Fever since 1 and half month. I do?

There is an entity called pyrexia/fever of unknown origin or PUO. This is actually not a diagnosis but means that there is a chronic fever the cause of which is unknown and proper steps should be taken to diagnose the cause of the fever with history, clinical examination and investigation. Since your throat infection is cured and there is no throat pain or tonsillitis presumably at present, the cause is not that for all practical purposes. Still I would like to check your throat. There are many types of fever and you haven't mentioned about it. Is it high grade above 101 degree F or low below 101 ? Daily fever or on alternate days ? Any other associated symptoms like rigor, tummy pain, burning urine, cough, headache, bodyaches, breathlessness etc ? Any unprotected sexual exposure ? Any exposure to contagious illnesses or foreign travel recently ? Any condition which lowers immunity like diabetes or immunological diseases/rheumatoid/ Collagen autoimmune diseases ? Are you talking any type of medicines or supplements ? See, we have to deduce like Sherlock Holmes here so it would be much better if you let me check you.

Some investigation advised: Routine blood examination, platelets, ESR, CRP, WBC morphology and toxic granules and shift. Blood for malaria parasite. Serum urea, creatinine, FBS, ppbs, rheumatoid factor, anti-nuclear factors. Widal test, typhoid serology Igm, Blood bactec culture aerobic and  anaerobic paired samples.These are very few but important blood examination. Yes these are few for diagnosing PUO. Chest X-ray PA view. Ultrasound of Whole abdomen/CT abdomen. If there is any bone pain, do a Xray of that particular bone and bone scan or MRI of that bone may be advised by a doctor if X-ray is suspicious. Urine routine examination and culture. Last but not the least HIV 1/2 detection in blood. Even if you are sure of non exposure do the test if other tests reports are within normal limits. Some common causes of PUO : TB lung, Lymph node TB, lung pneumonia especially in an immunocompromised person, bacterial infections like typhoid, chronic malaria, renal tract abscess, collagen/rheumatoid arthritis, chronic osteomyelitis, liver abscess, intra abdominal TB and chronic suppurative infections, drug or supplements induced fever, splenic abscess, infective endocarditis which is serious, rheumatic fever but classically there would be joint pain or swelling first before the heart valves are affected and it occurs in childhood. There may be thousand other causes.

Brother, if you have become confused by reading this which is what at least I would have been if I were on the other side of the phone, I would advise you to come to my clinic or contact me for a thorough clinical examination because all these investigations are not done simultaneously. Only clinical findings direct a doctor which investigation should get priority. So this is not firing in the dark. Having said all these, sometimes PUO diagnosis is very troublesome, expensive and irritating to the patient, not to mention the physical and emotional pain. What would you have told your patient if you were the doctor ? The truth isn't it ? That's what I have done ! Feel free to contact me on my mobile.