If the fever doesn't go away for a week, could it be a combined disease?

As we all know, although fever is a very common disease, if it is not controlled in time, it will cause the body's temperature to continue to rise, the immunity to drop rapidly, and in severe cases it will affect the development of the brain. Therefore, after having a fever, you should first take some physical methods to reduce the temperature. And generally speaking, people's fever does not last long. If you have a fever for a long time, it is likely caused by an organic disease. So, if the fever doesn’t go away for a week, could it be tuberculosis?

The possibility of tuberculosis cannot be ruled out. It is recommended to check sputum smear, chest X-ray, PPD test, etc. to clarify.

Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis that can invade many organs, with pulmonary tuberculosis infection being the most common. People who excrete bacteria are an important source of infection. A person does not necessarily develop tuberculosis after being infected with tuberculosis bacteria. Clinical illness may only occur when the body's resistance is reduced or cell-mediated allergic reactions increase. If diagnosed promptly and treated appropriately, most patients can recover clinically.

Clinical manifestations

1. Symptoms

There is a history of close contact with tuberculosis. The onset can be acute or slow, mostly with low fever (especially in the afternoon), night sweats, fatigue, poor appetite, weight loss, menstrual disorders in women, etc. Respiratory symptoms include cough, sputum, hemoptysis, chest pain, varying degrees of chest tightness or dyspnea.

2. Physical signs

Pulmonary signs vary depending on the severity of the disease and the extent of the lesions. It is difficult to find positive signs in early-stage, small-scale tuberculosis. Those with a wider range of lesions will have dull percussion, increased vocal fremitus, low alveolar breath sounds and moist rales. In late stage tuberculosis, fibrosis develops and local contraction causes pleural collapse and mediastinal displacement. In the early stages of tuberculous pleurisy, there is a pleural friction sound. When a large amount of pleural effusion is formed, the chest wall becomes full, dull to percussion, and the vocal fremitus and breath sounds decrease or disappear.

3. Classification and staging of pulmonary tuberculosis

(1) Pulmonary tuberculosis classification ① Primary pulmonary tuberculosis (Type I) is a primary syndrome with intrapulmonary exudative lesions, lymphangitis and dumbbell-shaped changes of hilar lymphadenopathy, which is more common in children, or only manifests as hilar and mediastinal lymphadenopathy. ② Hematogenously disseminated pulmonary tuberculosis (type II) includes acute miliary tuberculosis and chronic or subacute hematogenously disseminated pulmonary tuberculosis. Acute miliary tuberculosis: scattered miliary-sized shadows in both lungs, which are of the same size and density. The miliary shadows are evenly distributed and may merge with each other as the disease progresses. Chronic or subacute hematogenous disseminated tuberculosis: nodules and linear shadows of different sizes, new and old lesions, uneven distribution, and blurred or sharp edges appear in both lungs. ③ Secondary pulmonary tuberculosis (type III) This type includes various changes in which the lesions are mainly proliferative, infiltrative, caseous or cavitary. Infiltrative pulmonary tuberculosis: X-rays often show cloudy or small-scale infiltrative shadows with blurred edges (exudative) or nodules or cord-like (proliferative) lesions, large areas of consolidation or spherical lesions (caseous - visible cavities) or calcifications; chronic fibrocavitary pulmonary tuberculosis: mostly in the upper part of both lungs, also unilateral, with a large amount of fibrous hyperplasia, cavities formed in them, resembling broken cotton wool, lung tissue contraction, hilum lift, hilar shadow showing "weeping willow-like" changes, pleural hypertrophy, chest collapse, and local compensatory emphysema. ④ Tuberculous pleurisy (Type IV): Pleural effusion on the affected side. A small amount of effusion will result in a shallowing of the costophrenic angle. A moderate amount or more of effusion will result in a dense shadow with an arc-shaped upper edge.

(2) Stages ① Progressive stage: Newly discovered active pulmonary tuberculosis. During follow-up, the number and size of lesions increase, cavities appear or expand, sputum bacterial examination turns positive, and clinical symptoms such as fever worsen. ② During the follow-up of the improvement period, the lesion absorption improved, the cavity shrank or disappeared, the sputum bacteria turned negative, and the clinical symptoms improved. ③ In the stable period, the cavitation disappears, the lesion is stable, and the sputum bacteria continue to turn negative (once a month) for more than 6 months; or the cavitation still exists, and the sputum bacteria continue to turn negative for more than 1 year.