Sudden High Fever: Causes and Concerns in Internal Medicine

Unexplained sudden high fever?

Two nights ago, I suddenly experienced full-body shaking and a headache.
The next day, I woke up feeling weak all over and had a severe headache.
Later in the afternoon, my temperature rose to 39.3°C, so I went to a clinic for evaluation.
I had no signs of a cold at all.
The doctor advised me to monitor my condition and only prescribed antipyretics.
After taking one dose, my fever completely subsided.
I would like to ask the doctor two questions:
First, in cases of more serious infections like HIV during the acute infection phase, would taking one dose of medication be sufficient to suppress the symptoms? I am concerned because two months ago, I was scratched on my hand by someone’s nail, and I have been anxious about it for a while.
I was originally going to get tested anonymously, but then hospital staff, upon hearing my situation, told me it was impossible, so I did not go for the test.
Is it possible to have an acute infection two months later?
My second question is about anal fissures with bleeding.
If there is a risk of bacteremia, would taking one dose of medication be enough to manage it? Thank you.

Niming, 30~39 year old female. Ask Date: 2019/03/29

Dr. Hong Yuanbin reply Internal Medicine

Hello,
1.
In cases of more severe bacterial infections, it is usually sufficient to take just one course of antibiotics to control the infection.
Based on your description, it seems more likely to be a viral infection or a mild bacterial infection, which should be monitored further.

2.
The majority of HIV infections occur through sexual contact, so it is highly unlikely to contract HIV from a nail scratch.

3.
HIV does have a latency period.
If you have engaged in high-risk sexual behavior and are experiencing fever or flu-like symptoms, it is indeed necessary to get tested.

4.
In individuals with normal immune function, anal fissures typically do not lead to bacteremia.
If bacteremia were to occur, it would not resolve with just one course of antibiotics, so the likelihood of you having bacteremia is very low.

Thank you for your questions.

Reply Date: 2019/03/29

More Info

Sudden high fever can be a concerning symptom, and understanding its potential causes is crucial for appropriate management. In your case, the sudden onset of fever, accompanied by shaking, headache, and subsequent weakness, raises several important considerations.

Firstly, the absence of typical cold symptoms (like cough, sore throat, or nasal congestion) suggests that your fever may not be due to a common viral upper respiratory infection. Instead, it could be indicative of a more systemic issue, such as a viral or bacterial infection, autoimmune disorder, or even a reaction to medication. Infections can manifest in various ways, and sometimes the body’s immune response can lead to fever without other overt symptoms.

Regarding your specific questions about HIV and acute infections, it is important to note that acute HIV infection can present with flu-like symptoms, including fever, fatigue, and headache. However, the severity and duration of symptoms can vary widely among individuals. While it is theoretically possible for a single dose of medication to temporarily reduce fever, it would not eliminate the underlying infection. If you were exposed to HIV, it is advisable to undergo testing regardless of the absence of symptoms, as early detection is crucial for effective management.

In terms of the timeline for acute HIV infection, it typically occurs within 2 to 4 weeks after exposure, but it can take longer for some individuals. Therefore, if you are concerned about a potential exposure, it is essential to get tested, as anxiety over the situation can exacerbate your symptoms and overall well-being.

Regarding your second question about anal fissures and the risk of bacteremia, it is important to understand that while anal fissures can lead to bleeding and discomfort, they do not typically cause systemic infections unless there is a significant underlying issue. If an infection were to occur, it would likely present with more severe symptoms, including persistent fever, chills, and possibly localized pain or swelling. A single dose of medication may alleviate some symptoms temporarily, but it would not be sufficient to treat a serious infection like bacteremia, which requires more intensive treatment, often including intravenous antibiotics.

In summary, if you experience sudden high fever, persistent symptoms, or any new concerning signs, it is crucial to seek medical attention promptly. A healthcare provider can perform the necessary evaluations, including blood tests and possibly imaging studies, to determine the underlying cause of your symptoms. Additionally, if you have concerns about potential infections, including HIV or bacterial infections related to anal fissures, do not hesitate to discuss these with your healthcare provider. Early intervention can significantly improve outcomes and provide peace of mind.

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