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Dr. Andrew Rynne

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What causes recurring fever and weight loss in a child?

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Dr. Sudhir

Internal Medicine Specialist

Practicing since :2000

Answered : 1417 Questions

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Posted on Mon, 4 Aug 2014 in Child Health
Question: My seven year old daughter has been sick for the past 6 weeks. She has fevers that last for 2-3 days then she is fine for 1-2. Then the fever comes back. She has lost about 5 lbs in the past 3-4 weeks. Everyone can see that she is thinner. She has pretty much stopped eating. She OUT OF ENERGY. She sleeps everyday during the day, sometimes most of the day. Sometimes she does not have enough energy to walk normal distance (around the grocery store). Her Dr thinks that she might have lupus and is trying to get her into a specialist. The earliest the special can see her is the end of September my the end of October. I don't that she can wait that long if she keep deteriorating at this rate. Can she wait that long? Could it be something other than lupus? Her blood work said that her CRP levels are elevated.
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Answered by Dr. Sudhir 16 minutes later
Brief Answer:
In addition to lupus, I would like to rule out TB.

Detailed Answer:
Hello,

In addition to to lupus in view of intermittent fever and weight loss I would also like to rule out possibility of tuberculosis.

On off fever, weight loss and loss of appetite are common presenting symptoms of TB.In addition there may be chronic cough.

I think she should see doctor sooner , before October. Ask her GP to get investigations done for infectious causes.

This may promote for early referral to specialist.Hope this helps.Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudhir 15 minutes later
One more thing that I think is unusual about her fevers is that they break. Her fever just goes away. It is not like the flu where the fever breaks and you still fill bad for another day. Her fever goes away without breaking and she is ready to play again with her modified energy level.

She does not have any cough at all.
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Answered by Dr. Sudhir 17 minutes later
Brief Answer:
Such fever seen in autoimmune or chronic infection

Detailed Answer:
Hello,

Such fevers are seen in autoimmune like lupus or chronic infections like TB. Also fever is generally low grade unlike in flu.In case of TB fever is generally evening rising fever.

If the skin and joint symptoms are dominating then lupus would be my first consideration. If not then TB needs to considered.

In both cases, its better to get the appointment with specialist preponed.

You can convince her GP to get investigations done , so you are closer to diagnosis and this will save time when she sees specialist, helping to start treatment earlier.

If any other investigations were done , let me know to help you better.Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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