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Fever of unknown origin
Any infection disease specialist here kindly reply so that i can book a consultation ASAP. My brother 26, has fever since 25 days all investigations are normal including ct, dengue malaria, lft, echo, bp
Answers (29)
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Fever lasting 25 days needs a structured in-person review even when the tests listed so far are reported as normal. Those results do not exclude every cause, and it is important to review what was tested, when, and how the symptoms have evolved.
Next Steps
Please arrange prompt review with an internal medicine physician or infectious disease specialist. Bring all reports, a temperature diary, current and recent medicines, and details of travel, exposures and other symptoms. A coordinated review is more useful than repeating an arbitrary panel.
Health Tips
Go to emergency care for confusion, breathlessness, fainting, severe headache with neck stiffness, dehydration or unusual bleeding. Do not delay care while searching for an online reply.
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1. Kindly don't get panicked. Paying attention over the solution is appreciated. Consult general practitioner or physician via practo or Kindly visit nearby clinic in person.
2. Attention paid over the complaints, need thorough evaluation and management to solve.
3. Thank you for sharing via practo.
Next Steps
Kindly consult above specialists to reduce complications further.
Health Tips
1. Stay hydrated
2. Focus on easily digestible foods
3. Adequate rest and take antipyretic
tab pct500mg (1Morning-1afternoon-1night) post meals to stabilize high fever and tepid sponging temporarily.
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A fever lasting 25 days with baseline panels unrevealing fits classic Pyrexia of Unknown Origin (PUO) criteria and requires a systematic diagnostic approach beyond routine infectious screens. In a young patient, we need to broaden the workup to evaluate occult bacterial or deep-seated infections (e.g., serial blood and urine cultures, tuberculosis/GeneXpert, brucellosis,Scrub typhus, infective endocarditis), autoimmune and connective tissue disorders (ANA profile, rheumatoid workup, inflammatory markers like ESR, CRP,iron profile and serum ferritin), and lymphoproliferative etiologies. Please share his complete blood counts, peripheral smear, recent CT reports, travel/exposure history, and current temperature chart so I can guide and direct management promptly.
— Dr. Arijit Sinha
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A fever persisting for 25 days despite initial investigations requires a systematic medical evaluation. Please arrange a consultation with a physician as soon as possible.
Next Steps
Please carry all previous reports, including blood tests, cultures, imaging, details of medicines taken and a record of temperature readings. Further investigations should be guided by his symptoms, examination and exposure history rather than repeating tests indiscriminately. If he has breathing difficulty, confusion, severe weakness, persistent vomiting, reduced urine output or other signs of serious illness, please take him to an emergency department immediately. Avoid self-medication or starting antibiotics without medical advice.
Health Tips
If he has breathing difficulty, confusion, severe weakness, persistent vomiting, reduced urine output or other signs of serious illness, please take him to an emergency department immediately. Avoid self-medication or starting antibiotics without medical advice.
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A fever persisting for 25 days despite normal initial investigations requires a detailed clinical evaluation. Normal CT and routine blood tests do not rule out all possible causes of prolonged fever.
I would recommend reviewing the complete investigation reports, fever pattern, associated symptoms, travel history, medication history, and performing a thorough physical examination. Further investigations should be guided by the clinical findings rather than repeating tests blindly. An in-person evaluation by a physician or infectious disease specialist is advisable.
You can consult me through the Practo app for a detailed review of the case and guidance regarding the next steps in evaluation and management.
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Any fever that lasts for more than 3 weeks is considered as FUO , especially when the investigations are reported as normal.There are a number of infectious disease specialists available for consultation on practo platform,you can search in your area, consult physically for a clinical examination, appropriate investigations and management
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The history is too less to give a complete diaganosis and treatment.
Next Steps
Document the fever objectively, Also keep records of SPO2 BP Pulse input output
note if any other symptoms are consistent.
Repeat Complete Baseline
CBC with differential, platelet count and peripheral smear
ESR and CRPLFT: AST/ALT, ALP, GGT, bilirubin, albumin
RFT, electrolytes and serum calcium
Urine routine microscopy and urine culture
Three sets of blood cultures before antibiotics, from separate venipunctures
LDH and serum ferritinTSH
For Autoimmune causesANA, rheumatoid factor and ANCA, guided by clinical findings
Chest X-ray PA view, if not already done
Also evaluate for TB , Brucella
if still no dx
evaluate for lymphoma andnother hematological disorders
Health Tips
Meanwhile Keep Patient Hydrated, Have Balanced Diet, Proper Rest, Get Evaluated Properly
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Fever lasting over three weeks with a fully negative workup, including CT, dengue, malaria, LFT, echo and BP, fits what's usually called fever of unknown origin. This needs a more targeted round of tests to look for things like tuberculosis, deeper infections or an autoimmune cause that the first set of scans wouldn't catch.
Next Steps
An infectious disease specialist or general physician can order the next round, usually blood cultures, inflammatory markers like ESR and CRP, a chest X-ray, and specific tests for TB. Carry all his existing reports to that visit so nothing gets repeated unnecessarily.
Health Tips
If he develops weight loss, night sweats, joint pain or a new rash, mention it specifically, since it can point the workup in a useful direction. Please have him see an infectious disease specialist soon.
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