Persistent Elevated Body Temperature: the Causes and When to Seek Help

Persistent elevated body temperature?

Hello, doctor.
My usual body temperature is around 36 to 36.5 degrees Celsius, and it rarely exceeds 37 degrees except when I have a cold.
On April 7th, Thursday afternoon, I started experiencing headaches.
After taking pain relievers, I felt some improvement, but the pain persisted the next day.
After taking more pain medication, the effect lasted less than three hours before the pain returned, so I went to a clinic.
At that time, my axillary temperature was 37 degrees.
Since I had no other symptoms, the doctor prescribed one anti-inflammatory medication and one pain reliever.
That evening, I felt my body was warm with mild soreness, and my temperature was 38 degrees, not exceeding 38.5, so I drank more warm water.

On April 9th, my temperature remained around 38.5 degrees.
After taking antipyretics, my temperature decreased, but once the medication wore off, it rose again.
In the afternoon, fearing it might be the flu, I sought medical attention again.
At that time, my forehead temperature was 36.9 degrees.
Since I had no other symptoms, just a low fever, vomiting once, and diarrhea 3-4 times, I was diagnosed with gastroenteritis.
After taking the medication, my symptoms disappeared, but my temperature continued to remain elevated.
I then started taking traditional Chinese medicine for recovery.

In the first week, my temperature ranged from 37.6 to 38.4 degrees; in the second week, it was 37.4 to 38 degrees; in the third week, it was 36.9 to 37.6 degrees, occasionally reaching 37.9 degrees.
I feel warm but do not sweat much.
I also drink 2000 to 2500 ml of water daily.
When I use a fan, my exposed skin feels cold, but when I cover myself with a thin blanket, I feel hot, so I have to turn on the air conditioning to lower the surrounding temperature.

Could you please tell me what might be happening? I have no other adverse reactions, just a consistently elevated body temperature.
Is there anything specific I should pay attention to, or should I undergo any tests? I also have a history of hepatitis B and a family history of 3-4 cancer patients within three generations.

Youyou, 20~29 year old female. Ask Date: 2016/04/29

Dr. Liao Yaopan reply Family Medicine

Hello, if you have consistently elevated body temperature, it is advisable to visit a hospital for a personal evaluation by a physician.
You may first seek assistance from an infectious disease specialist at Changhua Hospital.
Take care.

Reply Date: 2016/04/29

More Info

Persistent elevated body temperature, or fever, can be a concerning symptom, especially when it deviates from your normal baseline. In your case, your typical body temperature ranges from 36 to 36.5 degrees Celsius, and you have recently experienced fluctuations between 36.9 and 38.4 degrees Celsius over several weeks. This situation warrants a closer examination of potential causes and when to seek medical help.

Understanding Fever and Its Causes
Fever is generally defined as a temporary increase in body temperature, often due to an illness. It is a common response of the immune system to infections, such as viral or bacterial infections. In your case, the initial symptoms of headache and subsequent diagnosis of gastroenteritis suggest that your body was responding to an infection. However, the persistence of elevated body temperature beyond the acute phase of the illness raises some questions.

Several factors can contribute to a prolonged elevated body temperature:
1. Infections: Even after the initial symptoms of an infection resolve, some infections can cause lingering fever. This can include viral infections, which may take longer to fully clear from the body.

2. Inflammatory Conditions: Conditions such as autoimmune diseases can lead to persistent fever as the body remains in a heightened state of immune response.

3. Malignancies: Given your family history of cancer, it is essential to consider that certain cancers can present with fever as a symptom, particularly hematological malignancies like lymphoma or leukemia.

4. Chronic Conditions: Chronic infections, such as hepatitis B, can also lead to intermittent fevers, especially if there is any liver inflammation or infection.

5. Environmental Factors: Your mention of feeling hot without sweating and the need to adjust your environment (using fans and air conditioning) could indicate that your body is struggling to regulate temperature effectively, which can sometimes occur in response to illness or other physiological changes.

When to Seek Medical Help
Given your symptoms and history, it is advisable to seek medical attention if:
- Your fever persists for more than a few days without improvement.

- You experience new symptoms, such as significant weight loss, night sweats, or persistent fatigue.

- You have any changes in your bowel habits or any new gastrointestinal symptoms.

- You notice any skin changes, such as rashes or unusual bruising.

- You have a family history of cancer and are concerned about potential symptoms related to malignancy.

Recommended Actions
1. Follow-Up with Your Healthcare Provider: It is crucial to communicate your ongoing symptoms to your healthcare provider. They may recommend further tests, such as blood tests, imaging studies, or referrals to specialists, to rule out any serious underlying conditions.

2. Monitor Symptoms: Keep a detailed log of your symptoms, including temperature readings, any associated symptoms, and how you feel throughout the day. This information can be invaluable for your healthcare provider.

3. Hydration and Rest: Continue to stay hydrated and rest as much as possible. Your body needs energy to fight off any potential infections or inflammation.

4. Avoid Self-Medication: While over-the-counter medications can help manage fever, avoid excessive use without consulting a healthcare provider, as this can mask symptoms that need to be evaluated.

5. Consider a Specialist Consultation: If your primary care physician is unable to determine the cause of your symptoms, consider asking for a referral to an infectious disease specialist or a hematologist, especially given your family history.

In summary, while your symptoms may not seem alarming at first glance, the persistence of elevated body temperature and your medical history warrant further investigation. It is always better to err on the side of caution when it comes to health concerns, particularly with a family history of serious illnesses.

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