What Causes Frequent Symptoms Like Severe Headache, Fever, Tiredness, Chills And Sweating?

Posted on Fri, 3 Jul 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 3 Jul 2015 Answered on

Thu, 30 Jul 2015 Last reviewed on

Question : Hi my son a usually healthy atletic 20 year old has frequent symptoms like a viral infection; Big Headache, 103 fever, tired feels abosultely out of it including shivering and sweat. depends a bit but every 3 to 5 months he is out of commission for 3-4 days, then he gets quickly better and then like nothing happened. All doctors so far could not find the issue. Extensive and exotic bloodwork was done, nothing unusual.
Now this happens since high school and I wonder if this could be related to events he has. Tests in school, something exciting happening or something he looks very much forward to. like this time he had great news from the internship he is in and looked forward to come home. Next morning he is very sick.

Ideas where to look?

Regards,

XXXX
YYYY@YYYY

Answered by Dr. Dr. Erion Spaho (1 hour later)

Brief Answer:
Paroxysmal sympathetic hyperactivity or fever of unknown origin.

Detailed Answer:
Hello and thanks for using HCM.

I have read your query and understand your concerns.

First there's need for more information about what possible causes of fever are excluded by testing.
- was hyperthyroidism as cause?
- which possible recurent infections are excluded?
- were excluded blood disorders (lymphoma eg.) as cause of fever?

In my opinion, there are two possible conditions to look for about your son's condition:
1. Paroxysmal sympathetic hyperactivity is a condition that causes increased activity of the sympathetic nervous system, triggered in some cases by strong emotions. Symptoms include increased heart rate, increased blood pressure, diaphoresis ( sweating) and hyperthermia or fever. This condition is associated with brain damage by different factors, but causes of unknown origin exist.

2. Fever of unknown origin, associated with chronic inflammatory diseases such autoimmune diseases, Vasculitis, sarcoidosis etc.

Hope this helps. I remain at your disposal for further questions and clarifications.

Best regards.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Dr. Erion Spaho (3 days later)

one point I did not mention
when he is sick he gets fevers and when the fever is treated he sweats a lot.
While he is sick blood tests show an elevated count of white blood cells.
after he recovers the blood counts are back to normal.

Answered by Dr. Dr. Erion Spaho (8 hours later)

Brief Answer:
Familial Mediterranean syndrome is a possibility.

Detailed Answer:
Welcome back.

Are you and your wife Mediterranean or Middle Eastern descendants?

If so, then there exists a syndrome called Familial Mediterranean Fever, an recessive inherited disease related to a gene defect (MEFV gene) and genetic testing needed.

Hope this helps. Best regards.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Erion Spaho (20 hours later)

Thanks, we are not. I am Swiss and my wife is XXXXXXX - Italian

Regards,

XXXX

Answered by Dr. Dr. Erion Spaho (4 hours later)

Brief Answer:
Fever of unknown origin should be assessed further.

Detailed Answer:
Hi again XXXXXXX

In this case then, most probably your son's symptoms are caused by fever of unknown origin, a condition where common causes of fever ( infections) are excluded clinically and by tests results, but other special tests are needed to assess less common causes of periodic fever.

I suggest you to discuss with your son's primary care Doctor about other tests needed to be done.

Hope I helped you. Wishing good health for you and your family.

Above answer was peer-reviewed by : Dr. Raju A.T