Unexplained recurrent high fever observed in a depressed adolescent

Area of Science:

• Adolescent medicine
• Psychiatry
• Case study research

Background:

• Physical symptoms frequently accompany depressive episodes in adolescents.
• The association between depression and fever in adolescents remains under-explored.
• This study presents the first reported case of unexplained recurrent high fever linked to depression.

Observation:

• A 15-year-old female experienced gradual-onset depression following a class change.
• Concurrently, she developed unexplained chills and recurrent high fever, unresponsive to anti-infective and antiviral treatments.
• Psychiatric evaluation revealed significant anxiety, depression, and somatic symptoms.

Findings:

• The adolescent patient received a combination of pharmacotherapy (venlafaxine, tandospirone, alprazolam), transcranial repetitive magnetic stimulation, visible light therapy, and psychological counseling.
• Within 6 days of treatment, her body temperature normalized, and her mood significantly improved.

Implications:

• Depression should be considered in the differential diagnosis of unexplained recurrent fevers in adolescents.
• This case underscores the importance of considering psychological factors in adolescent physical health presentations.
• Further research is warranted to explore the neurobiological mechanisms linking depression and fever in adolescents.