What is the condition if any patient has altered sensorium during fever and if fever resolves patient became batter.. and this cycle remains multiple times since 15 years.. what could be the cause?
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CDC fever altered mental status emergency signs encephalitis malaria
This is not one specific condition. The symptom pattern is best described as fever-associated altered mental status, often called febrile delirium or acute encephalopathy. It needs medical assessment, especially if it is happening now.
Possible causes include:
- Delirium from high fever or dehydration, particularly in children or older adults
- Low blood glucose, low sodium, kidney/liver dysfunction, low oxygen, or severe systemic infection during fever
- Fever-triggered seizures, with confusion/drowsiness after a seizure. Sometimes seizures may be subtle, such as staring, unresponsiveness, lip-smacking, or unusual behavior
- Recurrent infections, depending on location and exposures. In malaria-endemic regions, recurrent fever with confusion must prompt testing for malaria, including severe/cerebral malaria
- Meningitis or encephalitis, although repeated brief episodes over 15 years with full recovery makes one continuous untreated brain infection less likely
- Less commonly, an underlying metabolic/genetic disorder or recurrent inflammatory/periodic-fever condition
Fever plus altered sensorium is an emergency warning sign, not something to assume is harmless. The medical text reference specifically lists fever with altered sensorium or convulsions as needing urgent evaluation. The CDC also lists fever with altered mental status among presentations where serious infectious neurologic causes must be considered. Malaria can cause altered consciousness and seizures, and should be considered according to residence/travel exposure, as noted by CDC malaria guidance.
During an episode, go to an emergency department immediately, particularly if there is seizure, severe headache, neck stiffness, rash, repeated vomiting, breathing difficulty, weakness on one side, persistent confusion after fever drops, very low urine output, or inability to drink.
Useful evaluation during an actual episode:
- Blood glucose immediately
- CBC, electrolytes including sodium, kidney and liver tests
- Malaria rapid test and peripheral smear if relevant to the area/travel
- Blood/urine cultures and infection testing as indicated
- Neurologic examination, and sometimes CT/MRI, lumbar puncture, or EEG
Because the pattern has been recurring for 15 years, consultation with an internist/infectious-disease physician and neurologist is reasonable. Keeping a log of fever timing, temperature, confusion duration, possible seizure features, infections, travel, medications, and test results can help identify the cause.
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