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Why does my husband have low grade fever with a positive Mantoux test?

Q: My husband is suffering from low grade fever from the past 5 months. We consulted a doctor in UK, who prescribed paracetamol. After our return to India, we did a Mantoux test, which came positive, (20 mm). Our doctor suggested Combinex for 3 months and started the treatment. But there is no recovery till date. The fever usually starts at 4 pm and runs till 9-10 pm. He also has fatigue and muscular pain especially in the calf muscles and the back. Please advise.

A:Your husband has fever of undetermined origin; it is so-called because the offending agent is yet to be determined. Because he is Mantoux positive does not mean that he has TB although that would be a possibility. He was probably exposed to TB organisms sometime in the past, hence the positive reaction. Patients with the fever of undetermined origin are and should be thoroughly investigated by a consultant physician in a hospital setting. These can be very complex problems but in most cases the cause is usually found by a stepwise investigation in a hospital. I would suggest that you should get your husband referred to and seen by a hospital consultant physician.

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