Periodic Low Fever: Possible Causes and Next Steps

Periodic low-grade fever?

Hello doctor, recently I've been experiencing slight weakness in my limbs, and my body temperature rises to 37.7 to 37.8 degrees Celsius in the afternoon, during which I feel a bit unwell.
However, by the evening, my temperature returns to normal, and when I wake up after a night's sleep, my temperature is also normal.
I also have a cough, but it's not very severe.
However, yesterday when I coughed, I felt a slight pain in my chest.
I looked it up online and found that it resembles the symptoms of tuberculosis.
From a physician's perspective, do you think it could be that? Are there any other conditions that could match my symptoms, and what tests should I undergo?

Dàxuéshēng, 20~29 year old female. Ask Date: 2017/06/12

Dr. Hong Yuanbin reply Internal Medicine

Hello, the symptoms of tuberculosis are often very atypical, making it difficult to simply distinguish whether it is pulmonary tuberculosis based solely on symptoms.
Conditions such as chronic allergies, rheumatic autoimmune diseases, and chronic bronchitis can present similar symptoms.
It is recommended to consult a pulmonologist or a family medicine physician.
Typically, a chest X-ray is performed first to check for signs of tuberculosis.
If confirmation is needed, sputum tests or further examinations may be required to rule out other diseases.
Thank you for your inquiry.

Reply Date: 2017/06/12

More Info

Hello! It sounds like you are experiencing a concerning pattern of periodic low fever, along with some other symptoms such as mild weakness and a cough. Based on the information you've provided, let's break down your symptoms and explore possible causes, as well as the next steps you should consider.

Firstly, a low-grade fever is typically defined as a body temperature ranging from 37.3°C (99.1°F) to 38.5°C (101.3°F). Your reported temperatures of 37.7°C to 37.8°C fall within this range, indicating that you are indeed experiencing low-grade fever. The fact that your temperature returns to normal after a night's sleep is also noteworthy, as this pattern can sometimes suggest a non-infectious cause, such as stress, fatigue, or even hormonal fluctuations.

The presence of mild weakness and a cough, especially if accompanied by chest discomfort, raises some important considerations. While your symptoms could be related to a variety of conditions, it is essential to rule out any serious infections, including respiratory infections or conditions like tuberculosis (TB), especially given your concerns about chest pain when coughing. TB can present with a chronic cough, fever, and weight loss, but it is important to note that many other conditions can cause similar symptoms.

Here are some potential causes for your symptoms:
1. Viral Infections: Common viral infections can cause low-grade fevers, fatigue, and respiratory symptoms. These can include influenza or other upper respiratory infections.

2. Bacterial Infections: Conditions such as pneumonia or bronchitis could also lead to similar symptoms. If your cough worsens or if you develop more significant chest pain, it would be prudent to seek medical attention.

3. Tuberculosis: As you mentioned, TB is a possibility, especially if you have been exposed to someone with the disease or if you have risk factors. A chest X-ray and a tuberculin skin test or interferon-gamma release assay (IGRA) can help rule this out.

4. Non-Infectious Causes: Stress, anxiety, and fatigue can also manifest as low-grade fever and weakness. If you have been under significant stress or have had changes in your sleep patterns, this could contribute to your symptoms.

5. Autoimmune Conditions: Certain autoimmune diseases can cause periodic fevers and systemic symptoms. If your symptoms persist, further evaluation may be warranted.

Given your symptoms, here are some recommended next steps:
- Consult a Healthcare Provider: It is crucial to discuss your symptoms with a healthcare professional. They may recommend a physical examination and a detailed history to assess for any underlying conditions.

- Diagnostic Tests: Depending on your healthcare provider's assessment, they may suggest blood tests, a chest X-ray, or sputum tests to evaluate for infections or other conditions.

- Monitor Symptoms: Keep track of your symptoms, including any changes in your cough, the presence of sputum, or any new symptoms such as fever spikes or night sweats. This information can be valuable for your healthcare provider.

- Rest and Hydration: In the meantime, ensure you are getting adequate rest and staying hydrated. This can help your body recover and may alleviate some of your symptoms.

In conclusion, while your symptoms could be due to a variety of causes, it is essential to take them seriously, especially with the presence of chest pain and a cough. Seeking medical advice is the best course of action to ensure a proper diagnosis and treatment plan. Please take care of yourself, and I hope you find relief soon!

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