Fever: Could It Indicate a Different Illness?

Fever

I have had a continuous fever for three days.
I went to the hospital for an examination.
I had blood and urine tests; the blood test results were normal, but they found an elevated white blood cell count in my urine, which suggests there might be some inflammation, leading to a suspicion of a urinary tract infection.
The doctor asked if I experienced any burning or pain during urination.
To be honest, I don't feel any of those symptoms at all.
However, after taking the antibiotics prescribed by the doctor, my fever has started to subside.
I would like to ask the doctor if it is possible that I could have another condition under these circumstances.

Xiao Fen, 10~19 year old female. Ask Date: 2005/06/06

Dr. Lin Mingfeng reply Internal Medicine

To identify the cause of fever, the easiest approach is to start with accompanying symptoms.
Aside from pyuria (indicating an excess of white blood cells in the urine), no other accompanying symptoms were mentioned in the problem.
However, statistically, a urinary tract infection (UTI) is still the most likely cause.
Some girls with UTIs may have subtle urinary symptoms.
Additionally, the causes of pyuria could include interstitial nephritis, lupus nephritis, or urinary stones accompanied by hematuria.
However, these conditions are less common and usually present with other medical history or clinical findings, so the likelihood is low.

Reply Date: 2005/06/06

More Info

Fever is a common symptom that can indicate a variety of underlying conditions, and understanding its implications is crucial for proper diagnosis and treatment. In your case, having a fever for three consecutive days, along with the discovery of elevated white blood cells in your urine, suggests a potential urinary tract infection (UTI). While you do not currently experience symptoms like burning or pain during urination, it is important to note that UTIs can sometimes present with atypical symptoms, especially in certain populations.

The presence of fever often signifies that your body is responding to an infection or inflammation. Infections, whether viral or bacterial, are the most common causes of fever. In your situation, the antibiotics prescribed by your doctor seem to be effective, as indicated by the reduction in fever. This is a positive sign that the treatment is addressing the underlying infection.

However, your concern about whether you might have another illness is valid. While UTIs are a common cause of fever, other conditions can also lead to similar symptoms. For instance, kidney infections (pyelonephritis), which can arise from untreated UTIs, may present with fever, chills, and flank pain. Additionally, systemic infections, such as pneumonia or sepsis, can also cause fever and may not always present with the classic symptoms associated with those conditions.

Given that your blood and urine tests did not reveal any other significant issues, it is less likely that you have another serious illness at this time. However, if your symptoms persist or worsen, or if you develop new symptoms such as severe abdominal pain, persistent vomiting, or changes in mental status, it is essential to seek further medical evaluation.
In some cases, the absence of typical UTI symptoms does not rule out the infection. Some individuals, particularly the elderly or those with weakened immune systems, may not exhibit the classic signs of a UTI. Therefore, it is crucial to monitor your symptoms closely and maintain open communication with your healthcare provider.

In summary, while your current fever and urinary findings suggest a UTI, the possibility of other underlying conditions cannot be entirely dismissed. Continue to follow your doctor's advice, complete the course of antibiotics, and keep track of any changes in your symptoms. If you have any concerns or if your fever returns, do not hesitate to reach out to your healthcare provider for further assessment. Early intervention can be key in preventing complications and ensuring a swift recovery.

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