Increased temperature

Question

Hello,

I (31 years old, female) am suffering for more than 2 months of daily increased body temperature (around 37,8 – 38,0), which does from time to time develop into fever of 38,5 – 38,7. In addition, I feel very exhausted and get tired easily. During the i.v. therapy the temperature came down, but increased again very shortly after the end of the therapy. The increased temperature occurs mostly from the beginning of the afternoon respectively the evening. Furthermore, oral antibiotics do not improve the situation.
The CRP is slightly increased, which is rather untypical for me, as it has been negative the time before. A chest x-ray as well as an ultrasound investigation of the abdomen did not clarify the situation. Furthermore, an ultrasound of the heart did not give an explanation for the temperature. Which other reasons could there be for an increased temperature, if no other symptoms are there, like e.g. headache or abdominal pain? I know that my question is a bit difficult to answer because there could probably be many reasons for that, but I would be very thankful for further suggestions, what to look for. I am quite desperate, as I have been doing quite well for the past time and my pulmonary function is not too bad (FEV> 80%).

Many thanks in advance for answering.

Answer

Hello,
Fever is a quite unspecific sign and can occur in all imaginable situations – harmless to dreadful – the number of possibilities is very high. It is totally excluded that I could do a narrowing to a few possibilities nor give you a list of all possibilities via this way. This is not an easy task for the physician in charge, who can take into account all possibilities and then comes to a result via existing findings or via additional findings, which have to be investigated first of all.
To make it clear to you that this search does not lead in any case to success, I mention FUO – that is an abridgement for a diagnosis, in case one is not able to find the cause (or not yet able to find the cause), this stands for “fever of unknown origin”.
Yours sincerely,

Prof. Dr. TOF Wagner

17.11.2008