Persistent Fever: Should I Get a Blood Test?

[Defennder]

Hey guys I'm not looking for a diagnosis here, but I kind of need advice as to what I should do next. I have been down with fever since last Friday and I have been like shivering with cold at times followed by sweating. I've seen my doctor twice about this and I was prescribed some fever medication which I have taken every 4 hours as instructed. My body temperature has always been measured at 37.3 degrees Celsus lowest and 39.3 highest.

Most of the time when I feel chilly it'll be around 38.5 degrees Celsius, but it'll later drop the 37.4 degrees when I have taken the medication. I don't know whether this is expected of a normal fever but my doctor did recommend a blood test for me tomorrow, which is about less than a week after the fever outbreak started. She said it may be dengue or something known as chiku fever (not sure if I got it right). Is this too soon or should I follow her advice?

 

[Evo]

Follow her adice, if you've had a fever for almost a week, you need to find out the cause.

 

[hypatia]

Please YES, follow the advice of your doctor. Doing otherwise could produce some very grim results.

 

[Defennder]

Yeah I think I'll play it safe. But that also means I'll end up missing a few more days of lectures and tutorials, which really sucks.

 

[Moonbear]

Yeah I think I'll play it safe. But that also means I'll end up missing a few more days of lectures and tutorials, which really sucks.

Better than delaying treatment on something serious and missing the rest of the year or rest of your life due to illness. Hopefully you get a quick diagnosis and rapid treatment. Feel better!

 

[Defennder]

I just got the results of the blood test from my doctor. Turns out it wasn't dengue, nor even a viral fever. It was a bacteria infection. I never had a fever this bad ever before, though. But how long is a typical fever, if there is such a thing, expected to last?

 

[shirrok]

The fever is going to last as long as you have the infection, to some extent. The ups and downs you experienced were associated with the life cycle of the bacteria. As your medicine inhibits or kills the bacteria, the fevers will subside because fewer organisms will be coursing through your system.

 

[Moonbear]

If it's bacterial, just make sure you take the full course of antibiotics prescribed according to the doctor's orders, even if you start to feel better before you're done taking them.

 

[jim mcnamara]

Listen to Moonbear - Murray Perahia lost several years of concert piano work due to having a bacterial infection - and not running the full prescribed course of antibiotic.

 

[Defennder]

I'm following through the antibiotic treatment as prescribed. I still feel quite ill at times, was woken up rudely in the middle of the night at 3am because of a burning sensation at my neck. But the moment I got up, I started feeling chilly again. I took my temperature then, and discovered the fever was back (it was 38.5 degrees Celsius). I thought I had felt better earlier on the whole evening through the night.

But on the point of viral and bacterial fevers, is it actually possible to have more than 1 type of fever at the same time? A viral fever like dengue. along with a bacterial fever, or another viral fever?

 

[Defennder]

The fever is going to last as long as you have the infection, to some extent. The ups and downs you experienced were associated with the life cycle of the bacteria. As your medicine inhibits or kills the bacteria, the fevers will subside because fewer organisms will be coursing through your system.

Then I should be expecting my temperature increase to be less severe over time? Or would I be experiencing the fever chills and symptoms at a lower rate of occurrence with equal severity?

 

[Moonbear]

But on the point of viral and bacterial fevers, is it actually possible to have more than 1 type of fever at the same time? A viral fever like dengue. along with a bacterial fever, or another viral fever?

Well, fever is fever, but you can indeed have a viral and bacterial infection at the same time. Usually one illness leaves you susceptible to a second. For example, someone with flu who is doing a lot of coughing and irritating the lining of their bronchioles may wind up with a secondary bacterial infection (i.e., pneumonia) that takes hold because of the reduced barrier where all the irritation has occurred.

You're going to need to give the antibiotics time to work before the fever will go away, and then keep taking them to ensure the infection is completely cleared up. The fever is your body's natural way of trying to kill off the bacteria.

 

[Defennder]

Well, I'm down to the last pill of the antibiotics prescription. The fever has lessened in severity, though. I no longer have to shiver under blankets like before, but I still experience the headaches associated with the fever. It kind of prevents me from concentrating on studying for my midterms. And there doesn't seem to be anything I can do about it, except wait it out and make another trip to the doctor for more antibiotics.

One question, if fever is the body's natural way of killing off bacteria, then wouldn't taking paracetamol to bring down the temperature actually be counter-productive?

 

[Moonbear]

Well, I'm down to the last pill of the antibiotics prescription. The fever has lessened in severity, though. I no longer have to shiver under blankets like before, but I still experience the headaches associated with the fever. It kind of prevents me from concentrating on studying for my midterms. And there doesn't seem to be anything I can do about it, except wait it out and make another trip to the doctor for more antibiotics.

If you finished all your antibiotics and still have the symptoms, definitely call the doctor back. They should check that the strain of bacteria you have is sensitive to the antibiotic you were taking and that you don't still have a resistant strain continuing to make you ill.

One question, if fever is the body's natural way of killing off bacteria, then wouldn't taking paracetamol to bring down the temperature actually be counter-productive?

It depends on how high your fever is. If you're taking antibiotics to kill the bacteria and the fever is getting high enough to be dangerous to yourself, something to reduce the fever won't hinder the antibiotic from working, but will help avoid side effects of fever (or even help you feel well enough to do things like eat properly so you have the strength to keep fighting off the infection).

 

[Defennder]

Well okay I'm out of antibiotics, and I went today to the hospital to see if the doctor could prescribe some more for me. The physician who examined me earlier and whom prescribed the 5-pill antibiotics course has gone on leave and would not return till next Friday, but my fever still persists, although less severe.

What's strange is that the doctor at the hospital whom I consulted today for the first time did a blood test on me and compared the results to the blood test done by the previous doctor about 4 days earlier. He noted that the infection was still present, but he didn't prescribe the same antibiotics as the doctor before. Before, I was on the course of 5 Klacid MR 500mg pills, over time which I felt the fever lessen in severity. But now this doctor prescribed a different course of antibiotics altogether, which from the medicinal packaging, I see "Amoxicillin 500mg, Clavulanate 125mg tab".

What I don't understand is why he didn't prescribe the same type of antibiotics as before, especially when the first one appeared to be working. I told him that I no longer experienced chills and high fevers, only moderate fevers though it has yet to subside completely, and now he put me on a new course of medication. According to him, the blood test that was performed on me today could not discern the type of bacterial infection, so I don't think it's because he knew it was a bacterium which the previous antibiotic course did not cover. So what prompted him prescribe something different?

Any ideas?

 

[Moonbear]

Well, the likely reason is that the first antibiotic DIDN'T fully work...the bugs that survived the first one might be resistant to the first antibiotic. Amoxicillin is a broad-spectrum antibiotic, so unless you've had a culture done to specifically check for the type of bacteria and what antibiotics it is sensitive to, that's a good one to use when guessing.

 

[Defennder]

Thanks for answering my questions, Moonbear. By the way I just came across this which was referenced on Wikipedia, which says that bacterial infections would usually last more than 2 weeks:

http://www.antibiotics-info.org/bact02.asp

So that means I still have about 4 more days to go for a minimum of 2 weeks.