Q. I have fever and my temperature keeps changing. Are my symptoms associated with COVID-19?

Answered by
Dr. Ma Loida Sajonas
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Feb 17, 2021 and last reviewed on: Mar 13, 2021

Hi doctor,

I have fever since yesterday morning at 38-38.2 C. During the afternoon, my temperature went down. Later, the fever came back around midnight at 38 C. I have been out of work since yesterday. Now, my temperature is normal at 36.3 C.

#

Hi,

Welcome to icliniq.com.

May I ask for a few more questions to arrive with a diagnosis? Do you have sore throat, itchy throat, cough, cold, rash, loss of smell and taste? Do you have back pain, difficulty in urinating, or skin lesions like rash?

As fever alone is a manifestation of COVID-19, especially now that it is rampant. Do you have history of exposure to COVID-19 confirmed case or symptomatic patients? Any travel history to areas with high COVID rates? Other differential diagnosis are:

1. Dengue fever - we still see a lot of cases of dengue, we can only rule this out with a CBC (complete blood count) and platelet count with dengue NS1 ( non structural protein) and dengue IgG or IgM.

2. Urinary tract infection, we can rule this out through urinalysis.

Without the diagnostic tests, we cannot rule out any of these diseases. However, treatment is still supportive like Paracetamol for fever and to increase oral fluid intake. And we need the diagnosis to lead us to the right management, antibiotics for UTI (urinary tract infection), or fluid and platelet monitoring for dengue.


Investigations to be done:

1. CBC With platelet.
2. SARS-CoV-2 RT-PCR (reverse transcription polymerase chain reaction).
3. Urinalysis.

Probable diagnosis:

Rule out COVID-19 infection vs. SVI(systemic viral infection)

Treatment plan:

Tx. 1. Paracetamol 500 mg tablet 1 tablet every four hours for fever.
2. Oral rehydration salt (ORS) four sachet in one liter of water as fluid replacement.

Preventive measures:

WOF (warrant of fitness) - bleeding, abdominal pain. Isolate.

Regarding follow up:

Follow-up once with labs or once with symptoms progression.

Hi doctor,

I do not have an itchy throat or sore throat. I got soaked in the rain while coming home two days ago. And other than a runny nose and headache, I do not have any other symptoms. I have not gone anywhere other than work for the past few months.

#

Hi,

Welcome back to icliniq.com.

But I guess getting soaked in the rain will not give you a high-grade fever. Added differential diagnosis, in this case, is acute rhinosinusitis because of cold and headache. It is really hard to differentiate between a common cold and COVID 19 nowadays. We can still get infected unknowingly. I will suggest medicine for the runny nose. The headache might be due to the cold.


The Probable causes:

1. COVID 19 infection.
2. Systemic viral infection.
3. Acute Rhinosinusitis.

Treatment plan:

1.Alnix plus (Cetirizine and Phenylephrine) 5 or 10 mg tablet tablet once at bedtime for five days ;2. Vitamin C and Zinc 1 tablet once a day ; Alvedon 500 mg (Paracetamol) tablet 1tablet every four hours for fever; 4. ORS four sachet in one liter of water as fluid replacement.

Regarding follow up:

Follow up once with labs or symptoms progression.

Hi doctor,

Thank you, is it different if I had a cesarean section before a year. They said it is a relapse.

#

Hi,

Welcome back to icliniq.com.

When did you have your cesarean section and is the surgical site clean? Fever from CS is usually post operational (due to anesthesia) and surgical site. If it is high grade fever, we have to consider other diagnosis.

Hi doctor,

I had a cesarean section in march of last year, and I wear underwears that are up to my navel. I was not wearing my post girdle support at that time. I sometimes wear it when it is cold. Thank you.

#

Hi,

Welcome back to icliniq.com.

It is almost an year. I do not think it is related to the present condition. Please check your email.


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