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Q. I suffer from low-grade fever for seven days with high blood pressure. What is the cause?

Answered by
Dr. Muhammad Zubayer Alam
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Nov 13, 2021

Hi doctor,

I am 49 years old. I am a patient having high blood pressure without any other problem. During fever, my blood pressure got decreased from a high level to a lower range. Today, I had a blood pressure of 98/59 mmHg. As I am a patient with high blood pressure, I am taking Amloz AT 50 one tablet in the morning. I am having a low-grade fever continuously for seven days with weakness, swelling in my legs, and decreased appetite.

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Hi,

Welcome to icliniq.com.

Thank you for the query. I can understand your concern. According to your statement, you have been suffering from low-grade fever for seven days with weakness, leg swelling, and decreased appetite. You can undergo some investigations like CBC (complete blood count), Widal test, Weil Felix test, urine R/M/E (urinary routine and microscopic examination), serum creatinine, CXR P/A view (chest X-ray posteroanterior view), ECHO (echocardiography) to find out the exact underlying causes for your fever as well as leg swelling and then treat them accordingly.

You are currently using a medication called Amloz AT which contains both Atenolol and Amlodipine. It may cause leg swelling, decreased appetite, weakness, low blood pressure as its side effects. You can take broad-spectrum antibiotics like Cefixime 400 mg twice daily for 10 to 14 days to subside your fever. Take care. In case of any other query ask me.

Thank you doctor,

I am taking Doxycycline two tablets daily for three days. But I do not have any symptoms of corona except low temperature. So can I take Cefixime 400 mg? or can I continue taking Doxycycline tablet for another two days?

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Hi,

Welcome back to icliniq.com.

Thank you for joining again. Doxycycline is an antibiotic that is used to treat many different bacterial Infections. So, you can continue taking Doxycycline. As you have not mentioned any antibiotic earlier, so I have advised you to take Cefixime. You do not need to change your antibiotic right now. At first, do the above-mentioned investigations to find out the exact underlying causes for your present sufferings and then treat them accordingly. Take care. Let me know if I can assist you further.

Thank you doctor,

I have done all the investigations except CXR P/A view and ECHO. Now I am uploading the reports. My condition is the same as before. I am having a low temperature with weakness and a reduced appetite.

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Hi,

Welcome back to icliniq.com.

Thank you for joining again. According to your investigation reports, your Widal test is negative which means you are free from typhoid or enteric fever. But your urinalysis report has shown the presence of pus cells that means you are suffering from a urinary tract infection or UTI. You have already taken Doxycycline but still, urinary tract infection is present. So, Doxycycline is not able to subside urinary tract infection. You can take Cefixime 400 mg twice daily for seven to ten days for subsiding urinary tract Infection. You should have abstinence from any type of sexual activity and take plenty of fluids during this period. Urinary tract infection may present with fever, loss of appetite, nausea or vomiting, weakness, and many more. Hopefully, above mentioned medication and measures will help to subside urinary tract infection. Take care. In case of any other query ask me.

Thank you doctor,

I missed uploading one more file. Now I am uploading the file.

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Hi,

Welcome back to icliniq.com.

Thank you for joining again. According to your CBC (complete blood count) report, your hemoglobin, lymphocyte as well as PCV (packed cell volume) are below the normal levels. Bilirubin, neutrophils, or polymorphs as well as RDW-CV (red blood cell distribution width) are above the normal levels. But these blood parameters are not so high or low for indicating any serious illness. Blood test results may vary from laboratory to laboratory due to sample collection technique, examination procedure, and use of various reagents. So, do not be worried at all. You can repeat your CBC report a month later and then you can compare the results. Take care. Let me know if I can assist you further.

Hi doctor,

Thank you for your reply.

As per your advice, I have taken Cefixime 400 mg twice daily for seven days, but still, I have a fever of 98.5 F to 100 F. The weakness and appetite remain the same. In between, I have done some other tests. I also have a high CRP (31.93). I am uploading the report now.

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Hi,

Welcome back to icliniq.com.

Thank you for joining again. According to your statement, you still have a fever despite taking Cefixime and weakness. 98.4 F is the normal body temperature. A temperature of 100 Fahrenheit or more than 100 F is considered as fever.

Usually, fever is subsided with profuse sweating. So it may be a sign of dehydration. When your body does not have enough fluids, it is very difficult to maintain its regular body temperature, which may lead to fever-like symptoms. So, take plenty of fluids to keep your body hydrated and maintain the body's normal regular temperature. This will help you to subside your fever and weakness.

Again raised CRP is the marker of infection or inflammation. You have a history of urinary tract infection, so your CRP level can be raised due to the infection. Other causes like diabetes mellitus, high blood pressure, autoimmune diseases, high cholesterol, smoking, alcohol consumption, limited physical activity, obesity, and many more may cause increased CRP levels. CRP level will slowly return to its normal level after subsiding the underlying causes that may cause raised CRP levels. Take care. In case of any other query, knock me.

Hello doctor,

Thank you for your reply.

My body temperature gets increased up to 100 F every day continuously for 15 days. Did you see my other report? How to reduce CRP? Is it a serious issue? Is there any medicine needed for that, or any further test or examination will be required?

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Hi,

Welcome back to icliniq.com.

Thank you for joining again. I have already gone through your investigation reports (attachment removed to protect the patient's identity) several times and found that your CRP level (C-reactive protein) is raised above normal. Your hemoglobin level is below normal, your globulin level is above normal, and your hematocrit level is below normal. Blood tests for malaria and enteric fever have become negative, and USG (ultrasonography) has shown grade 1 fatty liver.

As your urinalysis test has shown urinary tract infections, the rest of the test results are not significant, so you are suffering from fever due to urinary tract infection. So, you can undergo urine for C/S (culture and sensitivity) to detect the underlying causative agent for your urinary tract infection and the most appropriate antibiotics for your present infection. You can also undergo some investigations like rt-PCR (Real-Time Polymerase Chain Reaction) for Covid-19 infection, Weil Felix test, CXR P/A (chest x-ray posteroanterior) view, or HRCT (High-resolution computed tomography) of the chest, serum creatinine, fasting lipid profile. These tests can help to detect the underlying causes of your fever and then treat them accordingly.

In the meantime, you can add Azithromycin 500 mg twice daily for ten days along with Cefixime 400 mg daily to cover atypical bacteria. Diet high in fiber and rich in fruits and vegetables will help reduce CRP levels quickly. Subsiding the causes for raised CRP will help to reduce the CRP level slowly. CRP is not a matter of concern, and it usually indicates the presence of infections or inflammations in the body. Exercising daily, avoiding cigarette smoking and alcohol consumption will help to reduce CRP levels too. Avoiding oily and fatty foods will help to control your fatty liver. Take care. Let me know if I can assist you further.


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