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Fever. Blood and widal test done. On tuberculosis medications. All test normal. What should be done?

sir my sister is having fever for last three months ,around 101 f . she got her blood test done ...the findings were widal test .. o antigen negative h antigen negative. bilirubin normal sgpt normal,malarial parasite not seen,esr 110mm first hour, haemoglobin 9.9gm,pleural fluid examination color straw hazy,protien 4.4gm%,chest pa view lt lower zone and cp angle is hazy-pl.effusion. Horizontal fissure is prominent on Rt side. RtC.P. angle is also hazy-effusion. cardiac shadow and bony cage are normal. sir she is under treatment but no progress she is getting tb medicines but health is detereoting and fever is not going, i consulted other doctors too but no progress what shoul i do
Asked On : Fri, 29 Jun 2012
Answers:  1 Views:  65
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Pulmonologist 's  Response
I don't think myself that it is tuberculosis as there is bilateral effusion and the right fissure is prominent. This is seen in cases of fluid overload which commonly is due to either a cardiac disease or some renal disease.
You shoud do a cardiac study like 2D echo to evaluate the heart and serum creatinine for renal disease however a complete check of the liver and renal profile would be better.
Fever may not be due to lung disease but such a high fever for 3 months cant be an infection or she would have been very toxic by now.
Evaluate for diseases like SLE and RA and Sarcoidosis
Answered: Fri, 18 Oct 2013
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