Persistent Low-Grade Fever and Immune System Concerns

Mild fever with elevated body temperature?

Hello Doctor, since April 22, my body temperature has been elevated, with ear temperature around 37-37.5 degrees Celsius.
The next day, I visited a pulmonologist, and I had increased sputum production in my lungs, so I was prescribed medication and advised to rest.
By April 29, my temperature remained elevated, and I felt fatigued.
After a blood test at the infectious disease clinic, my white blood cell count was elevated at over 12,000.
However, after reviewing my chest X-ray, the doctor noted the presence of sputum and assessed it as bronchitis, prescribing medication and advising me to rest, with a follow-up appointment in a week.

On May 4, during my follow-up, my white blood cell count returned to normal at around 10,000, and my lung condition had improved compared to the previous week.
However, my allergy index was elevated beyond normal levels, but the infectious disease doctor mentioned it was still acceptable and did not require special allergy testing.
Since my temperature remains elevated and uncomfortable, with ear temperature around 37.2-37.6 degrees Celsius, the infectious disease doctor stated that this does not constitute a fever and advised me to drink plenty of water and rest.
However, a colleague suggested that there might be an issue with my immune system (such as allergies, etc.).
Should I continue to investigate my immune and rheumatic system? There is a family history of lupus erythematosus, so I am uncertain if there is an issue with my immune system.
Alternatively, should I just rest and hydrate while observing for a few days? This is the first time I have experienced a sustained temperature above 37 degrees Celsius (my normal temperature is usually below 36.5), and I am unsure if this is simply due to my lung condition not fully recovering.

Wendy, 20~29 year old female. Ask Date: 2020/05/05

Dr. Liao Yaopan reply Family Medicine

Hello, the primary cause of fever is still likely to be an infection.
If the fever persists, other causes should also be investigated.
It is advisable to have an evaluation by an infectious disease specialist.
Online consultations are not equivalent to in-person medical visits and cannot provide a diagnosis or treatment recommendations.
Changhua Hospital cares about you.

Reply Date: 2020/05/05

More Info

Persistent low-grade fever can be a perplexing symptom, especially when it continues for an extended period, as you have described. Your experience of having a consistently elevated temperature ranging from 37 to 37.6 degrees Celsius, along with fatigue and respiratory symptoms, raises several important considerations regarding your health and immune system.

Firstly, it is essential to understand that a low-grade fever is often a sign of an underlying condition, typically an infection or inflammation. In your case, the initial diagnosis of bronchitis and the presence of phlegm suggest that your body has been responding to an infection. The fact that your white blood cell count was elevated initially indicates that your immune system was actively fighting off an infection. However, as you noted, your white blood cell count returned to normal, which is a positive sign that your body is recovering.

The persistence of a low-grade fever, even after the initial infection seems to have resolved, can be attributed to several factors. One possibility is that your body is still in the recovery phase from the bronchitis, and it may take some time for your immune system to fully stabilize. Additionally, elevated allergy markers can contribute to systemic inflammation, which might also manifest as a low-grade fever. Allergic reactions can cause the immune system to remain activated, leading to symptoms such as fatigue and mild fever.

Given your family history of autoimmune diseases, such as lupus (systemic lupus erythematosus), it is understandable that you may be concerned about your immune system's status. While having a family history of autoimmune conditions can increase your risk, it does not necessarily mean that you will develop one. However, if you continue to experience symptoms like persistent low-grade fever, fatigue, and any new or unusual symptoms, it would be prudent to consult with a healthcare provider specializing in immunology or rheumatology.

In terms of next steps, if your symptoms persist or worsen, it would be wise to seek further evaluation. This could include additional blood tests to assess your immune function, inflammatory markers, and possibly autoimmune screening tests. These tests can help determine if there is an underlying immune system issue that needs to be addressed.

In the meantime, focusing on self-care is essential. Adequate rest, hydration, and a balanced diet can support your immune system as it recovers. Monitoring your symptoms closely and keeping a record of any changes can also be beneficial when discussing your condition with your healthcare provider.

To summarize, while your persistent low-grade fever could be related to your recent bronchitis and allergies, it is essential to remain vigilant. If your symptoms do not improve or if you develop new symptoms, seeking further evaluation from a specialist would be a prudent course of action. Your health is paramount, and understanding the underlying causes of your symptoms will help guide appropriate treatment and management strategies.

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