HomeAnswersGeneral Medicinehigh esrWhy do I have high ESR and persistent fever after recovering from a viral infection?

Are high ESR and persistent low-grade fever suggestive of infection?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At October 6, 2022
Reviewed AtOctober 11, 2022

Patient's Query

Hello doctor,

I am a 51-year-old male. One month back, I had a viral fever for which I was prescribed tablets Ciffy 200 and Nicip Plus. Five days later, I recovered from the infection and returned to work. However, after a week, I started having severe joint and muscular pains and took tablet Nicip Plus again. Ten days back, I was diagnosed with dengue. My ESR was 80 mm/hr. The next day, I went for dengue and COVID-19 tests, both were negative. Also, my ESR increased to 120 mm/hr. Since then, I have been taking only multivitamins. However, I have persistent fever and weakness. What should I do for my high ESR and other blood parameters?

Kindly advise.

Answered by Dr. Arpit Varshney

Hello,

Welcome to icliniq.com.

I understand your concern.

I have reviewed your reports (attachment removed to protect the patient's identity). You seem to have pyrexia of unknown origin (PUO), as your reports show negative reports for COVID-19 and dengue. Also, high ESR is a marker of active inflammation. As you have fever and inflammation, I suggest you to get CT (computed tomography) of chest and abdomen done to detect any infection in the chest or abdomen. Fever and high ESR can also occur in tuberculosis.

Do you have any weight loss? Loss of appetite? How much temperature do you have? Is there a history of TB in your family? Are there any other symptoms apart from fever and joint pains? I suggest you to document your fever readings from now on. If you do not have fever, there is no need to worry about ESR.

I hope this helps.

Thank you.

Patient's Query

Hello doctor,

Thank you for the response.

My COVID-19 report is negative, but the interpretation of the result is positive (RNA specific to SARS-CoV-2 detected). What does it mean? I have not checked for weight loss. There is no loss of appetite, but I feel full after eating a small quantity of food. My fever is between 97.5 degrees Fahrenheit to 99.5 degrees Fahrenheit. My sister and brother had TB long back.

Answered by Dr. Arpit Varshney

Hello,

Welcome back to icliniq.com.

I have checked your report. It is negative. The interpretation is only for your reference. I suggest you start antibiotics for seven days, and if the fever persists, you can get a CT scan of the chest and abdomen done. Meanwhile, you can take the below medicines:

  • Tablet Azithromycin 500 mg twice daily for five days.
  • Tablet Cefixime 200 mg twice daily for seven days.
  • Tablet Flexon (Ibuprofen and Paracetamol) twice daily for three days.

Consult a specialist doctor, talk to him or her, and start medicines with their consent.

I hope this helps.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Arpit Varshney
Dr. Arpit Varshney

General Medicine

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