What Causes High Fever In The Morning With Body Chills?
Details written below
Detailed Answer:
Hi, thanks for posting your concern in the HCM.
A prolonged high fever with chills need further clinical examination and investigation to rule out viral fever, malaria, pneumonia, UTI etc. Any internal ear pathology and dyselectrolytemia should also be ruled out because of the altered body balance. A tuberculous etiology should also be ruled out.
For the time being my recommendations are-
1. Tab Paracetamol 500 mg as and when required for fever, at min. 6 hr interval
2. Tab Immunace Forte- One tab once daily for 7 days.
3. Plenty of oral fluid and ORS- 3 to 4 l/ day
4. Light diet rich in fiber and if you are non-vegetarian, animal protein and green leafy vegetables.
I need further information to rule out differential diagnoses-
1. Do you have cold & cough, chest pain, breathing difficulty.?
2. Do you have burning sensation during urinating?
3. Do you have retro-orbital headache or joint pain or rash?
4. How is your bowel habit at present?
5. Do you have yellowish urine and pain in right upper abdomen?
6. Do you have weight loss for more than 10% of body weight in last one month?
7. Do you have dizziness, slurring of speech, numbness and impaired sensation, pins and needles feeling, muscle weakness, ringing sensation in the ear?
8. Do you have any chronic disease e.g. diabetes, hypertension etc.?
9. Have you ever had blood transfusion or unprotected sexual intercourse?
You need to have the following investigations done too.
1. Complete blood count, CRP, urea, creatinine, electrolytes, Malaria dual antigen, NS1 antigen
2. Urine routine examination
You should also consult a local neurologist for evaluation of impaired body balance with fever.
Please write back with above mentioned information for further evaluation.
If you think I have satisfactorily resolved your query, please close the thread & rate my answer.
In case you have any new query in future, you can directly ask me questions @ http://www.HealthcareMagic.com/doctors/dr-kaushik-sarkar/68460. I will try my level best to help you.
Regards,
Dr. Kaushik
Further details needed
Detailed Answer:
Thanks for your reply.
Before giving answer to any of your questions, I would like to know the reason for which you are having Hydromorphone.
However, Hydromorphone can cause Sensory neural hearing loss on prolonged use, that may present with ringing sensation, impaired balance etc.
You should also follow the recommendations given above and do the investigations mentioned.
Please consult your local physician to consider any alternative to opioid medications because exclusion of an ototoxic drug is needed in your case. You should be examined by an ENT surgeon to evaluate the magnitude of your disease and its cause, so that it can be treated at the earliest.
If you have any queries, please write back.
If you are satisfied with my answer, please close the thread and rate my answer.
Regards,
Dr. Kaushik