Prolonged fever ranging from 101-103 F at irregular times ,mostly in the evenings.Since 8/05/2007 till date.?

Patients surgery done:
Mitral valve replacement in Feb 2000
Post operative drugs-Tab acitrom 5mg, ecosprin 150 mg OD.
Present history:
Fever from 8/05/2007 at irregular time, mostly in the evenings.
Hospitalised on 11-05-07 at hyderabad for two days.
Admitted at chennai on 18-05-07.Since he was operated in the same hospital
Biochemistry results done at the hospital
LEPTO SPORIASIS - negative
Discharged on 31-05-07 and advised to take antipyretics in case of fever.
Investigation in a hospital at chennai
Brucella agglutination - negative
Mantoux - No induration
HIV (ELISA) - Negative
CT chest - Shows normal study
Investigation done at Haemotology centre
SCAN
Inspite of various investigations sited above the cause of fever is unknown for the last 6 weeks.the patient has no other complaint except fever occuring once or twice daily.
We would be grateful for an expert opinion and course of treatment or suggest a specialist in and around chennai,Tamilnadu ,India.Request immeadiate response

contact ur doctor

thanks Report It

i would like 2 know the results of malarial parasite and microfilaria and esr rate,if this is also normal then it is puo, (pyrexia of unknown origin) this state is called as functional disease that is all organs are normal but symptoms are present then homeopathy is best try it

my sincere advice is to take him to doctor immediately.Go to apollo or any other believable hosptal.

Subacute bacterial endocarditis caused by Streptococcus viridans is the first possibility to be considered. Culture and antibiotics are needed after hospitalisation. Prophylactic long acting penicillin is generally given in all hospitals after surgery. Readmission to the same hospital where surgery is performed is suggested.

get echo to r/o endocarditis

also, malaria is possible

Irregular fever. Did you rule out malaria?

I agree that echo of heart is first choice given patient history of valve replacement. I'm assuming you've already done urinalysis, although you didn't mention it because common things are common you know. If this is infectious, an emperic course of antibiotics, maybe doxycycline since it covers many bugs that can cause relapsing fever like tick-borne dx and ricketsial species, isn't a bad idea, we use them so much anyways, why not give it a shot.