Suffering of high-grade fever 39.5°C most of time for 5 weeks, all tests normal, blind treatment of bacterial infection ineffective?

Suffering of high grade fever 39.5°C most of time for 5weeks

Suffering of high grade fever >39.5°C most of time for > 5weeks
She has no any signs or symptoms of infection or inflammation anywhere in her body , and all possible investigations done and all results within normal levels including : CBC, ESR, CRP, U/E/CR, LFT, TFT, BLOOD FILMS, LP, BLOOD CULTURES, URINE R/E, VIRAL SCREEN, EB VIRUS WIDAL TEST, Weil–Felix test , Brucella test, ABDOMINAL U/S, HIP JOINTS U/S, THYROID U/S, CHEST X-RAY, HIP JOINTS X-RAY, LUMBER VERTBERE MRI ( and some tests repeated many times )
She also received multiple antibiotic course as blind treatment including ( septren, cloxacillin, claforan, meronem, clarithromycin, procaine penicillin, ospen …… )
Clinically : except of her body temperature 39 -41°C despite paracetamol ( iv, orally and suppositories ) and ibuprofen syrups, she is stable , no complaint , no rash , no any significant symptom .
Note : 6 month ago she starred to gain weight and get obese , now her body weight = 30kg.
Female



Dr Ahmed Fawzy
Member
Dr Ahmed Fawzy

Hi
Any tempreture above 38.5 c can not be controlled by medication, only option now is to put her in ice bath the achieve 38.5 then Start on paracetamol , is here throat sore or does she have abdominal pain?

Dr. Ayman Darrag
Member
Dr. Ayman Darrag

hi,
is there any inflamed lymph nodes?
what is her age?
have you done parathyroid tests?

Dr Masr
Member
Dr Masr

Lumber puncture must ‘ve done . ASAP

The the patient must be examined thoroughly esp. , as there may be hidden abscess , but don’t forget the factitious fever .

What medications are you taking for that prolonged fever?

Dr.Honey
Member
Dr.Honey

Hi..
Thanks for the query..

If there is weight gain suddenly then get her thyroid and parathyroid levels checked..
Also cold sponges or cold water bath can help in reducing fever and continue paracetamol..

Hope this helps..

Regards..

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