Persistent Fever in Tuberculosis: Clinical Experience and Literature Review

Fever in tuberculosis has always been a challenge to clinicians treating the disease throughout history. There is a constant interplay between the host immune response and the bacillary load that results in high-grade fevers in patients with tuberculosis. In the setting of pulmonary tuberculosis, there is scant data regarding how long fevers last and the exact pathophysiology of its prolonged duration, especially once appropriate antituberculosis medication is initiated. This case report elucidates our experience in treating a patient presenting with smear-positive pulmonary tuberculosis with significant bacillary load; despite responding microbiologically to antituberculosis therapy, he clinically continued to have persistent fever.