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"19 year old female who has been experiencing a persistent fever for almost 2 weeks. What could be causing it?"


I am a 19 year old female who has been experiencing a persistent fever for almost 2 weeks. It has ranged from 99.8 for four days, then 100.8 for a few days, back down to 99.6 and then back up to 100.9. I have no other symptoms. No enlarged lymph nodes, no cough, no sore throat, nothing. I have no clue what could be causing this fever. I went to the doctor yesterday and they gave me prescription for azithromycin so that I wouldn't get any other infections while my immune system is down. Oh and the fever usually is worse after 5:00 pm everyday like clockwork. Any idea what could be causing it?


I am sorry to hear about your persistent fever. In cases such as this, it is critical that you undergo a thorough medical history, including questions about your occupation history, living environment, and animal exposure. You also need to undergo a thorough physical exam, and there are some basic blood tests that need to be performed.

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Therefore, I recommend you schedule an appointment with a different primary care doctor who can facilitate this. After undergoing an initial evaluation, you may need to see a different specialist, as well. In evaluating a fever such as yours, it is important to rule out an infectious cause. In addition to your history and physical exam, you may need to undergo a chest x-ray, complete blood count, and two sets of blood cultures to evaluate for additional evidence of infection. Many rheumatic disorders can cause a persistent fever, and it will be important to look for rashes or joint swelling that may point to such a cause. You may also need to undergo basic blood tests to look for a rheumatic disorder. Finally, although rare in someone your age, tumors can lead to persistent fever. I encourage you to see a primary care doctor to discuss these possibilities.

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