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Thursday, September 18, 2014
High Blood Pressure
ESR level and fever
My mother is 58yrs old, and has been suffering from High BP for almost 15 years. she had her menopause when she was 38. She currently weighs 210 pounds. Her blood CP shows Hematocrit at 38%. She has been having a low grade fever for almost two months now. Temperature varies between 99 to 99.6. Her ESR level has been 65. She has the fever from 3 in the afternoon till 7 in the evening. Abdomenal ultrasound shows a moderately enlarged liver with "fatty infiltrations". All other test-Mantoux test, ANCA, ANF, Rheumatoid factor, chest xray - are alright. she has visited many doctors, but her ESR level and the fever are not going away. What is wrong with her? Is this anything serious?
Fever that persists for more than a few days has to be taken seriously. Unfortunately, few symptoms in medicine have as many diagnostic possibilities as fever.
In the case of your mother, possibilities include:
- chronic infections like tuberculosis or histoplasmosis, Epstein-Barr virus, CMV virus or hepatitis
- collagen-vascular disease like lupus erythematosus or vasculitis
- lymphoma, Hodgkin's disease or other malignancies
- drug reactions
These are just a few possibilities. Your mother may need more testing, like blood and urine cultures, abdominal and chest CT, and possibly a bone marrow test.
Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati