Recurrent Fever: Immune System Challenges and Solutions

Repeated fever over the past two months?

Hello, since May, I have noticed that my immune system has been getting weaker.
I used to rarely get sick, but on May 8, I discovered I had shingles (the doctor said it was due to stress and a decline in immunity, and prescribed zinc for me).
After recovering, on June 9, I suddenly had a high fever at night (reaching 39 degrees Celsius), and during that week, I often felt the need to take deep breaths, with an itchy sensation in my lungs that made me want to cough.
The next day, I saw a doctor who suspected an upper respiratory tract infection; I tested negative for COVID-19, and was prescribed medication for a cold and fever.
After taking the medication for a few days, my condition improved.

On July 14, I suddenly had a fever again at night, so I took antipyretics, and I was fine the next day.
However, on July 21, I had another fever reaching 39 degrees Celsius at night.
The next day, the doctor tested me for COVID-19 again, which was negative, but I was diagnosed with influenza A.
I took antiviral medication and rested at home for over a week.
During that time, my fever fluctuated, but after a few days, I no longer had a fever, just a runny nose and a hoarse throat (with very little coughing).

Until this morning, July 30, I felt fine, but in the evening, I had a fever of 38.9 degrees Celsius again.
I thought I had recovered from the flu; why am I having a fever again? Is it possible that my immune system has been weak since May, causing me to have recurrent fevers so easily? What could be the reason? Which specialist should I see, and what tests should I undergo to assess my immune system and check for other conditions? Thank you very much.

Ning, 20~29 year old female. Ask Date: 2023/07/30

Dr. Liao Zhongxin reply Internal Medicine

1.
Since you have been diagnosed with influenza type A and are receiving treatment with oseltamivir, it is important to rest well and allow your immune system to recover to eliminate the virus from your body.

2.
As for persistent symptoms after infection, this is common with COVID-19, and influenza can also have lingering symptoms for 7 to 10 days; therefore, it is essential to wear a mask and maintain personal hygiene and a normal daily routine.

Reply Date: 2023/07/30

More Info

Recurrent fever can be a perplexing and distressing symptom, especially when it occurs frequently over an extended period. Your experience of having recurrent fevers since May, coupled with a history of shingles and respiratory infections, raises important questions about your immune system's functionality and overall health.

Firstly, it is crucial to understand that the immune system plays a vital role in protecting the body against infections. When the immune system is compromised, whether due to stress, underlying health conditions, or other factors, it can lead to an increased susceptibility to infections, resulting in recurrent fevers. In your case, the shingles outbreak you experienced in May could have been a sign of a weakened immune response, often triggered by stress or illness.

The pattern of your fevers, along with the diagnoses of upper respiratory infections and influenza, suggests that your immune system may be struggling to mount an effective response to pathogens. The fact that you tested negative for COVID-19 during these episodes is reassuring, but it does not rule out other viral or bacterial infections that could be contributing to your symptoms.

To address your concerns, it is advisable to consult with a healthcare professional, preferably an immunologist or an infectious disease specialist. They can conduct a thorough evaluation of your immune system and overall health. Here are some potential steps they may recommend:
1. Comprehensive Blood Tests: These tests can assess various components of your immune system, including white blood cell counts, immunoglobulin levels, and markers of inflammation (such as C-reactive protein and erythrocyte sedimentation rate). Elevated inflammatory markers could indicate ongoing infection or inflammation.

2. Immunological Assessment: Specific tests can evaluate the functionality of your immune cells, including T-cells and B-cells, which are crucial for adaptive immunity. This assessment can help identify any deficiencies or abnormalities in your immune response.

3. Review of Medical History: A detailed review of your medical history, including any previous infections, chronic conditions, and medications, can provide insights into potential underlying causes of your recurrent fevers.

4. Lifestyle and Stress Management: Since stress has been identified as a potential trigger for your immune challenges, discussing lifestyle modifications, including stress management techniques, adequate sleep, and nutrition, can be beneficial.

5. Vaccination Status: Ensuring that you are up to date with vaccinations, including the flu vaccine and others, can help bolster your immune defenses against common infections.

6. Follow-Up Care: Regular follow-up appointments will be essential to monitor your condition and adjust treatment plans as necessary. If an underlying condition is identified, targeted therapies may be required.

In conclusion, recurrent fevers can indeed be indicative of underlying immune system challenges. Your symptoms warrant a comprehensive evaluation to determine the root cause and appropriate management strategies. By working closely with healthcare professionals, you can gain a better understanding of your immune health and take steps toward improving your overall well-being. Remember, early intervention and proactive management are key to addressing recurrent infections and enhancing your immune response.

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