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Dr. P. Jyoti
Dr. P. Jyoti, Consultant MD
Category: Health
Satisfied Customers: 8941
Experience:  17 yrs experience in treating OPD & Emergency patients.
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unspecified chronic fever History of early stage 1 renal

Resolved Question:

unspecified chronic fever:
History of early stage 1 renal cell carcinoma and removal of kidney. 14 months later, I developed fever. The chances of rcc was 5%. Large bruises appear, feet hurt with trouble walking. The fever was once a month in Dec thru Feb. In March, they came every 2 wks; May they were every 9 or 10 days. Fever is now about every 5 days. They always are over 102, or 103 degrees. There is nothing that penetrates them, and now disableling. They last a day. I've had cultures done in a hospital with a 102.5 fever. There was no bacteria, fungus, parasite or anything abnormal that would cause a fever. I've been tested for rhematoid arthritis, leukemia, pneumonia, or blood disorders. I have had bone biopsy, bone marrow aspirations, cat scans, x-rays, and ultra sounds. Oncologist concluded untreatable, hepatologist predicts organ failures if untreated. Retired in Feb at 53, need to work but I'm too sick! Please, help! Infectious Dr no findings. Any suggestions? Debby
Submitted: 5 years ago.
Category: Health
Expert:  Dr. P. Jyoti replied 5 years ago.
This condition of unexplained fever is called PUO, or Pyrexia of Unknown Origin.

The three main causes of PUO are:

Infectious
Cancers
Autoimmune

You have already been examined for all three.

To rule out infectious diseases, you should consult your infectious disease specialist again. You should go over the list of infectious diseases given in the links below and discuss whether they have all been eliminated. Some infectious agents which might not have been tested for are Brucellosis, borellia, endocarditis, cholangitis, cytomegalovirus, epstein barr virus and fungal infections.

Your oncologist will have ruled out most causes of cancers.

To rule out autoimmune conditions, you should consult a rheumatologist. Although Rheumatoid arthritis has been ruled out, there are many other autoimmune conditions which can casue such fever and a rheumatologist would be the best specialist for this.

You should read up here:

http://www.patient.co.uk/showdoc/40000333/
http://www.emedicine.com/med/topic785.htm




I hope my answer has helped you. Please click on the green ‘accept' button below for accepting this answer. Feedback/Bonus will be appreciated.



Dr. P. Jyoti, Consultant MD
Category: Health
Satisfied Customers: 8941
Experience: 17 yrs experience in treating OPD & Emergency patients.
Dr. P. Jyoti and 4 other Health Specialists are ready to help you
Customer: replied 5 years ago.
I just want to say thank you. You have given me hope that maybe this rhematologist i have an appointment with Aug 31 will help me to do some further testing. Yesterday, when the oncologist said he was sure the fever was untreatable, I don't know why but I asked him to refer me to a rhematologist. One happen to be down the hall. I retired Feb 15, started school Feb 23 and thought during this period I would find out about my fever so I can work after medical billing and coding school which will end Dec 14. Lately, I don't know if I continue with the school or try to file for Social Security. I quess I will keep keeping on. Thank you for the hope, Debby

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