Hi. Thank you for writing to HCM.
Your boyfriend seems to be presenting a pattern of
fever that is typical in malarial infections. I would recommend that you have his blood tested for QBC malaria or a peripheral smear (whichever is available). The fever spikes when the parasites enter the blood and subsides when they hide inside an organ.
Liver being tender is also suggestive of malaria (Liver function tests may be normal in early stages).
Also since his WBC's are elevated it does indicate an infections. It would be useful to know the differentials such as if neutrophils are raised then it suggests a bacterial infection and in that case
typhoid must be ruled out. If lymphocytes are elevated then it may be viral and
dengue must be ruled out.
Therefore it is my opinion that you have him evaluated for this fever of unknown origin by a physician for a detailed work up, blood tests and
ultrasound of the liver or may be
CT scan of the abdomen. Based on the results appropriate management may be indicated. Currently
paracetamol to reduce fever is the only symptomatic option. Management for malaria, typhoid and dengue vary considerably.
Hope this helps. Do let me know if you have any other questions.