Mystery Diagnosis - Current Fever of Unknown Origin, Fatigue
21yo female
Symptoms: recurrent fever of unknown origin, fatigue and triple phosphate crystals in urine
Labs: negative for covid, flu, strep. Normal chest x ray. Cultures have been done, no infection noted. CBC and Chem 7 normal. Not pregnant. Kidney function normal.
Recurrent fever that comes every week or two for the last 3ish months accompanied with extreme fatigue. She can sleep all days for several days, the fever goes away for a few days and then comes back a week or two later. Doctors have no idea. Urology appointment pending.
Hi JJ,
You said the following:
'Symptoms: recurrent fever of unknown origin, fatigue and triple phosphate crystals in urine '
The following link discusses triple phosphate crystals in the urine and says that this is seen in upper urinary tract infections :
Here is a relevant quote :
' Triple phosphate crystals can be appeared in neutral and alkaline urine and are associated with upper urinary tract infections with urease-producing organisms. Urease breaks down urea into ammonia and carbon dioxide. Triple phosphate may suggest the presence of urea-splitting bacteria in the urine specimens.6 '
About 12% of infections have urease-producing bacteria, but you might have her doctor check for these bacteria. If they opt to use antibiotics, if the bacteria is found, please avoid the family of antibiotics called "quinolones," which includes many drugs such as ciprofloxacin and levofloxacin as two common ones, but this family of antibiotics carry significant side effect potential that should be avoided if at all possible.
Both fatigue and fever are commonly seen in UTIs.
Art
