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Q: My mother (age 51) has had a fever for several weeks. She has developed a rash all over her body. She went to the doctor for blood tests, and they said her blood sugar was high and some of the liver function results were abnormal. She does not drink or smoke and has no other conditions or illnesses. She went in for more tests today but will not know the results for one week. What is it that the doctors are testing for?
A: Increased heat in the body is generally caused by increased production, decreased elimination of heat, or a dysfunctional thermoregulatory system in the brain. Most causes of fever are due to the effect of toxins on the thermoregulatory center in the brain. These toxins could be due to many possible causes. Typical such possible causes include drugs, bacteria, parasites, fungal infections, viruses, and other infectious agents. Other possibilities include tissue injury due to trauma and also the breakdown of cells, as occurs in cancer, leukemias, autoimmunediseases, etc. In many of these cases, the fever may be accompanied by a rash.
In the particular case of your mother, you stated that she had abnormal liver function tests. Hence, one should consider the possibility of viral hepatitis as a possible cause of her fever and rash, which may be present with this disease. The differential diagnosis of hepatitis include many viral and bacterial diseases with which it may be confused. Examples include infectious mononucleosis, influenza, herpes simplex infections, cytomegaly virus infections, syphilis, etc. To determine whether your mother has indeed hepatitis, blood is examined to establish whether blood markers for hepatitis are present. However, as mentioned above, the abnormal laboratory values of your mother could also be accounted for by other possible conditions. If a diagnosis is not made from the blood results, a liver biopsy may be considered in order to establish a diagnosis. Also, a skin biopsy may also be considered in oreder to try to establish a diagnosis. I think your mother should specifically discuss with her doctors which tests they have already done, the results obtained, and how they are going to proceed in their attempt to establish a diagnosis.
Updated: 06/12/99
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