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Dr. D. Evans
Dr. D. Evans, Doctor (MD)
Category: Health
Satisfied Customers: 4464
Experience:  MS in ENT and Head and Neck Surgery , Attachment to Neurosurgery.
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My Father, age 59, has been suffering from a prolonged ...

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My Father (age 59) has been suffering a prolonged fever for the past two-three months. It started out as low-grade (99-100) accompanied by mild fatigue. About a month ago, the symptoms subsided and we thought he had recovered. Starting last week, he has been running a higher fever (usually around 100... but a few times it has reached as high as 104!).

He has been to the doctor several times, was referred to an infectious disease Doctor - had an MRI, CAT scan, multiple blood tests done... all showing up negative. No cancer, no pneumonia, no hepatitis, etc...

The infectious disease doctor at first thought he might be having a relapse of Rocky Mtn Spotted Fever (which he had several years back), but now he says it is not.

My father has had very bad sleep habits since he graduated college in the 60's. He stays up almost all the night. I was wondering if sleep deprivation could be a cause of his ailments?

If not, what do you think his problem could be? Where can he go for help?
Submitted: 8 years ago.
Category: Health
Expert:  Dr. D. Evans replied 8 years ago.

This condition of unexplained fever is called PUO, or Pyrexia of Unknown Origin.

While he is under investigation, you should rehydrate him adequately by having him drink large amounts of electrolyte fluids, electrolyte solutions can be bought OTC at pharmacies, you should discuss this with the pharmacist.


PUO could be both due to infectious diseases and non-infectious causes. There are a large number of infectious causes such as Miliary Tuberculosis, Lyme disease, Mycoplasma, Riccketsia, etc. Non-infectious causes include hyperthyroidism, cancers, etc.


The person to see for this is an Infectious Diseases Specialist for this. You have already done so and he also apparently failed to find any cause. Most of the other causes in the list also like cancer, etc. have been ruled out. In the circumstances, he would be considered a true PUO. Some cases of pyrexia of unknown origin really remain 'of unknown origin' despite many investigations. Of course it cannot really be on unknown origin, there is probably some cause which remains undetected either because the disease was subclinical or we not have the tests yet to detect the disease. Most such cases get better by themselves without the cause ever being found out, but in some cases the subclinical disease eventually becomes clinical, for example, a very mild hepatitis undetected by tests later becomes detectable.

Since you are following the correct protocol, you should continue to persist with this. Work closely with the infectious disease specialist and the other doctors. You should look up these sites for more info:
http://www.patient.co.uk/showdoc/40000333/
http://www.emedicine.com/med/topic785.htm




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