Persistent Fever for Days: Causes and Solutions

Having a high fever that has persisted for three to four days without subsiding?

Hello Doctor, I have been experiencing a fever since the first day, with an initial temperature around 38.5 degrees Celsius.
I went to see a doctor, who noted that my throat was particularly red.
The next morning, my temperature dropped to around 37.5 degrees Celsius, possibly due to taking antipyretics, but for some reason, it spiked again in the evening, accompanied by abdominal pain and diarrhea.
The abdominal pain and diarrhea lasted for a day until I took an anti-diarrheal medication, which provided some relief.
By the fourth day, although the previous symptoms had resolved, I developed a severe headache, and my temperature remained around 39 degrees Celsius.
Taking antipyretics only reduced my fever to about 38 degrees Celsius.
I am unsure of the cause.
Thank you, Doctor.

Miss Zhang, 10~19 year old female. Ask Date: 2021/05/20

Dr. Lin Wufu reply Internal Medicine

Hello! I apologize for the late response due to the pandemic.
First, your situation requires screening to rule out COVID-19, as patients with COVID-19 can present with symptoms such as fever, sore throat, and diarrhea.
If the screening is negative, the next consideration would be other viral infections, which usually improve on their own.
You are also welcome to visit the infectious disease outpatient clinic for further evaluation and treatment.

Reply Date: 2021/05/20

More Info

Persistent fever can be a concerning symptom, especially when it lasts for several days and is accompanied by other symptoms such as abdominal pain and diarrhea. Understanding the underlying causes of persistent fever is crucial for effective management and treatment.

Fever is a common response of the body to infection, inflammation, or other medical conditions. In your case, the initial presentation of a sore throat and redness in that area suggests a possible upper respiratory infection, which could be viral or bacterial in nature. Viral infections are more common and often resolve on their own, but bacterial infections may require antibiotic treatment.

The fluctuation in your temperature, where it drops after taking antipyretics (fever-reducing medications) but then rises again, is typical in many infections. The fact that you experienced abdominal pain and diarrhea could indicate a gastrointestinal component to your illness. Gastroenteritis, which can be caused by viruses (like norovirus or rotavirus) or bacteria (like Salmonella or E. coli), often presents with fever, abdominal pain, and diarrhea.
The persistence of your fever at around 39 degrees Celsius, despite taking medication, raises the concern for a more serious underlying condition. Infections such as pneumonia, urinary tract infections, or even more systemic infections like sepsis could present with similar symptoms. Additionally, conditions such as inflammatory diseases (like appendicitis or pancreatitis) or even non-infectious causes (like autoimmune disorders) could also lead to prolonged fever.

Given that your symptoms have persisted for several days, it is essential to seek further medical evaluation. A healthcare provider may recommend a series of diagnostic tests, including:
1. Blood Tests: These can help identify signs of infection (elevated white blood cell count), inflammation (elevated C-reactive protein), and assess liver and kidney function.

2. Urinalysis: This can help rule out urinary tract infections, which can sometimes present with fever and abdominal pain.

3. Imaging Studies: Depending on your symptoms, a chest X-ray or abdominal ultrasound may be warranted to check for pneumonia or other abdominal issues.

4. Stool Tests: If diarrhea persists, testing for pathogens in the stool may be necessary to identify any infectious causes.

5. Throat Culture: If a bacterial infection is suspected, a throat swab can help identify streptococcal bacteria or other pathogens.

In the meantime, it is crucial to stay hydrated, especially if you are experiencing diarrhea. Oral rehydration solutions can help replenish lost fluids and electrolytes. Rest is also essential for recovery.

If your fever continues to persist or worsens, or if you develop new symptoms such as difficulty breathing, severe abdominal pain, or confusion, you should seek immediate medical attention. Persistent fever can sometimes indicate a serious underlying condition that requires prompt treatment.

In summary, while fever can be a common symptom of various infections, the persistence of your symptoms warrants further investigation to determine the underlying cause. It is essential to work closely with your healthcare provider to ensure appropriate tests and treatments are initiated.

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