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21 Feb 2003

24 Hour fever
My Husband is 47 years old. For the past 6 months he has had the same problem at regular intervals of at least 3 or 4 weeks. He wakes up in the morning and complains that his body is aching, especially down his spine and his shoulders. Within the next 4 to 5 hours he developes the most violent fever. One minute his teeth are chattering and he is shivering and the next the sweat will be poring off him and he will be burning up. This last for the remainder of the day. The next morning he is completely recovered, and does not feel ill anymore. The only medication that I give him is Inza which is an anti-inflammatory. Could you please let me know what we should be looking for?
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Expert
CyberDoc
CyberDoc

01 Jan 0001

Worried, by definition he suffers from chronic PUO (pyrexia of unknown origin) – a difficult thing to treat. It will require thorough investigation by a specialist physician to get to the bottom of it. The most common causes of chronic PUO are infections, neoplasms and connective tissue disease. I’ll give you a list of the most common causes, but he will have to go for tests (often repeatedly) until they get to the bottom of it.
Infections: TB, toxoplasmosis, actinomycosis, psittacosis, candidiasis, malaria, amoebiasis, brucellosis, salmonellolis, “hidden” abscesses in the liver, kidney, pelvis and abdomen, Q fever, other fungi and virusses.
Neoplasms: lymphoma and leukaemia.
Connective tissue disease: rheumatoid arthritis, polyarteritis nodosa, systemic lupus erythematosis, gaint cell arteritis and acute rheumatic fever.
Other causes: drug reactions, sarcoidosis, pulmonary emboli, inflammatory bowel disease, intracranial pathology, familial Mediterranean fever, etc.
As you can see, this isn’t a DIY job and it might take some time before you have an answer. Good luck.
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