Chills, fever, Wellbutrin, Macrobid for UTI. ER?
March 23, 2025 6:07 AM Subscribe
Woke up with insane chills 2 hours ago. Chills still going on and fever went up to 102F. Just side effects? Or should I go to the ER? Details inside.
Just got a headache, but that's probably from shivering and tensing for 2 hours straight. I can breathe fine but it feels a little tight to take a really deep breath. That happens to me rarely. No shortness of breath.
Started taking Wellbutrin XL 150 mg three weeks ago.
Started taking macrobid yesterday (1 full day so far) for a mild UTI that I got last week. No UTI symptoms, no kidney infection symptoms like back pain or pressure.
Macrobid has chills and fever as side effects, though I've never reacted to it before.
I'm starting to feel less shivery after 2 hours. Waitit out? Go to ER? Should I take my next day's doses of meds?
It's Sunday, so doctor and urgent care are closed.
Just got a headache, but that's probably from shivering and tensing for 2 hours straight. I can breathe fine but it feels a little tight to take a really deep breath. That happens to me rarely. No shortness of breath.
Started taking Wellbutrin XL 150 mg three weeks ago.
Started taking macrobid yesterday (1 full day so far) for a mild UTI that I got last week. No UTI symptoms, no kidney infection symptoms like back pain or pressure.
Macrobid has chills and fever as side effects, though I've never reacted to it before.
I'm starting to feel less shivery after 2 hours. Waitit out? Go to ER? Should I take my next day's doses of meds?
It's Sunday, so doctor and urgent care are closed.
102 is too high. You must take some action. At least take acetominophen. Also call someone as Jane the Brown said. If it's geographically possible, go to the ER.
posted by JimN2TAW at 7:47 AM on March 23 [2 favorites]
posted by JimN2TAW at 7:47 AM on March 23 [2 favorites]
Call someone and/or go to the ER. Fever + chills = your body telling you something is very wrong.
posted by humbug at 8:34 AM on March 23
posted by humbug at 8:34 AM on March 23
I had the same side effects taking Macrobid for a UTI a few years ago. I went to the ER, for what it’s worth.
posted by MelanieL at 9:53 AM on March 23
posted by MelanieL at 9:53 AM on March 23
Definitely not the wellbutrin, especially at a 150 dose.
posted by Thorzdad at 10:06 AM on March 23 [1 favorite]
posted by Thorzdad at 10:06 AM on March 23 [1 favorite]
NAD but someone who has been to the emergency room a bunch of times. A fever and chills without any other significant symptoms isn't going to get you more than a shrug and some OTC meds from the ER. Especially if you're taking medication with it as a known side effect. I'm super cautious, but honestly, most ER doctors in my experience will just let you sit there for 10 hours and then send you home.
Take some acetominophen, drink some fluids, try to rest as much as possible.
HOWEVER, if you get any other symptoms (any sort of pain, rash, vomiting, shortness of breath, blurred vision, anything out of the ordinary) and/or your fever goes to 104F, you should definitely call someone or go to the hospital.
posted by fight or flight at 10:09 AM on March 23 [8 favorites]
Take some acetominophen, drink some fluids, try to rest as much as possible.
HOWEVER, if you get any other symptoms (any sort of pain, rash, vomiting, shortness of breath, blurred vision, anything out of the ordinary) and/or your fever goes to 104F, you should definitely call someone or go to the hospital.
posted by fight or flight at 10:09 AM on March 23 [8 favorites]
It's also possible that macrobid is the wrong antibiotic for whatever pathogen is causing your UTI, and is therefore ineffective. I think I'd go to urgent care. If UTI rages you can infect upstream into the kidney. You want to start the correct antibiotic. Also, drink a LOT to try to prevent this potential complication.
Question: did your original prescriber have you pee in a cup to do a culture? Lots of times an antibiotic is started for the usual suspects, but the culture/sensitivity will provide information on what antibiotic will kill the offending pathogen.
posted by citygirl at 10:25 AM on March 23 [1 favorite]
Question: did your original prescriber have you pee in a cup to do a culture? Lots of times an antibiotic is started for the usual suspects, but the culture/sensitivity will provide information on what antibiotic will kill the offending pathogen.
posted by citygirl at 10:25 AM on March 23 [1 favorite]
I am a generally healthy middle aged person and personally would not go to the ER for a 102 fever plus chills. I would take a fever reducing medicine, and if it didn’t bring my temp down I’d alternate ibuprofen and acetaminophen. If the combination of those two didn’t bring my temp down, I’d call a nurse line. I would continue to take my temperature and if it was above 103 (having already taken medicine) I would probably head to the hospital. If it was above 104 (having already taken medicine) I would probably call 911. If it hit 104.5 I would definitely call 911.
posted by maleficent at 10:29 AM on March 23 [3 favorites]
posted by maleficent at 10:29 AM on March 23 [3 favorites]
Bacterial endotoxins can cause chills, fever, and respiratory problems:
posted by jamjam at 11:38 AM on March 23 [2 favorites]
When Gram-negative bacteria are killed by the immune system, fragments of their membrane containing endotoxins are released in the blood stream and may cause fever and diarrhoea. The presence of endotoxins in the blood (endotoxemia) typically leads to hypotension, respiratory failure and reduced oxygen delivery.My guess is that you are experiencing the effects of the initial die off of the UTI bacterium caused by the antibiotic, and that this will subside without further intervention, but I think it's imperative to get in touch with some kind of urgent care authority to confirm that.
posted by jamjam at 11:38 AM on March 23 [2 favorites]
Your primary care office or health insurance may have an after hours nurse line. I'd call that if possible.
I'd also make sure to stay well hydrated - including something like pedialyte. Important with a UTI and even more so with a fever. Headache could be from dehydration.
posted by litera scripta manet at 11:55 AM on March 23
I'd also make sure to stay well hydrated - including something like pedialyte. Important with a UTI and even more so with a fever. Headache could be from dehydration.
posted by litera scripta manet at 11:55 AM on March 23
If you live alone, call *another human,* in addition to a nurse line or urgent care.
You need someone who knows you are sick and might be able to check on you.
Not trying to fear monger here, but we lost a friend of ours last month. He had had influenza (though vaccinated) in January, and was either not fully recovered or picked up YET ANOTHER of the massive glut of upper respiratory crap that is floating around this year.
He texted his dad that he was having trouble breathing, but he was gone by the time his dad made it over there. He was 47.
I am still recovering from a bout with pneumonia that started very unpredictably and very hard. This year’s infections are no fucking joke. Make sure you have someone who can get to you if you need them.
posted by St. Hubbins at 1:26 PM on March 23 [2 favorites]
You need someone who knows you are sick and might be able to check on you.
Not trying to fear monger here, but we lost a friend of ours last month. He had had influenza (though vaccinated) in January, and was either not fully recovered or picked up YET ANOTHER of the massive glut of upper respiratory crap that is floating around this year.
He texted his dad that he was having trouble breathing, but he was gone by the time his dad made it over there. He was 47.
I am still recovering from a bout with pneumonia that started very unpredictably and very hard. This year’s infections are no fucking joke. Make sure you have someone who can get to you if you need them.
posted by St. Hubbins at 1:26 PM on March 23 [2 favorites]
Response by poster: Thanks everyone. So far so good. Fever went down with ibuprofen. Checked blood pressure and oxygen saturation and both were fine. Will keep an eye on it and take it easy today. The points above about ER not doing anything other than monitoring are valid. And I don't live alone so we can always go to the ER.
posted by dabadoo at 1:36 PM on March 23 [4 favorites]
posted by dabadoo at 1:36 PM on March 23 [4 favorites]
Definitely not the wellbutrin, especially at a 150 dose.
Not necessarily. I had a major allergic reaction to that dose of Wellbutrin on that same timeline and dose. It's rare but less rare than you'd think (especially on that dose), and it includes tight breathing. In addition to the rest of what you're doing please check in with a psychiatrist about the Wellbutrin and a possible delayed allergy. You're likely fine if you're feeling better but it's good to keep an eye on.
posted by colorblock sock at 5:49 PM on March 23
Not necessarily. I had a major allergic reaction to that dose of Wellbutrin on that same timeline and dose. It's rare but less rare than you'd think (especially on that dose), and it includes tight breathing. In addition to the rest of what you're doing please check in with a psychiatrist about the Wellbutrin and a possible delayed allergy. You're likely fine if you're feeling better but it's good to keep an eye on.
posted by colorblock sock at 5:49 PM on March 23
As an ER provider, I would go to the ER. The Macrobid may not be covering whatever bug is causing your UTI and you may be developing a kidney infection. Can you find out the results of your urine culture and make sure Macrobid is appropriate? At the very least, someone febrile with a possible kidney infection in the ER would likely get a dose of IV antibiotics, IV fluids, blood cultures and labs. Pyelonephritis has a high rate of developing into sepsis.
posted by queens86 at 11:59 AM on March 24
posted by queens86 at 11:59 AM on March 24
I’m an ER nurse and I spend a large part of my workdays grumbling about inappropriate use of the ER - but I would go to the ER for this.
You have a known infection. you are already on antibiotics. so either
- you have more than one source of infection
- the suspected source is wrong
- the antibiotic is wrong
- the antibiotic is right but the infection is too strong
- your body is not effectively fighting a UTI and why is that
for me it boils down to - that temp is too high for an adult on antibiotics and i want a doctor to evaluate me. you probably just need a different antibiotic but still go to the ER, you dont want a kidney infection, they seem miserable.
posted by pintapicasso at 3:27 PM on March 24 [1 favorite]
You have a known infection. you are already on antibiotics. so either
- you have more than one source of infection
- the suspected source is wrong
- the antibiotic is wrong
- the antibiotic is right but the infection is too strong
- your body is not effectively fighting a UTI and why is that
for me it boils down to - that temp is too high for an adult on antibiotics and i want a doctor to evaluate me. you probably just need a different antibiotic but still go to the ER, you dont want a kidney infection, they seem miserable.
posted by pintapicasso at 3:27 PM on March 24 [1 favorite]
In the early bit of what became pneumonia, when I was dealing with sweats and chills - but an inexplicable 98.9 temp when I felt for SURE it had to be at LEAST 105 - I did consult my ER doc friend as to whether to hit up an urgent care or ER. (I eventually got a same-day regular clinic visit with a chest X-ray.)
DOC: You say you feel lethargic and short of breath [read: didn’t want to breathe in too deeply, by choice, so as to avoid coughing], so I probably would recommend an ER over an urgent care. That way they can do stuff like a complete blood count, EKG, etc.
But please understand, I don’t have malpractice coverage for advice given on the Internet. If you do report symptoms to me, I will think worst case scenario, and suggest the ER. You’re probably fine but things like a screening blood count are very appropriate.
ST. H: Yes, understood. (If I ask Dr. Internet, of course, it says I might have sepsis, so.)
DOC: Yes. We’re all dying, you know?
ST. H: Some faster than others.
posted by St. Hubbins at 11:28 PM on March 26
DOC: You say you feel lethargic and short of breath [read: didn’t want to breathe in too deeply, by choice, so as to avoid coughing], so I probably would recommend an ER over an urgent care. That way they can do stuff like a complete blood count, EKG, etc.
But please understand, I don’t have malpractice coverage for advice given on the Internet. If you do report symptoms to me, I will think worst case scenario, and suggest the ER. You’re probably fine but things like a screening blood count are very appropriate.
ST. H: Yes, understood. (If I ask Dr. Internet, of course, it says I might have sepsis, so.)
DOC: Yes. We’re all dying, you know?
ST. H: Some faster than others.
posted by St. Hubbins at 11:28 PM on March 26
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posted by Jane the Brown at 6:10 AM on March 23 [5 favorites]