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Frequent fever
For the last 4 years I effected with fever in every 2-3 months gap...some time I take antibiotics and some time not...cbc crp chest x-ray are normal...I have diabetic ..and I'm working in an hospital environment..what are the probable causes..? How to overcome it...
Answers (19)
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Need more history to evaluate.
Do connect for further treatment plan
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Kindly do connect and consult with me for better treatment plan and advice on practo app
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Recurrent fever every 2–3 months for several years can have many causes. In a diabetic person working in a hospital setting, repeated viral infections, occult bacterial infections, tuberculosis exposure, sinus/dental infections, urinary infections, poor glycemic control, autoimmune conditions, or less commonly hematological disorders should be considered. Normal CBC, CRP, and chest X-ray between episodes are reassuring, but further evaluation during the fever episode is more useful. Avoid taking antibiotics without proper indication, as this may mask the diagnosis and lead to resistance.
Next Steps
* Monitor and document fever pattern, duration, associated symptoms, and temperature.
* Get evaluated during an active fever episode with CBC, ESR/CRP, blood/urine cultures, LFT, RFT, urine routine, HbA1c, and targeted tests based on symptoms.
* Consider screening for TB, chronic sinus/dental infection, and autoimmune causes if symptoms persist.
* Ensure optimal diabetes control and adequate sleep/nutrition.
* Consult an Internal Medicine/Infectious Disease specialist for systematic workup.
Health Tips
Do not self-medicate repeatedly with antibiotics. Good hand hygiene, vaccination updates, stress reduction, and proper diabetic control can reduce recurrent infections. Seek urgent care if fever is associated with weight loss, night sweats, breathlessness, severe weakness, or persistent symptoms.
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Your Opinion
Recurrent fever every 2-3 months for 4 years needs a proper workup — and the reason your CBC, CRP, and chest X-ray came back normal is most likely because they were done between episodes rather than during one. Tests done when you’re well usually look well. That’s the single biggest gap in how recurrent fevers typically get evaluated.
Given your profile — hospital work, diabetic, age 28 — the main possibilities are:
1. A hidden focal infection that keeps flaring: urinary tract (very common in diabetics), chronic sinusitis, a dental focus, or a small perianal/skin source
2. Latent or extrapulmonary TB: healthcare workers in India have higher exposure, and a normal chest X-ray doesn’t rule out TB outside the lungs
3. Other chronic infections: typhoid carrier state, brucellosis (any animal contact?), and HIV must be screened given occupational exposure
4. Less likely but worth considering: autoimmune/inflammatory or periodic fever syndromes — only after infections are ruled out
Next Steps
The most important rule: get tests done during the next febrile episode, not after it settles. Bookmark this list.
During the next fever (within 24-48 hours of onset):
• CBC with differential, ESR, CRP, procalcitonin
• Urine routine + culture (highest yield in diabetics)
• Blood culture × 2
• LFT, KFT, HbA1c
• Typhoid IgM, malaria antigen, dengue NS1 if seasonal
Independent of episodes (do these soon):
• HIV ELISA, HBsAg, Anti-HCV — occupational exposure
• IGRA (TB-Gold) or Mantoux — important given hospital work
• Ultrasound abdomen — for hidden abscess, gallbladder, kidney pathology
• ENT + dental check-up — sinus or tooth focus gets missed often
• HbA1c + fasting/PP glucose — recurrent infections in diabetics often resolve once sugars are tightly controlled
This is the kind of problem that benefits from a proper consultation — the pattern of your fevers (duration, symptoms, response to medicines) matters as much as the tests, and one doctor owning the workup is far better than chasing tests episode by episode.
Helpful Tips / Word of Caution
• Stop self-prescribing antibiotics between episodes — this is critical. They suppress the infection temporarily and destroy the diagnostic yield when you actually need it
• Tighten diabetic control first — aim for HbA1c under 7. A lot of recurrent infection problems quietly disappear when sugars are properly controlled
• Keep a simple fever diary: date, peak temperature, duration, associated symptoms (cough, urinary, sore throat, etc.), what helped. Bring this to the next consultation.
• As a hospital worker, get your TB and HIV status checked annually — it’s standard occupational health practice
• Don’t ignore: fever above 102°F for more than 3 days, shaking chills, breathlessness, confusion, or chest pain — same-day consultation
• A proper sit-down consultation will help me build a structured plan rather than firefight episode by episode. After 4 years, you deserve a proper diagnosis, not just symptom relief.
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You have low immunity, frequent exposure to microbes in hospital environment
Antibiotics treat current infection, but have no protection towards future infections.
Improve immunity by healthy life style, good control of diabetes.
While working in hospital, adopt due preventive measures to avoid infections. For current febrile episode, get cbc done, tests for dengue, malaria, chickenguniya, take complete course of relevant antibiotic. To avoid future illness, keep strong immunity.
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Low immunity
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Hospital infection
Uti as u r diabetic.
Rest go for whole body check up n test to find out cause
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Recurrent fever every 2 months in a hospital worker with diabetes is common but definitely needs proper evaluation. Normal reports so far are a good sign, but we should find the exact trigger.
Book a quick consultation with me. I’ll review your history in detail and make a clear plan to stop these repeated episodes.
We’ll sort this out.
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I need proper history
What is the value of FBS PPBS AND HBA1C
YOU HAVE ANY INJURY
Send me a CBC report
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Based on your history,it may be hospital acquired infection, Do consult for detailed history and management.
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Dr. Shaikh Huzaif
General Physician
20 yrs exp
Mumbai
Please consult
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Ravi Kumar Nadella
General Physician
18 yrs exp
Hyderabad
Hospital acquired
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Take vaccination
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Dr. Gaurij Hood
General Physician
18 yrs exp
Valsad
Pls connect for further discussion and solution.
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Walk
Do connect and consult
Will help you
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Dr. Shreya Pradip Gudka
General Physician
9 yrs exp
Mumbai
Need more history
Any weight loss? How much is the fever ?
Consult a physician immediately
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Dr. Jenny Koshy
Internal Medicine
6 yrs exp
Pune
I may be mostly hospital acquired. So please wear protective devices.Also check if your sugars are normal.
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.