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Colitis Higher than normal temperature - infection or inflammation?

Hello,

I have been running myself around in circles over this for days and still haven't come to a decision, so I'm going to put this out there for more thoughts.

I had my first flare up with Crohn's back in July 2011. I was diagnosed in Sept 2011 and went on Humira in Jan 2012 after the side effects of other medications were deemed worse than the disease.

Around May 2015, I developed three abscesses (perianal), one right after the other. All three were lanced, but one formed an obvious fistula and the other two never quite healed all the way. They were relanced several times the the three months following the first time in 2015 and a more hard core lancing happened during a hospital stay in 2017. I just had one of them relanced on May 11th.

So, to the low grade fever and my dilemma. I get frequent low grade fevers that come and go, and have for over a year, it was one of the reasons why I wanted to get the bigger abscess and trouble maker looked at. I have also noticed an up tic in frequency of seeing blood and mucus in my stool since this last Jan (2020). The last time I saw my GI we were discussing moving me from just the monotreatment (Humira) to a dual treatment involving another drug to help the Humira do it's thing. I also have a round of blood work to get done tomorrow to see if I can tolerate the drug along with a CBC, TB, and Hepatitis A/B tests.

On April 20th, I developed a low grade fever that lasted two days. On April 21st,along with the low grade fever, every bowel movement I had that day had blood in it. This has never happened before. On April 22nd, both had vanished, so I documented it for my June 9th appointment and forgot about it.

However, on May 6th, the low grade fever returned. May 7th, so did the blood. Worried about complications from the abscess, I was put on antibiotics on the 7th. By the morning of May 9th, the low grade fever and blood disappeared, and the abscess was lanced and drained on May 11th. I remained on the antibiotics for the full course.

Unfortunately, within 24 hours of coming off the antibiotics (back on May 17th) the low grade fever has returned. On May 20th, the blood and mucus has been coming and going (I saw some on May 20, 23 and 24).

Now to my dilemma: is the low grade fever being caused by an infection that wasn't treated fully by the antibiotics? Or am I having a flare up because the meds are possibly not working they way they're supposed to? Is there a way to tell that doesn't involve an expensive trip to the ER? I want to deal with the infection - if it is an infection - but I can't afford on my current insurance to go to the ER unless it's truly necessary. I am worried about mentioning all this to my GI and him telling me to just go to the ER and get it done with.

Any thoughts? I know I have to talk to my GI (and I will, when they call me with the test results), I just don't know if I should do it asap (like tomorrow). I'm so scared of a huge bill I can't afford, I'm literally shaking thinking about it.

Thanks for your time,
kyuuichan
1 Responses
15695260 tn?1549593113
Hello and welcome to the forum.  We are very sorry you are having such issues!  This is complex.  You've been very thorough and stayed on top of your health so I commend you for that.  I would call your regular doctor.  ER is for emergency situations and this seems like it could and should be handled by your doctor in a non emergency manner.  I understand about not wanting to go to the ER for the expense of that can be unreasonable.  A doctors copay makes much more sense.  Your appointment is very soon and with these ongoing issues, you should be seen.  It sounds like recurrence of the same issue as the symptoms are always the same.  Colitis often causes a low grade fever, as you know.  Your colitis sounds like it indeed needs treatment management tweaks.  Please let us know your current status and if you can get to the doctor even sooner than your original appointment time.  
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