Persistent Fever: Is It Due to Tonsillitis?

Tonsillitis with recurrent fever for two weeks?

Hello Doctor: Since January 8th, I suddenly experienced throat discomfort and stomach pain.
Upon pressing the sides of my neck, I noticed swelling and significant pain, accompanied by a high fever of 39 degrees Celsius.
I visited a clinic and after taking medication, my fever subsided, but I had low-grade fevers for three days upon waking up.
On January 13th, I went to a major hospital for treatment.
At that time, I had a fever, so I was asked to wait in the emergency room.
A chest X-ray was normal, and tests for influenza and pneumonia were negative, but I had mild urethritis.
I took antibiotics for three days (but experienced severe edema).
On January 14th, I felt better after vomiting, and on January 15th, I vomited again but felt even better.
However, to this day, I still wake up with low-grade fevers (around 38 degrees Celsius), and I continue to experience edema and significant abdominal bloating, which is somewhat painful when pressed.
On January 20th, I visited an ENT specialist, who noted that my throat was still very red and swollen.
I mainly want to ask if my recurrent fevers (with one or two days without fever in between) are related to tonsillitis? Or do I need to further investigate the urethritis? (I have no discomfort when urinating.) Do I need to wait for the tonsillitis to resolve before my fever subsides? It has been 14 days of fever so far...
or would you recommend seeing a specialist for a more detailed examination? Thank you.
🙏🏻

Miss Wang, 20~29 year old female. Ask Date: 2021/01/21

Dr. Ji Zhaoyun reply Otolaryngology

Hello, if you have confirmed that you have undergone treatment but are still experiencing recurrent fevers for 14 days, it is recommended to revisit an otolaryngologist to assess the condition of your tonsils and simultaneously consult an infectious disease specialist to investigate the possibility of other infectious foci.
If symptoms persist, it is advisable to consult an oncologist to examine for lymphatic lesions.
Wishing you a speedy recovery.

Reply Date: 2021/01/21

More Info

Persistent fever can be a challenging symptom to navigate, especially when it is accompanied by other signs such as throat discomfort, abdominal pain, and swelling. In your case, the timeline of your symptoms suggests a complex interplay of factors that may or may not be related to tonsillitis.

Tonsillitis, which is the inflammation of the tonsils, can indeed cause fever, sore throat, and swelling in the neck. The fact that you experienced a high fever (39 degrees Celsius) and throat pain initially supports the possibility of tonsillitis. However, the persistence of low-grade fever (around 38 degrees) for an extended period, along with symptoms like abdominal pain and swelling, indicates that there may be more than just tonsillitis at play.

Your medical evaluations, including chest X-rays and tests for influenza and pneumonia, returned negative, which is reassuring but does not rule out other infections or inflammatory processes. The presence of urinary tract infection (UTI) symptoms, even if mild, could also contribute to systemic symptoms like fever. It’s important to note that UTIs can sometimes present with atypical symptoms, and the fact that you were treated with antibiotics suggests that your healthcare provider was considering this as a potential source of your symptoms.

The swelling you mentioned could be related to several factors, including fluid retention from the antibiotics, inflammation from the infection, or even a reaction to the medications. The gastrointestinal symptoms, such as vomiting, could also be a response to the infection or a side effect of the medications you were taking.

Given that you have been experiencing these symptoms for over two weeks, it is crucial to follow up with your healthcare provider. If your throat remains red and swollen, it may indicate ongoing inflammation or infection that needs further evaluation. You might benefit from seeing an ear, nose, and throat (ENT) specialist if you haven’t already, as they can provide a more detailed examination of your throat and tonsils.
Additionally, if the low-grade fever persists, it may be worthwhile to consider other potential causes, such as autoimmune conditions, chronic infections, or even malignancies, especially if you have a history of immune system issues. Blood tests, including a complete blood count (CBC) and inflammatory markers (like C-reactive protein or erythrocyte sedimentation rate), could provide more insight into what is happening in your body.

In summary, while tonsillitis could be a contributing factor to your symptoms, the persistence of fever and other systemic signs suggests that a comprehensive evaluation is necessary. It would be prudent to consult with your primary care physician or a specialist to explore further diagnostic options and ensure that any underlying conditions are addressed. Your health is paramount, and persistent symptoms warrant thorough investigation to arrive at an accurate diagnosis and appropriate treatment plan.

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