Persistent Low-Grade Fever: Possible Causes and Treatments

Q: Persistent Low-Grade Fever: Possible Causes and Treatments

Hello： The diagnosis of your condition may need to be determined by the treating physician based on a comprehensive assessment of your symptoms. <br>If the X-ray results are normal, pneumonia can likely be ruled out. <br>If you have yellow nasal discharge, you should consult an e

Persistent recurrent low-grade fever?

Three weeks ago, I experienced cold symptoms, including a sore and itchy throat, nasal congestion, mild fever, and muscle aches (ear temperature did not exceed 38.0°C).
After visiting an ENT specialist, I started medication and began to develop thick phlegm.
After stopping the medication, most symptoms improved, but after two or three days, I started to experience mild fever and throat itchiness again.
I visited a family medicine clinic, where the doctor suggested that the recurring fever might be due to a bacterial infection and prescribed antibiotics for three days.
After three days, the symptoms seemed to have improved, but two days later, I started to experience mild fever again and had severe coughing at night.
I returned for another consultation, and the doctor noted lung crackles upon auscultation, diagnosing me with pneumonia.
I was prescribed antibiotics again, and the next day, my cough improved significantly, with only occasional thick phlegm.
However, I continued to experience recurrent mild fever, with ear temperatures ranging from 36.6°C to 37.9°C, along with muscle aches and fatigue.
My appetite is fine, and I have no other symptoms.
Today, I visited a major hospital for an X-ray, and the doctor found no abnormalities in my lungs.
I would like to inquire about what this condition might be.

yuko, 30~39 year old female. Ask Date: 2015/12/19

Dr. Yang Wenda reply Pulmonology

Hello: The diagnosis of your condition may need to be determined by the treating physician based on a comprehensive assessment of your symptoms.
If the X-ray results are normal, pneumonia can likely be ruled out.
If you have yellow nasal discharge, you should consult an ear, nose, and throat specialist.
Recovery of physical strength and mental well-being may take a few more days.
It is recommended to drink plenty of water to help lower your body temperature.
Since the weather is cooler in the mornings and evenings, please wear a jacket to avoid catching a cold again! Best wishes!

Reply Date: 2015/12/19

More Info

Persistent low-grade fever can be a perplexing symptom that often leads to a series of medical evaluations and treatments. In your case, the history of upper respiratory symptoms followed by recurrent low-grade fevers suggests that there may be an underlying infectious or inflammatory process at play.
When evaluating persistent low-grade fever, it is essential to consider various potential causes. Infections, particularly viral and bacterial, are common culprits. Your initial symptoms of sore throat, nasal congestion, and muscle aches could indicate a viral upper respiratory infection, which is often self-limiting. However, the subsequent development of thick phlegm and the need for antibiotics suggest that a bacterial infection may have developed, possibly as a secondary complication.

The fact that you experienced improvement with antibiotics but then relapsed into low-grade fever indicates that the infection may not have been entirely resolved, or there could be another underlying issue. Conditions such as pneumonia, as diagnosed in your case, can lead to persistent symptoms even after initial treatment. The presence of lung crackles (rales) during auscultation suggests that there may still be some residual inflammation or infection in the lungs, which could explain the ongoing low-grade fever and fatigue.

In addition to infections, other causes of persistent low-grade fever include autoimmune diseases, malignancies, and chronic inflammatory conditions. Given that your X-ray showed no abnormalities in the lungs, it may be prudent to consider other diagnostic tests if the fever persists. Blood tests, including complete blood count (CBC), inflammatory markers (like C-reactive protein or erythrocyte sedimentation rate), and cultures, can help identify any ongoing infection or inflammatory process.

It is also important to consider environmental factors and lifestyle choices that may contribute to your symptoms. Stress, inadequate rest, and poor nutrition can weaken the immune system and prolong recovery from infections. Ensuring adequate hydration, nutrition, and rest is crucial in supporting your immune system during this time.

If your symptoms continue despite treatment, or if you develop new symptoms such as significant weight loss, night sweats, or persistent cough, it is essential to follow up with your healthcare provider. They may recommend further imaging studies, such as a CT scan of the chest, or refer you to a specialist for more in-depth evaluation.

In summary, persistent low-grade fever can arise from various causes, including unresolved infections, autoimmune conditions, or malignancies. Given your recent history of pneumonia and ongoing symptoms, it is crucial to maintain close communication with your healthcare provider to monitor your condition and adjust treatment as necessary. If symptoms persist or worsen, further investigation will be warranted to ensure that any underlying issues are addressed promptly.

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