Persistent Low-Grade Fever and Back Lump: Possible Causes and Next Steps

Mild fever for a week, chills (sudden cold awakening at night), and a sudden hard lump on the back?

Hello, I am currently working in mainland China and will need some time before I can return to Taiwan for medical treatment.
Therefore, I would like to ask for a preliminary diagnosis based on my symptoms.
Last Tuesday evening (September 15), I suddenly developed a fever with a temperature close to 38 degrees Celsius, but I did not have any cough or runny nose.
I experienced dizziness, weakness in my limbs, and mild diarrhea.
However, the week prior, I had experienced chills for several consecutive days and had a sore throat for just one day.
As of now (September 21), I still have a slight fever, with axillary temperatures ranging from 36.4 to 36.7 degrees Celsius, which is considered a low-grade fever.

This morning, I suddenly woke up cold in bed (the air conditioning was set to 24 degrees Celsius, and I was covered with a fall/winter blanket), and in the afternoon, I noticed a hard lump suddenly appeared on my back, which is painful to touch.
Yesterday (September 20) marked the onset of my menstrual period (I usually do not experience significant fever during my periods), and I am unsure if this is related, but I mention it for reference.

Over the past year, whenever I have a fever (regardless of whether I have a cough or runny nose), it takes more than five days for the fever to completely subside.
I have a habit of staying up late, usually between midnight and 1 AM.
During a health check two years ago, a gallbladder polyp measuring 0.7 cm was found, and there seems to be a hemangioma in my liver measuring 0.4 cm, which has been monitored annually without any signs of growth.

I would appreciate your assistance in diagnosing my condition.
Additionally, which specialty should I consult when I return to Taiwan? Would it be beneficial to consider traditional Chinese medicine for recovery?

smallhu, 30~39 year old female. Ask Date: 2009/09/21

Dr. Cai Yaozhou reply Internal Medicine

Visit the medical center to see the Infectious Disease Department for fever and the Surgery Department for a hard lump on the back.
For traditional Chinese medicine treatment, first go to the hospital's affiliated Traditional Chinese Medicine Department for consultation.

Reply Date: 2009/09/21

More Info

Based on your symptoms and medical history, it appears you are experiencing a combination of persistent low-grade fever, a new painful lump on your back, and some gastrointestinal issues. These symptoms can be indicative of several underlying conditions, and it is essential to approach them systematically.

Possible Causes
1. Infection: The sudden onset of fever, especially if it is accompanied by chills and malaise, could suggest an infection. This could be a localized infection, such as an abscess or cellulitis, particularly given the new lump on your back. The lump could be an inflamed lymph node or a skin infection, especially if it is painful to touch.

2. Inflammatory Conditions: Conditions such as autoimmune disorders (e.g., lupus or rheumatoid arthritis) can present with systemic symptoms like fever and localized pain.
3. Gastrointestinal Issues: The mild diarrhea you mentioned could be related to a viral infection or foodborne illness, which can sometimes accompany fever.
4. Hormonal Factors: Since you mentioned that your fever coincided with the onset of your menstrual period, it is worth considering that hormonal fluctuations can sometimes lead to mild systemic symptoms, although a fever of this nature is not typical.

5. Chronic Conditions: Your history of gallbladder polyps and liver hemangiomas should be monitored, but they are unlikely to be directly related to your current symptoms unless there is a complication.

Next Steps
1. Medical Evaluation: It is crucial to see a healthcare provider as soon as possible. Given your symptoms, you should consider visiting a primary care physician or an internal medicine specialist. If the lump on your back becomes more painful, red, or swollen, or if you develop additional symptoms like difficulty breathing or severe abdominal pain, you should seek immediate care.

2. Diagnostic Tests: Your doctor may recommend blood tests to check for signs of infection (such as elevated white blood cell count), inflammatory markers (like ESR or CRP), and liver function tests. Imaging studies, such as an ultrasound of the lump or a CT scan, may also be warranted to evaluate the nature of the lump and any potential underlying issues.

3. Symptom Management: In the meantime, you can manage your fever with over-the-counter medications like acetaminophen or ibuprofen, ensuring you stay hydrated. Monitor your symptoms closely, particularly the fever and the lump.

4. Consideration of Traditional Medicine: If you are interested in traditional Chinese medicine (TCM) for supportive care, it may help with symptom management, particularly for stress and overall wellness. However, it should not replace conventional medical evaluation and treatment.

5. Follow-Up: Once you return to Taiwan, it would be advisable to follow up with a healthcare provider. You may want to see a general practitioner first, who can then refer you to a specialist if necessary. Given your symptoms, a visit to an infectious disease specialist or a rheumatologist may also be appropriate, depending on the findings.

Conclusion
Your symptoms warrant a thorough evaluation to rule out serious conditions. While some causes may be benign, others could require prompt treatment. It is essential to prioritize your health and seek medical attention as soon as possible. Keep track of your symptoms, and do not hesitate to seek help if your condition worsens.

Similar Q&A

Understanding Persistent Fever and Back Pain: A Guide for Busy Professionals

Hello Dr. Liao, I apologize for taking up your time. I am a working individual, 155 cm tall and weighing 43 kg, and I have been troubled by back pain for a long time. Over the past year, the pain has worsened, radiating from my spine to a deep point in my epigastric area. During ...

Dr. Liao Zhongxin reply Internal Medicine
Dear readers: 1. If you experience chronic back pain, general fatigue, and low-grade fever, you should first consult a neurosurgeon or orthopedic specialist to determine if it is due to poor posture, scoliosis, or spinal issues. 2. Taiwan is considered a high-prevalence area for ...

Persistent Low-Grade Fever: Symptoms, Concerns, and Next Steps

Hello Doctor, I have been experiencing recurrent low-grade fevers since last Friday afternoon, and it has now been a week with no improvement. I visited a clinic where the doctor prescribed Tamiflu, but it has not been effective. My symptoms include persistent low-grade fever (ov...

Dr. Li Jian reply Internal Medicine
It is recommended that you go to the infectious disease department for further blood tests. Thank you for your inquiry.

Persistent Low-Grade Fever: Possible Causes and Next Steps for Evaluation

Hello, doctor. Last August, I had a fever reaching 38 degrees Celsius (ear temperature), which dropped to 37.7 degrees on the same day. However, I have been experiencing a persistent low-grade fever ranging from 37 to 37.5 degrees until March of this year. In March, I had two ins...

Dr. Chen Bozhang reply Family Medicine
Dear Ms. Tsai, I understand from your letter that you have been experiencing persistent low-grade fever since August of last year, and various examinations have not revealed a cause. Generally, the potential causes of continuous fever may include infections, rheumatologic and au...

Understanding Recurrent Fever: Causes and Concerns in Adults

Hello Doctor: Two years ago, on October 10th, while I was walking with a friend after visiting a night market, I started to feel pain in the back of my head, which then radiated to my back. Generally, I experience pain in the back of my head when I am very tired, but it usually r...

Dr. Liao Zhongxin reply Internal Medicine
Hello Nancy: 1. The fever and headache on October 10, 2005, may indicate a viral infection, possibly even symptoms of a central nervous system infection. After treatment (such as intravenous fluids and medication), the white blood cell count quickly rose from over 1000 to 4000,...