Ask a doctor on the topic of General medicine

Increased temperature does not improve

January 4, 2011 | 15,00 EUR | answered by Dr. med. Ralf Berg

Hello,

around December 16th (that's almost three weeks ago now, oh my) I caught a pretty bad cold with coughing, a runny nose, but no fever. I stayed at home, kept myself warm, and avoided any exertion. Only after about a week, when I thought I was getting better, did I venture outside. But in the evening, I was completely exhausted and strangely had a sudden increase in temperature (around 37.6, whereas my normal temperature is around 36.3). The following days were a cheerful interplay of exhausted and slightly healthier phases. For about a week now, my temperature has settled at 37.5 and the slightest exertion causes fatigue, exhaustion, and sometimes palpitations.

Is it normal for a viral illness to last this long? And with such an intermittent course? I just did a bit of research on the internet and read that Epstein-Barr Virus reactivation can occur, especially triggered by another infection. I might be overreacting, but I'm really worried.

I visited the doctor today as well. Listening to my heart didn't reveal any abnormal sounds, but there seems to be some lingering bronchitis in my lungs. Lymph nodes in my neck are slightly swollen. The doctor didn't think antibiotics were necessary because general fatigue is more of a symptom of a viral infection (what do you think, could an antibiotic possibly help?). I'm supposed to come back tomorrow for blood tests.

Could you reassure me a bit -- especially in terms of a three-week illness not necessarily indicating a chronic condition?

Thank you.

Dr. med. Ralf Berg

Thank you for your question.

I am happy to answer it, as I am fully able to tell you: Yes, a viral infection can drag on for a long time. It is not the norm, but it does happen. (I have experienced it myself)
The measure taken by your doctor to conduct a blood test is very sensible. On one hand, it may provide further clues about the past virus infection, and on the other hand, it may also reveal indications of another chronic condition, or not !!
The reactivation of EBV or Varicella/Zoster viruses by other viral infections is known and can prolong recovery. You may also suggest to your doctor an ECG examination to rule out involvement of the heart muscle (myocarditis, e.g. in case of infection with Coxsackie viruses). Unfortunately, there are hundreds of different viruses, some with numerous strains, making detection rare. It is most likely when a specific type is suspected based on the symptoms. Antibiotics, as your doctor rightly pointed out, are generally ineffective against viruses. While it is possible for bacterial infections to occur due to weakened immunity after a viral infection, it has been shown that prophylactic antibiotic treatment is rarely successful. I believe you are well advised to stay in touch with your primary care physician, so that if needed, the appropriate antibiotic can be administered.

With best regards and wishes for your recovery,
Dr. R. Berg