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Fluctuating fever for 5 days, all tests negative

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Fluctuating fever for 5 days, all tests negative

Postby c_alcazar » Tue Sep 23, 2008 9:39 pm

Hi,

A friend of mine has had fever for the last 5 days. The fever comes back at specific times of the day, around 2-3 am and during the afternoon and then dies down around 7 am or early afternoon. A blood test has been conducted and platelet count is within normal range, so dengue has been eliminated. (However, is it too early to detect for dengue?). He's also had stool test and urinalysis and all came out normal as well.

This is what he feels:
Headaches throughout the day
Swollen lymph nodes (next to the ear and one more somewhere on the leg)
fluctuating fever
expectorating clear gelatinous phlegm (but not coughing)
swollen/puffy eyes

a doctor has come to visit and gave him augmentin because she says it could be an infection. however, the fever has still been following its regular " schedule". is it too soon to gauge the effects of augmentin?

what could be the possible cause and what should we do in the meantime?

thank you very much for your help!
c_alcazar
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Re: Fluctuating fever for 5 days, all tests negative

Postby John Kenyon, CNA » Sun Oct 12, 2008 9:30 pm

Hello -

This sounds like a fairly typical viral infection that's found a home in the upper respiratory tract. The thick, tenacious mucous being brought up is usually an exudate that forms in the back of the pharynx, and so long as a bacterial superinfection doesn't develop this should run its natural course in around a week's time. The Augmentin should prevent or knock down any opportunistic bacterial infection, but the viral infection, if that's what it is (certainly sounds like it) will simply have to run its course, as there is very little that can be done to resolve viral things.

Dengue fever would be accompanied by a rash and excruciating joint pain (this the nickname "bonecrusher disease"). This doesn't sound like that, at least so far, although it could be a mild case. In any event dengue fever usually runs a course of about seven days anyway. It is usually diagnosed based on the clinical picture (high fever, severe headache, the characteristic joint pains, disabling dizziness, etc., plus a postive "tourniquet test", in which a constricting band is applied to an extremity and this causes spontaneous bleeding or brusing in the extremity, and via lab tests yielding a very high red cell count. This doesn't seem to be the case either.

Most any fever, bacterial or viral, tends to fluctuate regularly, peaking in the afternoon and again during the night. This is classic for most any febrile disease.

Hopefully by now your friend has recovered or is at least feeling better. I hope this is helpful to you.
John Kenyon, EMT, CCT
Non-invasive cardiology tech, Emergency and Critical Care technician, Critical Incident Stress Mgmt. specialist
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