anti-biotic and paracitamol.
After that went to ENT specialist, he told there is nothing as such in throat.
When its been 9-10 days. we went for complete blood & urine tests CPC / Widal / MP etc....
everything was normal BUT ESR was arround TLC 12000 and ESR 78.
On 15th day she got TLC 16100.
Administered a drip of anti-biotic and paracitamol. she remained with normal fever for almost 8 hours yesterday nigh she again felt fever.
Blood & urine culture is awaited. ALSO doctor has been waiting to get right amount of saliva / bulgum to be tested in lab.
REASON of the fever is still not traceable. Yes 1 thing little stretch & little pain on touching neck nerves from outside is still there.
kindly give your expertise opinion.
thanks.
Brief Answer:
Due to PUO.
Detailed Answer:
Hello,
Thanks for posting your query.
Prolonged fever for more than 2 weeks without a specific usual cause is termed as pyrexia of unknown origin (PUO).
PUOs are caused by infections (30-40%), neoplasms (20-30%), collagen vascular diseases (10-20%), and numerous miscellaneous diseases (15-20%).The list of possible causes is very long, the more probable ones in his case being ,
Abscesses- can be near the neck as it is painful.
Tuberculosis
Urinary tract infections or Hepatobiliary infections
Systemic bacterial illnesses/Fungal infections/Parasitic infections
Lymphomas/Leukemias/Solid tumours
Collagen vascular and autoimmune disorders
Endocrine disorders
The exact cause can only be established after extensive diagnostic evaluation by her doctors, which in her case is most probably an infection .
Considering her present blood tests it his advisable that she undergo the following investigations as per her doctors advise
1.A blood and urine culture test.
2.A CT scan of abdomen neck and brain (to rule out post surgery long term complications like infection or abscess)
3.A mantoux test for ruling out tuberculosis.
I hope her doctors would come to the exact conclusion soon.
Please do not worry as many of these causes are very much curable conditions.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Due to PUO.
Detailed Answer:
Hello,
Thanks for posting your query.
Prolonged fever for more than 2 weeks without a specific usual cause is termed as pyrexia of unknown origin (PUO).
PUOs are caused by infections (30-40%), neoplasms (20-30%), collagen vascular diseases (10-20%), and numerous miscellaneous diseases (15-20%).The list of possible causes is very long, the more probable ones in his case being ,
Abscesses- can be near the neck as it is painful.
Tuberculosis
Urinary tract infections or Hepatobiliary infections
Systemic bacterial illnesses/Fungal infections/Parasitic infections
Lymphomas/Leukemias/Solid tumours
Collagen vascular and autoimmune disorders
Endocrine disorders
The exact cause can only be established after extensive diagnostic evaluation by her doctors, which in her case is most probably an infection .
Considering her present blood tests it his advisable that she undergo the following investigations as per her doctors advise
1.A blood and urine culture test.
2.A CT scan of abdomen neck and brain (to rule out post surgery long term complications like infection or abscess)
3.A mantoux test for ruling out tuberculosis.
I hope her doctors would come to the exact conclusion soon.
Please do not worry as many of these causes are very much curable conditions.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sir thanks for detailed n prompt reponse.
1. Blood & urine culture report is awaited to get on monday.
2. After sending query to you, in the meanwhile,
Patient has given ger blood sample for all types of thyroid test. AND Ultrasound of neck which was suggested by An ENT when he found nothing like ENT problem.
3. It tells something wrong in the both sides of neck, which doctor told as swelling in thyroid gland due to some growth arround it.
Equally thyroid reports r telling something corelated.
DOCTOR, PLZ TELL WHAT TYPE OF GROWTH IT MAY BE LIKE ?
AND
WHAT WOULD VE THEIR RESPECTIVE TREATMENTS AVAILABLE ?
So far as now she has been given anti-biotic drip twice a day with SUMO for fever twice.
Thanks n Regards,
Simranjit XXXXXXX Sethi
1. Blood & urine culture report is awaited to get on monday.
2. After sending query to you, in the meanwhile,
Patient has given ger blood sample for all types of thyroid test. AND Ultrasound of neck which was suggested by An ENT when he found nothing like ENT problem.
3. It tells something wrong in the both sides of neck, which doctor told as swelling in thyroid gland due to some growth arround it.
Equally thyroid reports r telling something corelated.
DOCTOR, PLZ TELL WHAT TYPE OF GROWTH IT MAY BE LIKE ?
AND
WHAT WOULD VE THEIR RESPECTIVE TREATMENTS AVAILABLE ?
So far as now she has been given anti-biotic drip twice a day with SUMO for fever twice.
Thanks n Regards,
Simranjit XXXXXXX Sethi
Brief Answer:
Can be a lymph node swelling.
Detailed Answer:
Hello.
Thanks for writing again.
The growth in the neck can be due to an infection- abscess a lymph node swelling or a benign or malignant tumor. Let us wait for the ultrasound scan reports to find out. CT scan of the neck might also be needed to find the extent of the growth.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Can be a lymph node swelling.
Detailed Answer:
Hello.
Thanks for writing again.
The growth in the neck can be due to an infection- abscess a lymph node swelling or a benign or malignant tumor. Let us wait for the ultrasound scan reports to find out. CT scan of the neck might also be needed to find the extent of the growth.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Respected sir,
Thanks again for ur kind ans prompt response.
1. Should we ourself ask doctor to go for CT scan to avoid delay and to arrive at the right focus of medication a.s.a.p.
because its already 20 days my mother has been suffering from repeated fever and has been taking anti-biotics with paracitamol drips twice for last 2-3 days.
2. In case what type of malignancies use to be found in such type of growths near thyroid gland.
And kindly provide detailed info. On their respective treatments available.
Thanking you sir,
REGARDS,
SIMRANJIT XXXXXXX SETHI.
Thanks again for ur kind ans prompt response.
1. Should we ourself ask doctor to go for CT scan to avoid delay and to arrive at the right focus of medication a.s.a.p.
because its already 20 days my mother has been suffering from repeated fever and has been taking anti-biotics with paracitamol drips twice for last 2-3 days.
2. In case what type of malignancies use to be found in such type of growths near thyroid gland.
And kindly provide detailed info. On their respective treatments available.
Thanking you sir,
REGARDS,
SIMRANJIT XXXXXXX SETHI.
Brief Answer:
Infection likely.
Detailed Answer:
Hello.
Yes you can request a CT scan yourself to speed up the treatment.
The infection is a most likely possibility and it can be treated with surgical drainage and antibiotics.
A small node or thyroid nodule can need resection. Further treatment like chemotherapy or radiotherapy may be needed in case the biopsy suggests a malignancy. The treatment depends on the stage of cancer detected.
Regards.
Infection likely.
Detailed Answer:
Hello.
Yes you can request a CT scan yourself to speed up the treatment.
The infection is a most likely possibility and it can be treated with surgical drainage and antibiotics.
A small node or thyroid nodule can need resection. Further treatment like chemotherapy or radiotherapy may be needed in case the biopsy suggests a malignancy. The treatment depends on the stage of cancer detected.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Respected Sir,
Hearties Thanks for your expert opinion.
Kindly go through the detailed reports enclosed. and it is again requested
to throw some light on the right direction with your expert opinion.
Please go through the enclosed reports. and suggest accordingly.
THanks & Regards.
Hearties Thanks for your expert opinion.
Kindly go through the detailed reports enclosed. and it is again requested
to throw some light on the right direction with your expert opinion.
Please go through the enclosed reports. and suggest accordingly.
THanks & Regards.
Brief Answer:
Details below.
Detailed Answer:
Hello.
I have seen the attached reports. Your mother has an inflammation of the thyroid gland. This can be causing the fever she is having. The follow up Technetium uptake scan will help in ruling out presence of any nodes in the gland. Her Vitamin B 12 levels are also low for which she needs proper methylcobalamin supplements.
If her fever has subsided after the antibiotics and she is symptomatically better then there is no need to worry. Otherwise further investigations are needed to find out any other generalized cause for the fever. Malignancy is ruled out.
Blood and urine culture and other tests are needed if the fever persists.
Regards.
Details below.
Detailed Answer:
Hello.
I have seen the attached reports. Your mother has an inflammation of the thyroid gland. This can be causing the fever she is having. The follow up Technetium uptake scan will help in ruling out presence of any nodes in the gland. Her Vitamin B 12 levels are also low for which she needs proper methylcobalamin supplements.
If her fever has subsided after the antibiotics and she is symptomatically better then there is no need to worry. Otherwise further investigations are needed to find out any other generalized cause for the fever. Malignancy is ruled out.
Blood and urine culture and other tests are needed if the fever persists.
Regards.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Prasad
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