Q. What could be the reason for recurrent fever with high ESR and CRP levels?

Answered by
Dr. Sagar Ramesh Makode
and medically reviewed by iCliniq medical review team.
Published on Aug 04, 2018

Hi doctor,

I am getting a fever every day. But, every day the fever occurs and goes to a maximum of 100 degrees, and it gets back to the body temperature without any medications.

It is repetitive. I have done a few blood tests and am attaching the reports. I have found out that my CRP and ESR is very high (I have a history of aortic valve replacement surgery).

I am worried. I am taking Betaloc 12.5 mg, Ecospirin 75 mg, Warfarin 5 mg, Fibator 5 mg. Last week, I went out of the station, and I had a significant amount of traveling.

Dr. Sagar Ramesh Makode

Cardiology General Medicine Internal Medicine


Welcome to icliniq.com.

It is likely a viral fever only as it settles within four to five days. ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) are usually elevated due to viral fever or any other fever.

As it gets recovered within four to five days without any antibiotics, then it is likely a viral fever, and the possibility of other infection goes down like infective endocarditis, typhoid, malaria. So there is no need to get worried.

One may get repeated viral fever with travel, change in environment or change in food and the body clears it successfully. So there is nothing to worry about it.

Since you have an aortic valve replacement, then we have to be vigilant regarding the possibility of infective endocarditis.

So you should get your ESR and CRP done after two weeks, and if they are still elevated, then you should get an echocardiogram done to rule out infective endocarditis.

For more information consult a cardiologist online.---> https://www.icliniq.com/ask-a-doctor-online/cardiologist

Thank you doctor,

My fever has not settled. It is appearing once every day with a maximum of 100 degrees and goes down without medications. The temperature is coming every day repetitively. CRP is 5.4 mg/dL (much higher than range), and ESR is also very elevated.

Dr. Sagar Ramesh Makode

Cardiology General Medicine Internal Medicine


Welcome back to icliniq.com.

It is viral fever as it persists for a week. But, it needs to be evaluated. So we need to rule out typhoid fever and infective endocarditis.

So you should get some blood test done like

  • Widal test for typhoid,
  • echocardiography for infective endocarditis
  • dengue NS1 (nonstructural protein 1) done.

You may get done from any private laboratory and echocardiogram from a cardiologist only as it is difficult to see infection on the prosthetic valve. You can take tablet Paracetamol if it is needed.

For more information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist

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