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Recurring Fever

Recurring Fever

Recurring fever is a symptom that is seen in many diseases. Read on to know all about the various causes, accompanying symptoms and treatment for this condition.
Dr. Sumaiya Khan
Last Updated: Mar 22, 2018
Fever, which is also known as pyrexia, is a condition where there is an increase in the body temperature, usually by about 1 - 2 degrees. Recurring fever is a symptom where the fever fails to recede and keeps coming back in the form of recurrent bouts. It may often occur in conjunction with other serious symptoms, like constant vomiting, irritability, loss of appetite, body pain etc. Thus, there are many diseases that can cause recurring fevers in children and adults, so it is important to diagnose the disease first and then try to treat the disease rather than the symptom. More often than not, the cause of it can be diagnosed easily with the help a detailed history of the patient. For instance, if the patient says that he has recently been to a tropical country then there are high chances that it could be malaria or typhoid, as these diseases are endemic in most tropical countries. However, let us understand about the other possible causes and what may be the treatment options to deal with them.


Typhoid is one of the most common causes of recurring fever. This is a disease that affects the gastrointestinal tract and is caused by the bacteria Salmonella typhi. Typhoid fever symptoms include slowly progressive fever accompanied by rashes and profuse sweating. Classically there is fluctuation between high fever and low-grade fever in typhoid, which thus, manifests as recurring fever. In fact, typhoid is said to be one of the most common causes of this type of fevers in adults.

Animals like cattle, dogs, pigs and camels can get affected by the bacteria called Brucella and humans coming in contact with these animals are at risk of acquiring the bacteria. Slaughterhouse workers, veterinarians, farmers, etc., are at a higher risk of getting Brucellosis. It is also caused by ingestion of unsterilized milk or meat. Symptoms of this disease include joint and muscle pain, profuse sweating and recurring fever.

Malaria is notorious for its fever. In this condition, there is infection caused due to Plasmodium vivax which leads to symptoms like fever, shivering, vomiting, arthralgia, anemia etc.

Other similar causes of recurrent fever include tuberculosis, lymphoma, cancer, borreliosis, hepatitis, cholera, rat bite fever, toxoplasmosis, etc.

Periodic Fever Syndromes
These are a set of genetic disorders where the person experiences recurrent episodes of fever accompanied by various other inflammatory symptoms. Hence they are also known as autoinflammatory syndromes. There are two types of periodic fever syndromes viz., hereditary and non-hereditary periodic fever syndromes.

Hereditary Periodic Fever Syndromes

Familial Mediterranean Fever (FMF)
It is the most common type of periodic fever syndrome and as the name says, it affects or is predominantly seen in specific racial group originating from the eastern Mediterranean area.

As we know that FMF is a genetic disease, the gene that is responsible for causing it is called the MEFV gene. It affects the protein called pyrin, which plays an important role of regulating and controlling the inflammation in the body. When there is a defect in the gene, the regulation of inflammation is affected and hence, the patients suffer from episodes of fever along with other symptoms.

Hyperimmunoglobulinaemia D syndrome (hyperIgD syndrome, HIDS)
Other, a very rare type of hereditary periodic fever syndrome is Hyperimmunoglobulinaemia D syndrome (hyperIgD syndrome, HIDS). It is an inherited autoinflammatory syndrome that shows recurrent episodes of fever along with headaches, abdominal pain, skin rash and enlarged lymph glands. The populations that are affected by this syndrome belong to the Northern European areas, the Netherlands and Northern France.

Non-hereditary Periodic Fever Syndromes

PFAPA Syndrome
It is the most common cause of recurrent fever in children, which usually occurs between the first five years and as early as 1 month of age. The main features of this syndrome are pharyngitis, adenitis, periodic fever and aphthous stomatitis. It has been reported mostly in the areas of Europe and America, however, there is no exact correspondence between its occurrence and geographical conditions, gender or race.

Schnitzler Syndrome
A French dermatologist, Dr. Liliane Schnitzler identified and described the condition in the year 1972, hence it is named as Schnitzler syndrome. The cause of this syndrome is unknown therefore, its diagnosis is often delayed. The patients may approach a general physician, dermatologist, rheumatologist, hematologist because of varied and confusing symptoms.

Accompanying Symptoms

It is very rarely seen that fever is the only symptom of a disease. Hence, given below are the commonly seen symptoms in conjunction with recurring fever:
  • Increased heart rate
  • Profuse sweating
  • Chills and shivering
  • Nausea and vomiting
  • Pain in stomach
  • Abdominal cramps
  • Loss of appetite
  • Lethargy, fatigue and weakness
  • Inability to concentrate

The treatment will depend on the cause of fever. This symptom can lead to various complications if not dealt with on a priority basis. Firstly, the cause of fever will have to be correctly diagnosed. Normally, a blood test or a urine test for the specific microorganism suffices to check for that condition, for example, a Widal test for typhoid helps in reaching a confirmed diagnosis of typhoid. So, once the diagnosis has been confirmed, the treatment for the condition is given. Normally for recurring fever, only anti-pyretics will not suffice as there is mostly a need for systemic treatment in such cases. Hence, administration of antibiotics is almost always done in cases of recurring fever. Depending on the severity of the disease, the antibiotics can be administered in oral or intravenous form.

Precautionary Measures

Although we cannot protect ourselves from exposure to the bacteria and viruses surrounding us, we can at least keep them from infecting us. This can be done by maintaining proper hygiene and a nutritional diet on a regular basis. Given below are a few tips, take a look:
  • Wash hands frequently throughout the day and especially before meals and after using the washroom. Also, if you have a pet in the house, ensure that you wash your hands after petting him.
  • It is recommended to make use of a liquid hand wash instead of soap, for there is a high possibility of germs sticking to the soap and transferring to the hands of another person.
  • If you have cold and cough, ensure that you are using a disposable tissue for sneezing or coughing. Throw the used tissue in the trash and wash hands properly.
  • Drink plenty of water and other fluids to keep yourself hydrated and avoid overexertion.
To sum it up, if you are experiencing repeated episodes of fever for a while, don't neglect, contact your health care provider immediately and get appropriate treatment.

Disclaimer: This HealthHearty article is for informative purposes only and does not, in any way, intend to replace the advice of a medical expert.