104 fever for over a week

104 degree fever for a week
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drzeoli
Message 16 of 16 , Jan 15
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Thanks for your response, Eric.  And thanks again to everyone who replied to this topic.

I want to give a follow-up on this case, fyi.

As a recap, an 18 yo young man was suffering with a 104 degree fever for a week along with flu-like symptoms including fatigue, muscle aches, cough, and diarrhea.  Treatment included all of the usual things like bedrest, plenty of water, anti-viral herbs, colloidal silver, hydrotherapy, homeopathy, vitamin C therapy, etc.  He was feeling somewhat improved and did not return for his planned visit a few days later.

Instead he returned to the clinic five days later with new symptoms of labored and shallow breathing.  At this point we obtained a chest x-ray and a CBC to confirm a diagnosis of bacterial pneumonia.  This was a scary situation for me.  The young man looked terrible, and his vitals were similarly terrible.  He could breath only by panting using his diaphragm, and his ribcage wasn't moving at all.  His resting pulse rate was 120 beats per minute.  He still had the 104 degree temperature.  His blood pressure was 120/45.  The finger oximeter showed an oxygen concentration of 84 percent.  Neutrophils were elevated and calcium, sodium, and chloride were all below the reference range.  When I encouraged him to take deep breaths so that I could listen to his lungs, this was somewhat possible.  Interestingly, his lungs sounded fine on auscultation.

I learned a lot about pneumonia from this case.  There are at least two types of presentations of pneumonia on a chest x-ray.  One type is reported as "diffuse airspace disease", meaning that there is no consolidation of lung tissue.  Luckily this was the type my patient had.  The second type is much more problematic and likely requires immediate hospitalization.  Lobar pneumonia shows lobar consolidation on an x-ray, and this is a much more serious situation.

A five-day course of azithromycin, 250mg four times per day, cleared this case up quickly.  Hospitalization was not necessary.  I like to think that if the patient and his family were more compliant with my treatment recommendations, then it would have been possible to avoid the use of antibiotics.  But maybe I am wrong about this?  Any comments?

David Zeoli, ND, LAc
Charlottesville, VA






Eric Yarnell
Message 15 of 16 , Jan 14
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Or West Nile virus which is definitely circulating in the US (while dengue is pretty limited to bits of TX and FL). Just wait until chikungunya gets here.


Eric Yarnell, ND, RH(AHG)
Seattle, WA



laurarepola
Jan 13
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Some viruses are so strong!  It certainly sounds like the flu, but probably feels more like Dengue fever.  Interesting thread folks.
Laura Repola, ND
Butte, MT



dr_bier
Message 13 of 16 , Jan 7
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Hi David,

All good questions, and I think the answer to all of them is yes. It's a both-and situation, in that clearly this was a very difficult virus for mom, and you would want to do everything possible to boost her and the son so that they could get through it quicker.

Was it an immune building exercise and is there a deeper cause? I think only the future will show. If mom keeps getting sick more often and is down longer then the average, than there is clearly something in her immune response that needs more help. If not, than this particular virus hit her hard, probably helped strengthen her and that's the end of it.

Jacob makes a good point about the terrain/field that's incredibly important to remember. And I think we all have seen that viruses tend to come in patterns - this one hits most people with a cough for 2 weeks etc. Around that is the bell curve of life that may be the interaction between the field and the individual human being - some knock it out in 2 days, some take 4 weeks. When someone is too far off the end of the bell curve - still coughing as badly 6 weeks later and looking more like pneumonia, then I get concerned.

Some randomly related thoughts -
- Viruses/bacteria will have greater predilection to causing illnesses in different people based on genetics/microbiome/haplotypes etc. Those of us with kids have probably noticed that 100 patients can cough in our faces with no problems, but my kids would sort through 1000s when in school, pick the one that matches our systems just right, and bring them home to get me sick. My immune status being consistent, some viruses match better.

-Possibly related to that, some people/families get different infections based on their set-up, weaknesses etc. As a family, we didn't get the pukes, no matter what viruses were going around, whereas other families seem to get them all the time. One would get seemingly every throat virus, the other the sinus ones.

-We are likely going to be seeing things getting significantly worse - with the melting of so much of the permafrost  etc around the world and insects spreading into larger and different ecological niches, viruses that haven't been around for millennia and that we likely have no immunity too are reappearing  -http://www.mnn.com/earth-matters/climate-weather/stories/melting-ice-could-release-old-viruses

I



Ian D. Bier, ND, PhD, LAc, FABNO
Naturopathic Doctor, Licensed Acupuncturist
Fellow, American Board of Naturopathic Oncology
Vice-Chair, Board of Medical Examiners, American Board of Naturopathic Oncology



jacobschor
Message 12 of 16 , Jan 6
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I hear phrases to this effect often, "Oh I had that bug and felt awful.  It lasts ten days".

When people hear my voice, they often tell me this.  That because they have had a bout of acute laryngitis, they have had the same infection as I have had and that the course of the illness will be similar.

 In their statement the implication is that the symptoms are specific to the strain of virus or bacteria causing the infection and the assumption is that whoever becomes infected with that particular bug will have similar symptoms.

Whatever happened to our idea of the fertile field?  I think there is a great variation in disease expression that will be dependent on the host, their individual nutritional status, immune function, their sleep debt, their genome, biome, vital force and other individual influences on field shall we say fertility.

Lots of people catch the flu each winter.  A percentage of people die from it.  In general it is the old and the young, the immune compromised and the comorbid that succumb, though some years the influenza virus shifts and those most susceptible do not fall into the normal categories we worry about.

Assuming your family has the flu rather than something else....  It does appear that your and they are in the thick of flu this past week.

Unfortunately every once in awhile some kid gets sick with what we expect to be a short lasting acute infection and it turns out to be something more complicated.  We had a 23 month old boy two weeks ago who came down with the same crud as his two older siblings had and we were quite ready to write it off.  The kid had been kind of punky all fall with one infection after another.  Again, older siblings in preschool and kindergarden, it didn't seem that out of the ordinary.  Except that the pediatrician ran a CBC and found ALL.

So perhaps I'm still reacting to this child's diagnosis or perhaps to my own chronic condition that has nothing to do with the many case histories of laryngitis that strangers have shared with me over the years. Whichever it is, they should be  timely reminders that we need to treat the individual and not generalize to quickly about the presumed disease.


Jacob Schor
Denver CO



drerikak
Message 11 of 16 , Jan 5
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If it's helpful you can also send patients to this blog post: Don't suppress that fever! (and why I don't like Tylenol) - Naturopathic Pediatrics
 image
Don't suppress that fever! (and why I don't like...
Annika got her first fever over Christmas. It went up to 105.8° F (on a temporal artery thermometer). I can just hear the other parents now: …
View on naturopathicpediatric...
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(Titled: Don't Suppress that Fever (and why I don't like Tylenol)

It also has links to the Children's hospital article about fever management.  Actually fevers aren't intrinsically dangerous until 108 degrees.  Yikes that is high!

- Erika Krumbeck
Montana Whole Health & Naturopathic Pediatrics



Dr. Coleen Murphy
Message 10 of 16 , Jan 4
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Hi David,

would you still say that her sickness was a necessary part of building strength?
In this case I would think that yes the mother does need to get sick to strengthen her immune system.
The fact that she was sick for so long makes me think that she is weak and has a poor constitution

Would you want to do something to help the son get through this illness in a shorter amount of time with less weight loss than the mother?
I would certainly add immune herbs/ food like mushrooms. But also, I would expect the son to have a shorter duration than the mother. I would expect he is not as run down as his mother.

Being a naturopath, would you want to find a deeper cause to the illness so as to prevent it from happening again?
I would be looking at the mother's overall health. She needs to address her weakness and lack of immune strength.


~Dr. Murphy Assalian
Orange County, CA



Mona Morstein
Message 9 of 16 , Jan 4
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Hello, David,

I love discussions about sickness, and yes, naturopathic medicine absolutely believes getting sick is a clearing of gastrointestinally based “toxins” from the body; that the toxins establish an unhealthy mileau that the microorganism is used to dissipate. With these kinds of high fevers, the key is 1) letting the body work naturally and not surpressing symptoms and 2) ensuring the illness doesn’t cause a serious consequence, such as pneumonia. Using naturopathic medicine, and rest (especially) can ensure both factors are taken care of. Losing weight is not a problem, and is easily gained back.

Mona Morstein, ND, DHANP
Tempe, AZ
www.diamend,info
Official Sponsor of NatChat—Doctor’s Data Labs




drzeoli
Message 8 of 16 , Jan 3
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Hi Ian,

Thank you for your response.  I think that you bring up a good point for discussion.  How sick should "healthy" people be getting?  I suppose that from a certain perspective, you could say that everyone in the family mounted a good immune response and that this is a sign of good health.  But where do we draw the line between what's normal and what needs to be addressed at a deeper level?

I provided most of the details, but I didn't tell you everything.  The mother of the family had the hardest time with this illness.  She was sick in bed with a fever for two-and-a-half weeks.  She stopped eating at one point and lost about 10 pounds as a result.  It took a lot of effort and a variety of treatments to support her through this illness, but she did eventually make a full recovery.

Knowing these details, would you still say that her sickness was a necessary part of building strength?  Would you want to do something to help the son get through this illness in a shorter amount of time with less weight loss than the mother?  Being a naturopath, would you want to find a deeper cause to the illness so as to prevent it from happening again?

Respectfully,
David Zeoli, ND, LAc
Charlottesville, VA





David Zeoli, ND, LAc
Message 7 of 16 , Jan 3
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Thanks for your response, Dr. Blake!

I will recommend the Spanish mantle.

David


Ian Bier
Message 6 of 16 , Jan 3
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Fever - Myths Versus Facts.pdf
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Hi David,

I am interested in understanding your thinking about finding it 'hard to understand how it happened', or maybe just furthering the discussion. I tell patients that getting sick is like body building for the immune system - a necessary part of building strength. We don't want to be sick all the time, or have something linger for weeks to months, but processing viruses and bacteria is necessary to keep the immune system tuned up. It sounds like everyone mounted a good immune response, and then it resolved. Or am I missing a piece of the case?

Fevers are an essential part of the immune response and are perfectly safe up to about 106. Allkids.org (Johns Hopkins) used to have a great Myth vs Fact sheet on fever which they've taken down, but I have a pdf of (attached). I use it to give to fearful parents so that they can see that even the most conservative of medical establishments supports allowing fevers to go. St Louis Children's Hospital has posted the same -  http://www.stlouischildrens.org/articles/kidcare/fever-myths-versus-facts.

I





Ian D. Bier, ND, PhD, LAc, FABNO



Mona Morstein
Message 5 of 16 , Jan 3
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Yup, my first sick patient of the week had that exact bug. She got over it fine, only it lasted 10 or so days with her. Just stayed home and nothing serious occurred.

Mona Morstein, ND, DHANP
Tempe, AZ
www.diamend,info
Official Sponsor of NatChat—Doctor’s Data Labs



Eric Blake
Message 4 of 16 , Jan 3
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I can't find the thread on my iPhone but I did just want to say that the Spanish mantle ( a loosely wrung wet sheet pack) is a specific for fevers over 104. Repeat as needed once warm until the fever breaks.

Sincerely
Dr. Blake

Eric Blake ND, DAc
Naturopathic Physician,
Diplomate in Acupuncture
Member of the Oncology Association of Naturopathic Physicians
Member of Oregon Association of Naturopathic Physicians



Dr. Jena Peterson
Message 2 of 16 , Jan 2
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Hello
I have actually seen this with a parasitic infection, caused a high fever, malaise, and various flu like symptoms as well as loss of appetite.  This particular parasitic infection was obtained by swallowing dirty water, but aside from loss of appetite had no other GI symptoms or signs.
I ended up treating presumptively with mebendazole (not available in the US any longer) and had immediate improvement.  The disease was then present in another family member, just emphasizing how easily fecal oral transfer happens in a household!  The next family member got the illness within a few days of the first, and when treated with the same medicine she also improved dramatically and quickly.  Albendazole is the drug that has "replaced" mebednazole, and the mebendazole is available in Canada still.
Hope this helps.
Jena Peterson ND
Seattle

Full Circle Natural Medicine www.doctorjena.com Dr. Jena Peterson Naturopathic Medicine



drzeoli
Message 1 of 16 , Jan 2
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Hello Everyone,

Over the past month, I have seen a family of four adults one-by-one suffer flu-like symptoms along with an unremitting 104 degree fever for a week or more.  They are a health-conscious family with excellent diets and lifestyle habits, and it's hard to understand how this ever happened.

First the daughter got sick, then a week later the parents, and now finally the son is sick this week.  The daughter and parents have since made a complete recovery. The son is the only family member who is currently suffering with this.

All of them had very similar symptoms including a cough, body aches, loss of appetite, diarrhea, vomiting, and a 104 degree fever that lasts for a week or more.

Has anyone else seen anything like this?  Do you have any advice?  We've tried all of the usual treatments for the son, but his fever continues despite well chosen homeopathics, herbs, vitamin therapy, acupuncture, hydrotherapy, etc.

Any help would be greatly appreciated.

Thanks!!
David Zeoli, ND, LAc
Charlottesville, VA