Prolonged Fever: When to Seek Medical Attention

Q: Prolonged Fever: When to Seek Medical Attention

Hello： Based on your description, there is a significant chance of a viral infection, and other possibilities such as tuberculosis or autoimmune diseases cannot be ruled out. <br>If the fever persists, I recommend that you return to the hospital's infectious disease department fo

Fever for one week?

Fever for a week, with daily temperatures exceeding 38 degrees Celsius, except for one day.
On the fourth day of the fever, I was examined in the infectious disease department of the hospital, where my WBC was 4400, CRP was 0.4, and platelet count was 298,000.
Other symptoms included joint pain and sore throat.
Due to the persistent fever, I returned for a follow-up on the seventh day, where my WBC was 6400, CRP was 0.39, and platelet count was 290,000.
Most symptoms remained similar, but I experienced some skin reactions resembling allergies, with intense itching and small rashes that resolved quickly.
During the fever, I also experienced palpitations with a heart rate of 120 beats per minute.
Additionally, tests for rheumatoid arthritis were negative.
The physician suggested a possible adenovirus infection but could not rule out the possibility of an autoimmune disease.
I researched online and found that adenovirus infections seem to occur mostly in children.
Can adults also get infected? I am uncertain whether my current condition is an infection or something else.
If the fever persists, at what point should I see a doctor again?

fang, 20~29 year old female. Ask Date: 2010/10/07

Dr. Qiu Zhengbin reply Internal Medicine

Hello: Based on your description, there is a significant chance of a viral infection, and other possibilities such as tuberculosis or autoimmune diseases cannot be ruled out.
If the fever persists, I recommend that you return to the hospital's infectious disease department for further evaluation.
If the cause remains unidentified, you should seek care at a medical center.
Wishing you a speedy recovery.

Reply Date: 2010/10/07

More Info

Prolonged fever, particularly when it exceeds 38 degrees Celsius (100.4 degrees Fahrenheit) for an extended period, can be a concerning symptom that warrants medical attention. In your case, experiencing a fever for a week, with daily temperatures above 38 degrees, alongside symptoms such as joint pain, sore throat, and skin reactions, indicates that further evaluation is necessary.

From the information provided, your laboratory results show a white blood cell (WBC) count that is within normal limits, albeit on the lower end, and a C-reactive protein (CRP) level that is also within a normal range. These results suggest that there may not be a significant bacterial infection, as elevated WBC counts and CRP levels are typically associated with such infections. However, the presence of symptoms like joint pain, sore throat, and skin reactions could indicate a viral infection or an autoimmune condition.

Adenovirus infections can indeed occur in adults, although they are more commonly associated with children. Adults can experience a range of symptoms from mild respiratory illness to more severe manifestations, including fever, sore throat, and gastrointestinal symptoms. The fact that your physician mentioned the possibility of adenovirus infection aligns with your symptoms, but it is also crucial to consider other potential causes, including autoimmune diseases, which can present with similar symptoms.

The itching and rash you described could be a manifestation of an allergic reaction or a viral exanthem, which is a rash associated with viral infections. The heart palpitations and elevated heart rate (tachycardia) you are experiencing could be related to fever, anxiety, or even an underlying infection. It is essential to monitor these symptoms closely.

In terms of when to seek further medical attention, consider the following guidelines:
1. Persistent Fever: If your fever continues beyond a week, especially if it remains high (over 38 degrees Celsius), it is advisable to return to your healthcare provider for further evaluation.

2. Worsening Symptoms: If you experience any worsening of your symptoms, such as increased joint pain, difficulty breathing, severe sore throat, or any new symptoms, seek medical attention promptly.

3. Signs of Dehydration: If you notice signs of dehydration (such as decreased urination, dry mouth, or dizziness), it is crucial to seek help.

4. Neurological Symptoms: If you experience confusion, severe headache, or any neurological symptoms, these warrant immediate medical evaluation.

5. Skin Reactions: If the rash worsens or you develop additional rashes, especially if accompanied by fever, it is essential to consult a healthcare provider.

6. Heart Symptoms: Given your reported heart rate of 120 beats per minute, if you experience chest pain, shortness of breath, or any other concerning cardiovascular symptoms, seek emergency care.

In conclusion, while your current symptoms may suggest a viral infection, the possibility of an autoimmune condition should not be overlooked. Continuous monitoring of your symptoms and proactive communication with your healthcare provider is essential. If your fever persists or worsens, or if you develop new concerning symptoms, do not hesitate to seek further medical evaluation. Your health and well-being are paramount, and timely intervention can lead to better outcomes.

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