Recurring Monthly Fevers: Unraveling the Mystery Beyond Flu and COVID

Recurring fever every month that is neither influenza nor COVID-19?

Since changing jobs in the second half of last year, I've been experiencing a lot of health issues (previously, I would only catch a cold once every six months).
In May, I developed numerous unexplained red spots on my thigh, which were occasionally itchy, but they faded after two weeks, so I didn't pay much attention to them.
For a while, my health was normal, although I did experience gastrointestinal discomfort due to stress.
However, from November 23 to February 24, I had high fevers almost every month, each time starting with a sore throat, followed by a fever that ranged from 37 to 40 degrees Celsius, along with body aches and fatigue lasting for 2 to 3 days.
Initially, I took over-the-counter medications to reduce the fever, but I found that they were ineffective, and I eventually needed to see a doctor to recover.
In January and February, I tested for COVID-19 and influenza, both of which were negative.
In February, I also experienced a new symptom of ear fullness! My eating schedule is irregular due to working at a department store, but I try to get a full 8 hours of sleep each night.
I have a history of mitral valve prolapse and seasonal nasal allergies, which cause post-nasal drip, and I also have mild anxiety for which I take medication.
I'm wondering what could be going on? I suspect my immune system might be compromised, but I'm unsure which specialist to consult—should I see an ENT specialist? The medication prescribed by the doctor in February included Erythromycin, Mucodyne, and a cough relief complex capsule (PS: none of my close contacts have caught my cold, even after sharing food with me).
When I first graduated, I experienced occasional tinnitus, which only occurred during stressful times, about once every three to four months, but it would resolve quickly.
After starting my new job in May, I experienced it more frequently, with one severe episode where I could barely hear customers speaking, but it resolved quickly.
I haven't had that issue for a while now.

Luna, 20~29 year old female. Ask Date: 2024/02/13

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your inquiry.
Recurrent fever is still a concern, and I recommend that you see a rheumatologist for further evaluation and testing.
The Allergy, Immunology, and Rheumatology Department at Changhua Hospital of the Ministry of Health and Welfare is here to assist you.

Reply Date: 2024/02/13

More Info

Recurring monthly fevers can be a perplexing and concerning issue, especially when they are accompanied by other symptoms such as sore throat, body aches, and fatigue. Given your history of experiencing these fevers since changing jobs, along with your existing medical conditions, it’s essential to consider a multifaceted approach to understand the underlying causes.

Firstly, the pattern of your symptoms suggests that you may be dealing with a recurrent infection or an inflammatory condition. The fact that you experience a sore throat followed by a high fever indicates that there could be an infectious agent involved, even if tests for COVID-19 and influenza have returned negative. Viral infections, such as those caused by adenoviruses or other respiratory viruses, can sometimes present with similar symptoms and may not always be detected by standard tests. Additionally, bacterial infections, particularly those affecting the throat or sinuses, could also be a possibility.

Your mention of experiencing a significant amount of stress and gastrointestinal discomfort is also noteworthy. Stress can have a profound impact on the immune system, potentially leading to increased susceptibility to infections. Chronic stress can result in the release of cortisol, which, while initially helpful in managing acute stress, can suppress the immune response over time. This could explain why you are experiencing these recurrent fevers and illnesses more frequently than before.

The presence of the red spots on your thigh, which resolved on their own, could indicate a dermatological reaction or an allergic response, possibly linked to your seasonal allergies. Allergies can exacerbate respiratory symptoms and may contribute to a cycle of inflammation that affects your overall health.

Given your existing conditions, such as mitral valve prolapse and seasonal allergies, it is crucial to approach this situation holistically. Consulting with a primary care physician or an internist would be a good starting point. They can perform a thorough evaluation, including blood tests to assess your immune function, inflammatory markers, and any potential underlying infections. If necessary, they may refer you to a specialist, such as an allergist or an infectious disease expert, for further evaluation.

In addition to medical evaluation, consider lifestyle modifications that can support your immune health. Prioritize a balanced diet rich in vitamins and minerals, particularly vitamin C and zinc, which are known to bolster immune function. Regular physical activity, adequate hydration, and stress management techniques, such as mindfulness or yoga, can also play a significant role in improving your overall well-being.

Lastly, keeping a symptom diary may help you and your healthcare provider identify any patterns or triggers associated with your fevers. Note the frequency, duration, and any accompanying symptoms, as well as any potential environmental or dietary changes that coincide with the onset of your symptoms.

In summary, while recurring fevers can be indicative of an underlying issue, a comprehensive approach involving medical evaluation, lifestyle changes, and stress management can provide clarity and potentially alleviate your symptoms. It’s essential to seek medical advice to rule out any serious conditions and to develop a tailored plan for your health moving forward.

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