Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
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Can Antibiotics Cause Fever?

Wednesday, 16 Dec 2009 08:49 AM

Question: For two years, I had persistent fevers, chills, and sweats that gradually increased during the day and peaked at some point during the night. I had many tests and made two trips to the Mayo Clinic. I started taking a single 500 mg Tylenol every four hours day and night which seemed to help, but whenever I quit taking the Tylenol, the fevers would come back. They finally stopped, but after taking antibiotics for a sinus infection, the fevers returned. A liver biopsy showed an inflamed liver. Could antibiotics have inflamed the liver and caused the fevers?

Dr. Hibberd's Answer:

Yes, antibiotics can cause fever, but I am concerned that this has been permitted to last over two years. Investigating your complaints is long overdue. Let’s get the facts in order:
1) First stop all medications and supplements, but only after your doctors’ approval.
2) What do you mean by fever? Do you use medications other than Tylenol? You will need to chart this fever over at least 7 days (oral temperature at least three or four times a day and more often when you feel you may have a fever, chills or sweats) but perhaps as long as a 14-21 day period.
3) Have you traveled overseas? Do you have well water exposure? Do you eat raw meat or raw fish?
4 ) Has your hepatitis (liver inflammation) been investigated, and if so what are the results?
5) Did your PSA return to normal, and is there any sign of prostate enlargement or inflammation now?
6) Repeat blood panels for CBC, sed rate, PSA and comprehensive metabolic panel with three sets of blood cultures along with a urinalysis will set a decent baseline to work from.

You may be very surprised to see where this information leads. Some diseases are characterized by the type of fever pattern they produce, while others will give clues within the blood panels suggested.

Once you have this information at hand, I recommend you consult your physician for re-evaluation of your complaint. This time, be persistent or ask for a referral to someone who will help you track down the cause, perhaps an infectious disease specialist if your fever chart documents temperatures of over 100.5. You may have a low grade infection, endocarditis, inflammation or even an autoimmune or malignant disorder that requires a rigorous and systematic approach in order to diagnose.


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