Persistent High Body Temperature: When to Seek Medical Help

Abnormal elevated body temperature?

Hello doctor, I am inquiring on behalf of my wife, who is 28 years old.
Here is the situation: she has had an elevated body temperature for about two weeks, with different readings from each ear.
One ear measures between 36.8°C and 37.4°C, while the other ranges from 36.8°C to 37.7°C.
The temperatures vary each time, often showing one ear at over 37°C while the other is in the 36°C range.
Regardless of how we measure, one ear consistently exceeds 37°C, with the highest recorded temperature being 37.7°C, which then drops to 37.4°C after about two hours.
Prior to this, her body temperature was consistently between 35°C and 36.5°C, and she has never experienced such prolonged elevated temperatures.
She also has symptoms including lower abdominal pain and soreness, which sometimes alternates sides, and occasionally pain in her buttocks.
Additionally, she has experienced dizziness, fatigue, a feeling of bloating, and low mood, but does not have any cold symptoms.
There is also intermittent pain in the vaginal area, described as a feeling of being stretched.
Initially, we suspected a gynecological issue, but after visiting a gynecologist, the doctor reported everything was normal, with no abnormalities in the uterus or vagina, and confirmed she is not pregnant.
The doctor prescribed some pain relief medication, but her condition has not improved.
I would like to ask the doctor which specialty we should consult for my wife's condition and what could be causing these symptoms.

You Ni, 20~29 year old female. Ask Date: 2020/05/21

Dr. Liao Yaopan reply Family Medicine

Hello, your persistently elevated body temperature may primarily be due to an infection, but other causes such as autoimmune diseases or tumors should also be ruled out.
It is recommended to seek further evaluation from specialists in infectious diseases and immunology/rheumatology.
Please note that online consultations are not equivalent to in-person medical visits and cannot provide a diagnosis or treatment recommendations.
Changhua Hospital cares about your health.

Reply Date: 2020/05/21

More Info

When it comes to persistent high body temperature, especially in the context of your wife's symptoms, it's essential to approach the situation with a comprehensive understanding of potential underlying causes and the appropriate steps to take. Given that your wife has been experiencing elevated temperatures for about two weeks, along with various other symptoms, it is crucial to consider both the physiological and pathological aspects of her condition.

Firstly, the normal body temperature for adults typically ranges from 36.1°C to 37.2°C (97°F to 99°F). A temperature consistently above this range, particularly if it fluctuates between 36.8°C and 37.7°C, can indicate a mild fever or a low-grade fever. While this may not seem alarming at first glance, the persistence of these symptoms, especially in conjunction with other complaints such as abdominal pain, dizziness, fatigue, and emotional changes, warrants further investigation.

The variability in temperature readings between the two ears could be attributed to several factors, including the method of measurement, the presence of earwax, or even slight differences in blood flow to each ear. However, the fact that one ear consistently shows a higher temperature suggests that there may be an underlying issue that needs to be addressed.

The symptoms your wife is experiencing—lower abdominal pain, feelings of pressure, and emotional changes—could be indicative of several conditions. Since a gynecological examination has ruled out issues related to the uterus and vagina, it may be beneficial to consider other potential causes. These could include:
1. Infections: Persistent low-grade fevers can often be associated with infections, such as urinary tract infections (UTIs) or pelvic inflammatory disease (PID). These conditions can sometimes present with abdominal pain and discomfort without overt symptoms like fever or chills.

2. Inflammatory Conditions: Conditions such as endometriosis or other inflammatory disorders can lead to chronic pain and may also affect body temperature regulation.

3. Hormonal Imbalances: Hormonal fluctuations, particularly those related to the menstrual cycle, can sometimes lead to changes in body temperature and mood.
4. Autoimmune Disorders: Certain autoimmune conditions can cause persistent low-grade fevers and a variety of systemic symptoms.

5. Stress and Mental Health: Emotional and psychological factors can also manifest physically, leading to symptoms such as fatigue, mood changes, and even physical pain.

Given the complexity of her symptoms and the duration of her elevated body temperature, it would be advisable to seek further medical evaluation. A good starting point would be to consult with a primary care physician or an internist who can perform a thorough assessment, including a detailed history and physical examination. They may recommend additional tests, such as blood tests, imaging studies, or referrals to specialists, depending on their findings.

In summary, while your wife's temperature readings may not indicate a severe medical emergency, the persistence of her symptoms suggests that further evaluation is necessary. It is essential to address both the physical and emotional aspects of her health to arrive at a comprehensive diagnosis and appropriate treatment plan. Seeking medical attention sooner rather than later can help in identifying any underlying issues and ensuring that your wife receives the care she needs.

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