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How can recurrent fever be cured?

Q: My 29 years old husband is suffering from recurrent fever for the last 3-4 months. It started with high fever with chills, so he was given anti-malarial drugs and he felt normal. Then again after 15 days he got the fever with chills then he was given antibiotics. Again after 15 days of the treatment, the same thing happened and he was given anti-malarial Flacigo. The 4th time he was admitted to the hospital for 5 days and was on anti-malarial medication. When he got fever for the 5th time he was given Lariago DS, Falcinil and Doxy then after that Primaquine for 5 days twice daily. His test result showed ESR-35, spleen-mildly enlarged, liver infection (when admitted to hospital 4th time) but the malaria, tuberculosis (TB) and dengue test were negative every time. His red blood cells and white blood cells were low, platelet count was 2.4, but when admitted to the hospital 4th time the count was 2.6 then it became 1.2 and it recovered up to 1.57, mantoux test-negative, blood culture and urine culture – normal. During fever he suffers from body ache, joint pains at times and leg pain whenever he exerts. In a nutshell, he gets high-grade fever with chills and after taking medicines he becomes fine but after 2 weeks of treatment he again gets fever. What should we do now? How can it be cured? Please advise.

A:In our country, recurrent fever with spleen and liver involvement, chills, joint pains is most likely to be malaria. It is a good idea to take primaquin to try and eradicate malaria. If the fever persists, tests would be needed including malarial smear at the time of fever, malarial antigen. Other causes of similar fever including partially treated typhoid, haematological disorders, kala-azar, endocarditis, Felty's syndrome, brucellosis etc would need to be ruled out. Meet a medicine specialist. Your physician would be able to order the appropriate tests for the same.

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