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I need to know why I never run a fever with bacterial infections. I do run fevers with viral infections. Sometimes this has led to problems with receiving accurate and timely diagnosis of serious illness. I still run into problems and disbelief when I try to explain the problem to physicians.
Can anyone tell me why there is no fever? How can I convince health professionals not to consider lack of fever while evaluating me? This is a major concern.
Do you frequently get bacterial infections?
Do you get chills with bacterial infections?
Not frequently. A few times a year maybe. I do not experience chills unless I have a viral infection.
Fever in bacterial and viral infections have some differences. The substances responsible for fever are called pyrogens. In viral infections these are produced by the body's immune cells - lymphocites. In bacterial infections pyrogens are produced by bacteria and immune cells - mostly neutrophils. Pyrogens acts on brain thermo-regulatory centers in the hypothalamus, thus provoking the body to change temperaturem, causing fever. Lack of fever response may be due disturbed thermo-regulatory center or deficiency of endogenous pyrogens or sensitivity to pyrogens.
Impaired immune response also can cause frequent infections with reduced fever response. Anorexia is shown to cause lack of fever in bacterial infections and the most probable reason for this is underlying immune deficiency (congenital or as a result of underfeeding is not clear).
If nobody checked your immune status, I suggest to talk with your doctor about testing your immune system for immune deficiencies. If all turns out normal, then you most likely reason would be that you have reduced sensitivity to bacterial pyrogens.
Thanks for the advice. You sound like you know what you're talking about.
If there is a problem, will I be able to carry some sort of documentation so that the doctor's will know I do not run fevers for bacterial infection?
To give you some examples of past obstacles without fever- endocarditis, spinal epidural abscess, strep throat (resulted in glomerulonephritis), cellulitis, and so on.
Also, I do not have anorexia.
Yes, if there are problems it will be included in your medical records and the doctor would be aware of it.
The examples of infections you had are not very benign, so I'd really advice that you have your immunity checked. Some of them like spinal epidural abscess can normally present without fever, and absence of fever at all is not marker that exclude possible bacterial infection.
I listed anorexia just for illustration of the various conditions that may cause absence of fever in bacterial infections and immune deficiencies.
I will take your advice. I too have often wondered why I have had such infections.
Thank you. It was a pleasure answering your question.