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911DOC
911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5087
Experience:  Emergency Medicine Physician
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Hello! two days ago I had a sudden onset of fever, lower back

Resolved Question:

Hello! two days ago I had a sudden onset of fever, lower back & leg muscle pain, headache. No sinus & lung infection. An unusual combination of symptoms of a typical flu. As the condition worsened I ended up in the ER where they gave 2 drip fluid injection and Tylenol for fever. They were concerned about meningitis because headache was not going away but CT scan was normal. After some food the headache also dissipated. I was released and told to immediately go to ER if conditions worsen.

A day later I still feel weak, but the strange thin is that my body temperature (measured under the tongue with a high quality digital thermometer) is fluctuating between 97.6 and 101.4 degrees all within a couple of hours. I go from sweating to feeling normal to feeling very cold and back to sweating again!

I never experienced such a temperature swing with a viral infection. Is this normal and shoul I just ride the heat wave out for a few days or go back to ER?

Thank you,
Brian
Submitted: 12 months ago.
Category: Medical
Expert:  911DOC replied 12 months ago.

911DOC :

did they do a lumbar puncture? a spinal tap?

911DOC :

standing by

911DOC :

the reason I ask is that you mention that the ER docs were considering meningitis...

911DOC :

well, if that is so, the only way to rule that out and to make sure you don't have it is to do a lumbar puncture or spinal tap

911DOC :

a ct does not disprove meningitis

911DOC :

in fact it woudl be normal in most cases

911DOC :

standing by

911DOC :

to respond place your cursor in the box below and type then click 'reply'

Customer: They were considering a spinal tap especially since blood pressure was dropping. But after some food BP came back up and headache dissipated so they did not do the spinal tap (which I prefer not to do unless absolutely necessary)
911DOC :

then we can not say that you did not have meningitis and do not have it now

911DOC :

if you do it is likely viral

911DOC :

and will pass

911DOC :

because the bacterial kind would have killed you

911DOC :

which is why when I consider a spinal tap

911DOC :

on a patient

911DOC :

I make them sign informed consent if they refuse

911DOC :

do you have a rash?

Customer: No rash. And considering the rapid onset of flu-
Customer: like symptoms I assumed viral infection. Could it be bacterial? By the way I forgot to mention severe throat pain when swallowing which does not go away even with the pain medication
911DOC :

have you been out of the country recently?

911DOC :

in the woods?

911DOC :

camping?

911DOC :

standing by

Customer: No
911DOC :

okay

911DOC :

so would you say you are better today than yesterday?

Customer: But in February I contracted herpes from my girl friend who did not know she had one. And last night I started with a few minor sores.
911DOC :

pretty typical... stress or illness can bring on a recurrence of herpes

911DOC :

where are the sores?

Customer: Headache is much better. Muscle ache is much better. Fever and temp fluctuation is worse, and I feel good at times and very weak at others, fluctuating with the temp
911DOC :

that's okay, that's typical

911DOC :

this does sound viral

911DOC :

standing by

Customer: One small sore on the penis shaft, a couple at the site of pubic hair!
911DOC :

okay

911DOC :

so I do not think you need to go back to the ER, certainly not tonight

911DOC :

it's times like these when having a primary care physician

911DOC :

as if you go back to the ER you will likely not see the same doctor

911DOC :

and they will have to start over

911DOC :

but

911DOC :

as long as you are making improvement

911DOC :

even with the shaking and the chills

911DOC :

I do not think you need to go back to the hospital

Customer: I live in Switzerland and am in Chicago on vacation...
911DOC :

if you develop worsening headache, stiff neck, and high fever then I would go right away.

911DOC :

I understand

Customer: In your opinion it is not viral infection? If it is bacterial isn't it important to go on antibiotics?
Customer: what constitutes high fever?
911DOC :

I do think it is likely viral, but my opinion hardly matters... what the ER doctor told you is what matters as they did the testing

911DOC :

again, if this were bacterial meningitis you would likely be dead

911DOC :

there is nothing about these symptoms that suggest a bacterial infection... it does sound like a form of flu... a viral infection

Customer: OK thank you. Above what temp would you go to ER and do you suggest staying on the pain killer/fever reducers?
911DOC :

I think above 103, since you are here vacationing, would be a safe number to think of... that's 39.4 celcius... and yes, stay on the Tylenol every four hours with plenty of fluids.

Customer: Ok thank you.
911DOC :

you are most welcome

911DOC :

I am very sorry that you got sick on your vacation

911DOC :

and I hope you feel better soon

911DOC :



Thank you so much for your question. It was a pleasure talking with you. If this answer has been helpful to you please consider leaving positive feedback. Should you require my assistance in the future simply start your question with ‘for 911doc’, and I am usually on the site most days.


Best


Customer: One last question please. In ER they gave me Tylenol, but at the hotel I started taking Ibuprofen. Typically Sudafed works well for me. Is it OK to switch to Sudafed, or do I go to Tylenol, or stay with Ibuprofen?
911DOC :

you could actually take all three

911DOC :

though the less the better

911DOC :

you could take Tylenol, three hours later motrin (ibuprofen), three hours later Tylenol, three hours later ibuprofen etc...

911DOC :

the sudafed can be used every six hours

911DOC :

standing by

Customer: Thanks! Have a great evening.
911DOC :

you too

911DOC :

hope the rest of your vacation is a pleasant one

911DOC :

good night

911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5087
Experience: Emergency Medicine Physician
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