Lack of fever during acute infections

Not having a proper fever is definitely a thing for ME CFS
- from my own experience.
- and from discussion/comments from prof Meirleir

important is to make the distinction between
1. High fever (= pyrexia) = sustained high temperature +38°, sweating, chills, cold/hot, aching muscles/body
2. Low grade fever(ish) or flu-ish = slight increase temperature, flu-ish symptoms (headache, sore throat, etc)

There’s definitely a ME CFS group that never gets high fevers - even in case of the first Covid infection or similar. I myself, for example, do not ever get high fevers, since ME CFS, even when I had severe sepsis and had to be hospitalized.

This ‘never-high-fever’ seems more common with the longer term ill and more severe.
Often in the early stage of ME CFS you get continuously sick from every virus running around.
In the later more severe stages, this might happen less.

At least, in my case: nowaydays I never even get a real immune reaction. Like the last time I had to cough continuously or had a real continuously, runny nose I don’t even remember.
It’s always this increase of symptoms without a proper attack from the immune system to the virus invader.

I don’t know how much other patients can relate to this experience, early stage versus late stage??


Note: I remember during/after the only one real successful therapy I ever had during my long illness - the only period I was improving - I got (high) fevers again + proper immune reactions
And I actually enjoyed the fevers.
And even better: I enjoyed the feeling when the fever had left my body: no brain fog and less fatigue

 

Well if you have, so have all the GPs that I’ve seen who generally seem skeptical about infection as a cause of infection symptoms unless temperature is raised.

 

Those GPs may indeed be wrong then, because there is nothing unusual about not having a fever with a cold, for example. Here, some images from the CDC and the Cleveland Clinic, where the symptom fever is called rare or is absent for the common cold. From what I understand, in the case of some adults, some low-grade fever may happen if there is a raised temperature but that's it. It is also normal not to have any.

I'm sure the common cold is not the only infection (or bunch of infections more precisely) that doesn't characteristically raise body temperature. I also had glandular fever without any actual fever and my GP didn't bat an eye, he suspected glandular fever right away regardless.

I don't doubt that there are GPs who are skeptical about infections unless you have a raised temperature, I just don't think they are very good GPs.

 

Tbf to them it’s not been all GPs altogether but certainly the majority that I’ve seen in recent years. I don’t think it’s colds that they expect to see temperatures for, just everything else.

Also I have no way of knowing whether or not they deny infection without a high temperature when what they really think is that I specifically can’t have an infection because I have ME and therefore, they assume, I mostly imagine infections that I don’t have. And this is their go to, without proof to the contrary like a temperature, or if it’s that they earnestly believe temperatures must occur.

I do feel confident though that they do earnestly believe that an infection without a temperature is a trivial matter. I’ve been treated way better on the odd occasion that I have raised a temperature.

 

I have exactly the same experience in the Netherlands.
GP’s / doctors Have this standard question in their repertoire when you Come for a consult and you describe a period of viral (or bacterial) infection: Do / did you have a temperature ?

This seems to be like a ‘triage’ (decision tree) to decide if the illness you have / had is serious or not.
I presume there is (some) truth to that as a fever-reaction is the body’s most effective response to start fighting a serious infection.

But they don’t take into account the group of patients that rarely develops a fever.
I think this accounts for ME CFS (at least for a cohort)
But as I understand also for some healthy peopz that never (or seldom) get fevers. Also as I understand from above discussion from pre-MECFS experience.
(I certainly did get fevers pre-MECFS)


Some GP and other MD examples from my personal experience:
- when I had severe sepsis, but no fever, it really took the Drs much longer before I got hospitalized. 7 days after GP visit, absolute insane
- Also, when I had another bacterial infection and when I had pretty severe COVID again the lack of fever did not help me

 

Oh goodness. You’re lucky to be alive. But not at all lucky to be so seriously ill and neglected for so long. I’m so sorry to hear this.

 

What eventually convinced the doctor to send you to hospital?

 

My blood tests came back : all markers went through the roof.
Had to rush to the hospital.