Extended low grade fever - when is it doctor time?

April 25, 2011 8:21 AM

Low grade fever for 10 days with (mostly) no other symptoms. When is it doctor time?

(I understand that you are not a medical professional, or if you are, you are not mine)

Saturday night, about a week and a half ago, I had a 100.4 fever as measured on an ear thermometer. Stayed in bed the next day and rested, as I had some fatigue. Took it easy Monday as well. The fever stuck around, fluctuating between 99.5ish and 100.4, depending on which ear and time of day. Fatigue mostly went away, no other symptoms presented. I didn't take any medicine, except for Saturday night (aspirin). A strange side note - I took my temperature in both ears each time, and the left ear was consistently lower - sometimes just 2/10 of a degree, sometimes as much a full degree.

Also during these first few days, I have to go to the bathroom A LOT. Every bit of water weight seems to want to leave my body. I was down 6 pounds at my weekly weigh-in, and I hadn't been that good/active the preceding week.

Cut to Wednesday, 4 days after the fever showed up. Fever's still here. My husband suggests going to the doctor, but except for the presence of the fever, I feel fine. I call the nurse hotline associated with my insurance, run through this history with a nurse. She suggests treating it at home, but going to the doctor if certain symptoms present (higher fever, difficulty breathing, sudden headache, etc.)

Last night, fever is still present, around 99.5 or so. I decide to go to the doctor today. This morning, both ears are showing around 98.6 (normal for me, as measured in my ears, is about 97.6, so this is still elevated). I reconsider going to the doctor, since my only symptom is a fever, I have a "normal" temperature right now, and no other symptoms. Really, what could they do for me other than send me home with the same instructions the nurse gave Wednesday? My temp has not fluctuated above 100 in about 48 hours, and the difference between ear temperatures has been less pronounced as well.

So. Questions:
Should I go to the doctor anyway? What are some common causes of low grade fevers, and why is this one sticking around? Is it normal to have such large temperature variations between ears, or is it indicative of something?

posted by booksherpa to health & fitness (19 answers total)

Five days ago. Doctor time was five days ago. Go.
posted by 8dot3 at 8:30 AM on April 25, 2011 [3 favorites]

And for the record, I had a similar issue a few weeks ago and it turned out to be a reaction to a new medication I'd started taking weeks before. For some reason I was fine for a couple weeks when I started taking it, and then BAM, a week of fever. I discontinued the med and then started taking it again, and had a HUGE allergic reaction and ended up in the ER. Any new meds lately?
posted by 8dot3 at 8:32 AM on April 25, 2011

My daughter, who is 3, had a fever without other symptonms for over a week not long ago. I consulted a friend who is Physician's Assistant about how worried I should be, since the fever was well-controlled with Tylenol and she seemed to feel pretty well otherwise. My friend said, "Unless she develops other worrisome symptoms, we don't usually start worrying until about 10 days." At just about 10 days, my daughter finally slept through the night with no fever, so I never did take her to the doctor or get any kind of diagnosis.

I'm just tossing that out there as a similar kind of experience. I hadn't either experienced that kind of extended fever or had any of my kids have one like that before. I probably wouldn't go to the doctor in your shoes, especially since the fever is down a bit this morning.

I might, however, call the nurse line again, or call and talk to one of the nurses at my doctor's office, just to be on the safe side. I would have been much less comfortable not taking my daughter to the doctor had I not had a PA friend to consult.
posted by not that girl at 8:36 AM on April 25, 2011

What are some common causes of low grade fevers

Early pregnancy.
posted by amro at 8:38 AM on April 25, 2011

Nope, no new medications at all or changes to existing meds. Not pregnant either.
posted by booksherpa at 8:40 AM on April 25, 2011

Also during these first few days, I have to go to the bathroom A LOT. Every bit of water weight seems to want to leave my body. I was down 6 pounds at my weekly weigh-in, and I hadn't been that good/active the preceding week.

This is extremely worrisome, even without the extended fever. Low-grade fever over time is a sign of all sorts of things, from persistent infections to much scarier stuff. Please go to the doctor.
posted by you're a kitty! at 8:40 AM on April 25, 2011

Any out of country travel in the last couple of months? My doctor checked me for malaria.
posted by 8dot3 at 8:45 AM on April 25, 2011

I once had agonizing, pounding headache (as in, I could not function or even sleep without Tylenol or Advil at extra strength doses; those tampered it down to a dull roar) and a fever for two weeks, with no other symptoms.

I was suspected for either a case of meningitis and the final diagnosis turned out to be really warped symptoms of a UTI. (I'm still skeptical of that one, but the antibiotics either healed me or the timing was really, really good, so whatever.)

Hi thee to a doctor ASAP.
posted by Hakaisha at 8:51 AM on April 25, 2011

I haven't been out of the country at all recently. Bathroom frequency is back to normal, as is my weight - 5 of those 6 pounds are back, sigh. Yes, illness is not the way to lose weight, but it was my best weigh-in in FOREVER!

Haven't had a headache in the past 10 days, except for my current, quite mild one.
posted by booksherpa at 8:53 AM on April 25, 2011

Last spring I had a (short-term) fever related to sinus infection that spread (probably due to mis-use of a neti pot). But that came and went in a few days, not 10.
posted by filthy light thief at 8:54 AM on April 25, 2011

Dehydration also causes low grade fevers. Given the amount you say you are peeing, I assume that also means you must be drinking a lot, but if not, make sure you are replenishing your fluids.

No comment on going to the doctor, just wanted to chime in about possibilities. I am a huge hypochondriac, and sometimes take my temp just for funsies, and when I called my doctor about a similar situation that is what he told me. When I upped my fluid intake for a couple days, down it came.
posted by CharlieSue at 8:55 AM on April 25, 2011

Go to the doctor. It's been 10 days, you might have something that warrants more tests and/or antibiotics. Primary care, urgent care or clinic.

IANAD
posted by Mister Fabulous at 8:58 AM on April 25, 2011

Allergies can give me a low-grade fever with no other symptoms, just since my immune system is going crazy I guess. My fever usually hovers around 99 or so, and sometimes a fever won't register but my face and head *feel* hot. Seasonal allergies have been getting worse generally, due to climate changes.

BUT, if you go to a doctor, I would ask about a white blood cell count. I had a long cold (over a week) and they drew blood to test my white cell count. That would let you and the doctor know if something more serious could be going on.
posted by shortyJBot at 9:03 AM on April 25, 2011

I had a similar problem last year. You could have a abscess tooth. Most people have a lot of pain associated with this but I never did. Low grade (100.4ish) and it was up and down for 2 weeks. Went to the doctor who sent me to the ER because I was dehydrated. 2 bags of fluid and lots of tests later they had no idea. I remembered hearing somewhere that an abscess can cause other weird issues so I scheduled an appointment and sure enough. After a root canal I was almost good as new. I would do doctor and dentist just to be sure.
posted by pleuroma at 9:47 AM on April 25, 2011

Autoimmune disorders are notorious for causing these kinds of persistent elevated temperatures but not-quite-fevers. Fatigue as well. Don't know about the peeing.

The basic screening test for many autoimmune disorders is the ANA, which is a simple blood test. It can give false positives, and can be positive even when there are no problems or symptoms, so if you do get a positive test, it might not be a big deal.

Good luck!
posted by the young rope-rider at 9:55 AM on April 25, 2011

Yeah, you just described me with mono - worse yet, I'd get 'normal' every day...and then spike a fever in the evenings. 3-4 day of a fever, max. Day 5/6 off to the doctor.
posted by filmgeek at 11:37 AM on April 25, 2011

Go to the doctor. Do it.
posted by that's candlepin at 1:09 PM on April 25, 2011

After reading all the responses (and more nudging from my husband, pointing to the folks in this question saying "Go!") I decided I'd rather feel silly going to the doctor for a fever that wasn't present at the moment, then get sicker if it turned out to be serious. Preliminary diagnosis is a recurrence of a UTI from a few months ago. I've got some antibiotics, and they're going to do a full urinalysis just in case something else is going on, but the PA isn't expecting anything.

So, thanks all!
posted by booksherpa at 1:22 PM on April 25, 2011

This is just for educational purposes, since you were already seen by a doctor, but an ear thermometer is not very accurate. If you want an actual reflection of your temperature, you ought to use an oral thermometer. The ear thermometer can be thrown off if you have wax in your ear, for example.

From a physician's perspective, also, a fever is generally a temp of 100.5 or greater. Even if a person says their body temp runs lower than 98.6, 98.6 is still a normal temperature, not a fever. A lot of things can increase your temperature to a minimal degree like that, and not all of them are illnesses. For example, stress, travel, medications, exercise, weather, etc.

That said, I'm glad you got a diagnosis, and it certainly fits with your urinary symptoms. Get well soon!
posted by treehorn+bunny at 10:46 PM on April 25, 2011