Help Needed So Bad

[Achilles2323]

Ok here it goes I have

POTS Gilberts syndrome GERD And first degree heart block

The problem i have is that i am running a 99.0 - 100.4 fever for 2 weeks str8 Only symptom to.accompany this is fatigue in the legs and lightheaded

No cough No runny nose No sore throat No diheria

But it is annoying because i dont feel my self

Doctor ran cbc Strep test And flu test All came back good Only slighty low vitamin d

Can any 1 help me please?

[Angelaintexas]

Ugh, weird. Usually fever is a tell tell sign of infection, but if CBC was good, than idk? ( I would think its likely that your body is just regulating it that high, the same way that your body can regulate it low. (My normal temp is 95.0)

-sorry I can't help, maybe ask your dr to just completely work you up, like you could be producing to much adrenalin?

[arizona girl]

I'm not sure what is up with the fever, this is new and not normal for you right? Have they also checked your crp? It is another marker for infection. If you had a workup to see if your immune system is working properly? CRP along with a total quantitative immunoglobulin, sub igg panel, followed by a vaccine challenge would prove or disprove it. If your immune system is compromised in some way you are not able to put up a normal fight. A fever though is a least a positive sign your body is doing something.

If this feve doesn't go away I'd go to urgent care and see if they come up with something different then your primary.

Normal White Blood Cell Count Does Not Rule Out Bacteremia

Daniel J. Pallin, MD, MPH

Journalroduction

Abstract

Of 289 patients with bacteremia, 52% had normal WBC count and 17% had neither WBC elevation nor fever.

Introduction

Despite multiple studies showing that a normal white blood cell (WBC) count does not exclude serious disease,

physicians in all specialties continue to behave as if it did. To assess whether a normal WBC count or absence of

fever reliably excludes bacteremia in patients with suspected infection, investigators conducted a secondary analysis

of data from a prospective study of 3563 adults who had blood cultures at a single emergency department.

Among 289 patients (8%) with positive blood cultures, 77% had fever and 48% had elevated WBC count on initial

measurement. Neither fever nor an elevated WBC count was noted in 17% of bacteremic patients.

Comment

The fact that leukocytosis is associated with infection does not mean that the white blood cell count is a good test for

infection, because many patients with infection have no leukocytosis, and many patients with leukocytosis have no

infection. Temperature is also not foolproof, but this investigation was limited by its reliance on initial temperature

only, and some patients may have been found to be febrile later in the visit. The WBC count is the right test for

neutropenia and malignancies of the white blood cell, but it is not a discriminatory test for infection. When evaluating

a patient for possible infection, WBC counts should be used only as part of validated multivariable decision rules that

have adequate predictive value for medical decision making, such as the Bacterial Meningitis Score (JW Pediatr

Adolesc Med Jan 31 2007).

Journal Watch © 2012 Massachusetts Medical Society

[britishangel6]

While a normal cbc is reassuring for certain issues, the fact that you've had a temp for so long is concerning. I would want an explanation from my doc. If they want to attribute it to POTS or dysautonomia, fine, but they need to check for everything else first!

When it started was it low grade as well? What initially prompted you to take your temp?

CRP isn't used as much in adults as children but that doesn't mean it wouldn't show anything. It could be viral; cbc would usually show immune response but if it's prolonged the acute response may have passed (and eventually WBC would be low due to prolonged immune response). Just throwing it out there, have you been tested for TB? You don't have many of the signs but with the fever if may be worth ruling out as it's currently a 'fever with undefined origin'; higher risks for TB include working in the medical field, travel to or close contact with countries with high TB rates, work/exposure to jail/prison. Finally, if you had the cdc done soon after the fevers began I would ask the doctor to repeat with any other tests he/she orders.

Good luck

[Achilles2323]

thanks

what exactly is tb?

still have the slight fever only at night

gonna see the doctor he will run other blood test and then send me to a rheumatologist

[arizona girl]

Tb stands for tuburculosis. While it is on the rise in certain segments of the population, it isn't common in others. However, if you think you may have been around someone that had it or have been around the sub population that have it, it can't hurt to get tested. It is a simple skin test called a ppd.

Mine is actually positive but I have no detectable disease. So that can happen too.

A CRP c reactive protein, actually is being used more and more in the adutl population, especially in cardiology and in patients who are immune compromised, as I am. It is often a more effective marker for infection and inflammation then a cbc. I know this as I have also had abnormally elevated crp and hscrp. It however is not a test that most primary doctors go to first. You will probably have to ask for it.

Hope the rheumy appointment goes well and you feel better soon.

Glad to hear that the fever is only in the evenings now. If you are at all interested in reading up on immune deficiencies you can go to primaryimmune.org and read there.