[81F] Experiencing severe headache, fever, and confusion

Patient Description

An 81-year-old female has been experiencing a severe headache localized in the front part of her head, rated 8 out of 10 in intensity, starting suddenly 7 days ago, coinciding with the commencement of prescribed eye drops. The headache is described as aching, with no relief found from resting or any other measures. Accompanying symptoms include fever that presents at night and dissipates by morning, accompanied by significant sweating to the extent of soaking the back of her shirt, confusion impacting daily functioning, and a loss of appetite with minimal food intake over the past 6 days. The patient has a medical history of thyroid surgery approximately 40 years ago and gallbladder removal 5 years ago, with no ongoing conditions from these surgeries. She is currently on blood pressure and thyroid medications. Recent diagnostic tests, including an MRI and a CT scan, initially suggested a small stroke, which was later reconsidered. The CT scan appeared normal, and doctors have raised the possibility of tick fever as a diagnosis.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possible conditions:

  • Side effects from eye drops: Some eye drops can cause systemic side effects, including headaches, confusion, and fever. However, these side effects are rare and usually occur with specific types of eye drops like glaucoma medications.

    • Treatment: If you suspect your symptoms are related to your eye drops, you should stop using them and contact your doctor immediately.
  • Infections: Certain infections can cause headaches, fever, confusion, and loss of appetite. These include tick-borne diseases like Lyme disease or Rocky Mountain spotted fever, as well as other types of bacterial or viral infections.

    • Treatment: If an infection is suspected, your doctor may prescribe antibiotics or antiviral medications.
  • Dehydration: Given that you're not staying well-hydrated and have a loss of appetite, dehydration could be contributing to your symptoms. Dehydration can cause headaches, confusion, and fever.

    • Treatment: It's important to drink plenty of fluids and eat nutritious foods. If you're severely dehydrated, you may need to receive fluids intravenously (through an IV).
  • Stroke or Transient Ischemic Attack (TIA): Given your age and symptoms, it's possible that you experienced a stroke or TIA, which is a "mini-stroke" that lasts only a few minutes. Symptoms can include sudden headache, confusion, and weakness. However, you mentioned that your doctors have ruled this out.

    • Treatment: If a stroke or TIA is suspected, it's important to seek immediate medical attention. Treatment can include medications to break up clots and prevent future strokes, as well as rehabilitation therapy.

What you can do

  1. Contact your doctor: Given the severity of your symptoms and your age, it's important to seek medical attention immediately. Your doctor can help determine the cause of your symptoms and recommend appropriate treatment.

  2. Stay hydrated: Try to drink plenty of fluids, even if you don't feel thirsty. This can help prevent dehydration.

  3. Rest: Try to get plenty of rest. This can help your body recover.

What you should look out for

  • Worsening symptoms: If your symptoms get worse or you develop new symptoms, seek medical attention immediately.

  • Signs of a stroke: These can include sudden numbness or weakness in the face, arm, or leg, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, or loss of balance or coordination; or sudden severe headache with no known cause.

Remember, I'm an AI and not a doctor. It's important to consult with a healthcare professional who can evaluate your symptoms and condition.

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8 mo ago


People Also Ask


Can eye drops cause severe headaches and confusion?

Yes, certain eye drops, especially those used for glaucoma, can cause systemic side effects such as headaches and confusion, although these are rare. If you suspect your symptoms are related to eye drops, contact your doctor immediately.


What are the common symptoms of tick-borne diseases like Lyme disease?

Common symptoms of tick-borne diseases like Lyme disease include fever, headache, fatigue, and a characteristic skin rash. If you suspect a tick-borne disease, consult a healthcare provider for appropriate testing and treatment.


How can dehydration contribute to symptoms like headaches and confusion?

Dehydration can lead to symptoms such as headaches, confusion, and fever because it affects the body's ability to function properly. Staying hydrated by drinking plenty of fluids is important to prevent these symptoms.


What should I do if I suspect a stroke or TIA?

If you suspect a stroke or TIA, seek immediate medical attention. Symptoms include sudden numbness or weakness, confusion, trouble speaking, vision problems, dizziness, or a severe headache. Early treatment is crucial to minimize damage.

1 Comments


Leo#3962

7 mo ago

How are you doing now? Have your symptoms gotten better at all?

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