Fever of Unknown Origin in a Nigerian Doctor: An unusual case

The causes of persistent fever in sub-Saharan Africa are enormous and unraveling the diagnosis could be a daunting task when investigations for common infective and non-infective conditions and treatment response to the most logical differential diagnoses have proved disappointing. We report the case of a 29 year old Nigerian medical practitioner with recurrent high grade fever, petechie and body weakness for over three weeks, whose condition remained largely undiagnosed after rigorous laboratory investigations. He received numerous antimicrobials without remission of fever but withdrawal of all medications was associated with cessation of fever which left us wondering if it was a case of drug fever. The possibility of drug fever should be entertained in patients being investigated for fever of unknown origin who have received several medications without change in the height and pattern of fever.