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What Causes High Fever With Neck Stiffness While Suffering From Chronic Lyme Disease?

Posted on Wed, 28 Dec 2016

Question: My wife has had a fever for 7 days along with a variety of other symptoms: headache, neck stiffness, sensitivity to light & sound, suffers from chronic lyme disease (which carries a couple of co-infections). She's been in and out of the ER the past 5 days and doctors can't seem to pinpoint what's wrong...even after a chest Xray, lumbar puncture, blood cultures, CT scan. Any advice?

Answered by Dr. Mahaveer Patil (45 minutes later)

Brief Answer:
Pyrexia of unknown origin

Detailed Answer:
Hi,

Thank you for posting the query.

I have gone through the medical history and understand your concern.

Primarily,from the symptoms,i would clinically diagnose her as having meningitis.
But if lumbar puncture has been done and if it has turned out to be normal,then other causes of fever should be considered.

Sometimes,there are cases where exact cause of the fever cannot be found out inspite of having all the tests done.
This usually happens in viral infections.WBC count will give a clue about active infection.

Pyrexia of unknown origin (PUO),needs a consideration here.
The fever occurs due to unknown causes and such types of fevers are usually self-limiting,resolve spontaneously within 2 weeks of onset of the fever.

Symptomatic treatment in the form of iv fluids,antibiotics,maintaining hydration and taking antipyretics should be given.

If symptoms still does not resolve,she needs to be admitted to the hospital and intravenous broad spectrum antibiotics need to be started.

I hope the answer was useful.

Feel free to ask me any further doubts that you may have.

Thank you.

Kind regards.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Mahaveer Patil (10 minutes later)

Thanks Dr. XXXXXXX

So, is Pyrexia just a clinical term for "fever" or is it something more severe? Does PUO just mean that she has a fever and nobody can figure out it's origin?

Answered by Dr. Mahaveer Patil (18 minutes later)

Brief Answer:
Nothing to worry about

Detailed Answer:
Hi,

Yes,pyrexia is just another clinical term for fever. Nothing serious.

PUO simply means a fever whose origin cannot be figured out by various tests.

Thank you.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Mahaveer Patil (5 minutes later)

Don't take this the wrong way but I think we already knew that she has a fever and we can't figure out the origin.

Is there any further insight to what might be causing it or the recommended treatment?

This definitely doesn't seem like nothing to worry about. My wife is suffering intense pain in her ears, head and neck...and even said her heart seems to be "turning over" (her words) and is seriously scared.

Perhaps I should also mention that she has shortness of breath and seems to be gasping for air when her fever elevates.

Answered by Dr. Mahaveer Patil (18 minutes later)

Brief Answer:
Query answered

Detailed Answer:
Hi,

I said "nothing to worry about" with reference to the word "pyrexia".

Don't think otherwise.

I understand that these complaints are definitely significant and she should be hospitalised as soon as possible.

There are many other tests meant for diagnosing diseases pertaining to various organs of the body.

e.g.- ECG,2-D echo for heart related causes.
Liver and kidney function tests for respective organ functioning.
MRI for brain and ear related causes. etc

Only when she is hospitalised,proper diagnosis and medical treatment can be offered.

I were your doctor,i would have admitted her under medical supervision and done further tests untill proper diagnosis is made.

Do let me know if you have any further doubts.

Thanks

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Nagamani Ng