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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes recurring fever and high erythrocyte sedimentation rate?

Hello Sir/Madam,
Three weeks before my mother had chilling fever and night sweats. We consulted a doctor and blood and urine tests confirmed that she had urinary infection. To substantiate, her ESR was as high as 90 mm/hr.
The antibiotics did not solve the problem and she was admitted for a series of injections which cured her fever and she was discharged.
Two days later, she had fever again and we took her to KMC Manipal. Her ESR was constantly high around 70-85. Doctors ruled out TB, Malaria, and Typhoid (though doc gave Malaria tablets to avoid risks)
At the moment, my mother has mild recurring fever (99degrees for 2 hrs once in two days) and a high ESR. We are concerned; can you help ?
                                                                 
Mon, 23 Feb 2015
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Geriatrics Specialist 's  Response
Hi,
Thanks for asking.
Based on your query, my opinion is as follows.
1. High ESR indicates ongoing inflammation. CRP levels would be more accurate to assess current inflammation.
2. She might be having a foci of infection at some spot, which is currently unknown. As fever is persistent, along with high ESR, search for the foci is necessary
3. Need to look into lymphocytes or neutrophil levels to assess for infection. Get CRP, blood counts and urine and blood culture to assess further.
Hope it helps.
Any further queries, happy to help again.
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