Worried About Fever

I saw my GP today for a follow up visit. They checked my temperature and I was running a low fever. It went up a little as the day went on, but not high enough to cause alarm. I think I've had this fever for about a week now without realizing it, because I have felt terrible. However, I'm not sick with anything communicable, like a cold, flu, etc. What concerns me is that the last time I had a fever like this with no apparent cause, it shot up to 104.3 and I ended up in the hospital for 5 days with sepsis. I'm terrified of that happening again.

Now, I'm on TPN, and I have a PICC line in my arm. When I was hospitalized, they theorized that the sepsis was caused by a PICC line infection, even though my site looked perfect. They tried to culture the end of my line, and nothing grew at all. So they couldn't definitively say it was a PICC line infection. The only cultures that grew anything were from my blood. But when I went into the hospital, I was having severe abdominal pain, so I thought it was related to my GI problems.

I know many people with Crohn's run fevers. I also know that many people with Crohn's end up in the hospital for days or even weeks. For those here who have ended up hospitalized, I'm wondering, were you ever hospitalized for a high fever? Also, for those of you who were given antibiotics while in the hospital, were you given the antibiotics for a fever caused by a bacterial infection related to your Crohn's?

I'm just trying to get a handle on what might be going on with me. Thanks in advance for your help.

Brian

I don't have any other symptoms besides the fever and worse D than usual. That's why I don't think it's a bug. When I went into the hospital last time, they never checked for an abscess or anything else gastrointestinal, besides doing an abdominal ultrasound, which wouldn't show anything anyway. I think they were so convinced that it was due to my PICC line that they didn't even bother.

I was given antibiotics at the hospital, as well as when I went home. They put me on a 10-day course of IV Vancomycin, which knocked out the infection fairly quickly. I actually felt better than I had in months after the Vancomycin. It only lasted for about a week though.

Thanks, and wow, that had to have been frightening being packed in ice because the fever was so high. I felt like I was becoming delirious at 104.3, so I can't imagine what you felt like. I'm sorry to hear about your experience. It couldn't have been easy dealing with that and being in the hospital for over 2 weeks. But it helps to know that I might not have been off base about it being gastrointestinal last time, and possibly this time as well. It kind of freaked me out when my TPN pharmacist called me and said "you know, I have the reports, and they don't really have any evidence of it actually being a PICC line infection". It's scary to think Crohn's can cause sepsis out of nowhere.

Yes, the PICC line is for IV Nutrition, also known as TPN. A PICC line is a type of central line, but instead of being in the chest, it's placed in the arm. It stands for Peripherally Inserted Central Catheter. It can get infected fairly easily, and the infections can lead to sepsis and become fatal if not treated immediately.

I've had it for 5 years now. When I first got sick, I started dropping tons of weight. It seemed like everything I ate made me sick, no matter what it was. It carried on for about a year and a half, until I had been reduced to 105 pounds, as a 5'10" male. It was at this point that I was hospitalized, and put on TPN to get my weight back up to a healthy level. It was supposed to be temporary, but without a proper diagnosis and treatment, it stretched on for years. I've been trying to get a diagnosis for 8 years, and it was only in the past couple months that Crohn's was even considered as a possibility. My new GI believes that I have it, and he's doing the proper tests to confirm it. Once it's confirmed, I can start treatment and hopefully no longer need the TPN. I'm currently awaiting the results of some blood tests and for my insurance to approve the capsule endoscopy.

hey brian... having been on TPN for almost 13 years, i say, get rid of the dang picc. if your gionna be on it long term more than ayear, you should have been offered a central line years ago. less prone to infection, longer lasting, easier to use etc... i have had FUO ( fevers of unkonwn origin) for many years and have had every test imaginable to find a cause. none ever found. they used to come around about every 6-8 weeks last for 3 days and vanish just as rapidly as they came. in amatter of minutes some times. i routinely hit 104 and even up to just over 105 once. its a bad thing to have to go through. never been hospitalized for them , sure trips to the ER but nothing is ever found. good luck.

in my 3 epsodes of sepsis, none were ever related to the lines. always leaking bowel, abcess, or blood infection from prcedures. died the first time in '99, but the other too were just hospitalizations till i felt better and then home for more iv antibiotics. usually 4 weeks at a stretch.. you have to be sure that the cultures come back clean or it can start all over again in a while when the colony of bacteria regrows.

Do you have an Infectious Disease Doc? I'm guessing you are followed by one since you have a PICC? I would insist on more blood cultures, STAT! They should draw cultures from your PICC and a vein.

Adults don't usually run fevers. If you have had once for several days, don't play around, get the cultures! I had a fever back in March for 20+ days. I had no other symptoms. Endocarditis (strepacacous mitis). Now I have congenital heart disease, which is why I was vulnerable, but the bacteria grew very large and I had to have open heart surgery to clean the infection and replace my aortic valve.

The moral of the story, if you have a fever there is something wrong. Get it figured out.

jdiane,

I'm sorry to hear what happened with you. I had an Infectious Disease specialist following me when I was in the hospital with sepsis, but not since then. On a positive note, my fever has dissipated on its own. I chalk it up to Crohn's or a bug without any other obvious symptoms. Because Crohn's itself can cause fevers, it's tough to figure out what's going on in the absence of additional symptoms. If it had exceeded 102, I definitely would have had it checked out.

randy,

Mine was also staph...but they apparently never identified which one. All my records say is "coagulase negative staph", which corresponds to multiple species of staph, including the one you had. They assumed that it was a line infection, and therefore, made its way up my line from the skin. Staph lugdenensis is a commensal of the skin as well, but in your case, it was obviously in the GI tract as well. That's interesting to me, because the same thing could have been the cause of my sepsis, but the doctors just assumed it had to be my PICC line. Thanks for letting me know.

Hi Brian - I was DX'd w/UC in '82, colon out in '93, now they're thinking Crohn's. For about 5-6 years I experienced fevers of up to 104. These would appear sporadically in the beginning but became more and more frequent. I'd feel like crap, I'd call them flu-things - they included terrible headaches, fatigue, eye pain, etc. I was tested and tested, everything negative (including blood cultures). At this point, no one was suspecting Crohn's. Never went to the ER, never to the hospital. However ...

In Dec. 2010, my girl parts started to swell, so I requested an MRI, fearing a fistula. My dx was correct, I had a fistula running from my jpouch through the perineum. The happy news was that the fevers stopped once the abscess/fistula appeared, and the abscess was lanced. I haven't experienced fevers/flu-things since the fistula dx., which was 1-1/2 years ago. The thought is that there was some intestinal leakage going on due to the fistula formation, causing a major infection. I've been on antibiotics for the fistula, so perhaps that had something to do with the disappearance of the fevers ... but I'm currently off antibiotics (only 2 days), and feeling just fine.

I'm just sayin' ... I'd ask about getting an MRI to rule anything like this out. It's not likely you have anything like this going on, but ruling it out would be a very good thing.

Best wishes --