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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Recurring High Fever, Shivering, Body Pain, Bone Pain, Sore Throat. Possibility Of TB. Treatment?

I am sick from last 6 weeks. I have now every second week very high tempreature with shivering . It last few hours and then I feel very warm. My gp suggest that I have tb. I am not coughing and neither I had lost weight. I also eat well. The only thing is disturbing me is tempreature which brings body pain, soar throat and severe bones pain. Soon tempreature off I feel better but it come back again. I have been gone through so many test like sputum test, culture test, blood test and ct scan . So far no medication has been given just paracetamol . Ian fed up with uk NHs queue system. Now I have next appointment on 29 jan. can not wait that long please advice me something
Fri, 4 Jan 2013
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Psychiatrist 's  Response
Hello and welcome to Healthcare Magic. Thanks for your query.

I understand that the persistent fever has been causing you a lot of distress and suffering. You seem to be having a "Fever of Unknown Origin(FUO)". Any fever which is persistent for more than 3 weeks and remains undiagnosed despite having multiple hospital visits and 1 week of all the basic tests is classified as FUO.

Extrapulmonary tuberculosis is the most frequent cause of FUO, which is why your doctor must be suspecting the same. Now extra-pulmonary tubeculosis does not involve the lungs and so does not have the typical symptoms of cough, sputu, weight loss, etc. and the regular tests done to detect TB (like sputum tests for TB) will all be negative. In such cases, a special test like Interferon TB Gold may be applied to detect the presence of TB infection. In some cases, when all possible tests have been done, and there is a suspicion of TB, empirical treatment for TB can be started even without an established diagnosis.

I can understand that it can be very frustrating to have persistent symptoms without a diagnosis. But unfortunately, the evaluation of FUO needs a systematic approach, ruling out all possibilities one by one, starting from the most common to the least common. So, please be patient and liaise with your GP regarding further evaluation and treatment.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
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Recurring High Fever, Shivering, Body Pain, Bone Pain, Sore Throat. Possibility Of TB. Treatment?

Hello and welcome to Healthcare Magic. Thanks for your query. I understand that the persistent fever has been causing you a lot of distress and suffering. You seem to be having a Fever of Unknown Origin(FUO) . Any fever which is persistent for more than 3 weeks and remains undiagnosed despite having multiple hospital visits and 1 week of all the basic tests is classified as FUO. Extrapulmonary tuberculosis is the most frequent cause of FUO, which is why your doctor must be suspecting the same. Now extra-pulmonary tubeculosis does not involve the lungs and so does not have the typical symptoms of cough, sputu, weight loss, etc. and the regular tests done to detect TB (like sputum tests for TB) will all be negative. In such cases, a special test like Interferon TB Gold may be applied to detect the presence of TB infection. In some cases, when all possible tests have been done, and there is a suspicion of TB, empirical treatment for TB can be started even without an established diagnosis. I can understand that it can be very frustrating to have persistent symptoms without a diagnosis. But unfortunately, the evaluation of FUO needs a systematic approach, ruling out all possibilities one by one, starting from the most common to the least common. So, please be patient and liaise with your GP regarding further evaluation and treatment. Wish you all the best. Regards, Dr. Jonas Sundarakumar