FEVER

Fever (also known as pyrexia or febrile response) is one of the most common medical signs and is characterized by an elevation of body temperature above the normal range of 36.5–37.5 °C (97.7– [2] 99.5 °F) due to an increase in the temperature regulatory set-point. This increase in set-point triggers increased muscle tone and chills. As a person's temperature increases, there is, in general, a feeling of cold despite an increase in body temperature. Once the new temperature is reached, there is a feeling of warmth. A fever can be caused by many different viral or bacterial conditions ranging from benign to potentially serious. Some studies suggest that fever is useful as a defense mechanism as the body's immune response can be strengthened at higher temperatures, however there are arguments for and against the usefulness of fever, and the issue is controversial. With the exception of very high temperatures, treatment to reduce fever is often not necessary; however, antipyretic medications can be effective at lowering the temperature, which may improve the affected person's comfort. Fever differs from uncontrolled hyperthermia, in that hyperthermia is an increase in body temperature over the body's thermoregulatory set-point, due to excessive heat production or insufficient thermoregulation
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Definition[edit]
Temperature Classification Core (rectal, esophageal, etc.) Hypothermia Normal Fever Hyperthermia Hyperpyrexia <35.0 °C (95.0 °F)[3] 36.5–37.5 °C (97.7–99.5 °F)[2] >37.5–38.3 °C (99.5–100.9 °F)[1][4] >37.5–38.3 °C (99.5–100.9 °F)[1][4] >40.0–41.5 °C (104.0–106.7 °F)[5][6]

Note: The difference between fever and hyperthermia is the mechanism.

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V T E
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A wide range for normal temperatures has been found. Fever is generally agreed to be present if the elevated temperature is caused by a raised set point and:  Temperature in the anus (rectum/rectal) is at or over 37.5–38.3 °C (99.5–100.9 °F)
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  Temperature in the mouth (oral) is at or over 37.2 °C (99. brucellosis. activity level. For example.typhoid.g. with a slow stepwise increase and a high plateau.2°C (>98.4–37.3 °C (99. e.0 °F).9°F) while the [9] normal daily temperature variation is typically 0.8 °F). (Drops due to fever-reducing drugs are excluded. the range of normal.0 °F) In healthy adult men and women. lobar pneumonia. sex. A raised temperature is not always a fever. and more.) . the temperature of a healthy person rises when he or she exercises. For example.7 °C (99. as the set-point is normal.7°C (>99. Normal body temperatures vary depending on many factors.8–100.4–37.5°C (0.6 °F).0 °F). Types[edit] Performance of the various types of fever a) Fever continues b) Fever continues to abrupt onset and remission c) Fever remittent d) Intermittent fever e) Undulant fever f) Relapsing fever The pattern of temperature changes may occasionally hint at the diagnosis:  Continuous fever: Temperature remains above normal throughout the day and does not fluctuate more than 1 °C in 24 hours.9–98. but this is not considered a fever.0 °C (95.2 °C (91. Typhoid fever may show a specific fever pattern (Wunderlich curve of typhoid fever).2–38. and for axillary (the armpit) it is 35. or typhus. On the other hand.1 °F) may represent a clinically significant fever. time of day. Harrison's textbook of internal medicine defines a fever as a morning oral temperature of >37. healthy temperatures for oral temperature is 33. ambient temperature.8 °C (93. if it is unusually high for that person. urinary tract infection. so a "normal" temperature of 37. medically frail elderly people have a decreased ability to generate body heat. for tympanic membrane (the ear drum) it is 35.9°F) or an afternoon oral temperature of >37.8 °C (95.9°F). for rectal it is 34. including age.9 °F) [7] Temperature under the arm (axillary) or in the ear (otic) is at or over 37.7–100. a "normal" temperature may be a fever.9–100.5 – [8] 37.

pyaemia.g. rubeola andenteroviral infections. this fever is. Immediate aggressive cooling to less than [14] 38. serotonin syndrome. also called febrile neutropenia. Kawasaki [15] syndrome. and the patient recovers fully in less than a week. malaria. is a fever in the absence of normal immune system function.7 °F). Infections are the most common cause of fevers. especially if the cause is unknown. However. Because of the lack of infection-fighting neutrophils. . This kind of fever is more commonly seen in people receiving immune-suppressing chemotherapy than in apparently healthy people. drug effects. Infections commonly associated with hyperpyrexia [15] include: roseola. neuroleptic malignant syndrome.. e. there is some debate as to whether this [11] pattern truly exists. then generates heat to achieve this temperature. Following are its types  Quotidian fever. Pel-Ebstein fever: A specific kind of fever associated with Hodgkin's lymphoma. typical of Plasmodium malariae malaria. later cycling [10] back to normal. A neutropenic fever. orsepticemia. Hyperpyrexia[edit] Hyperpyrexia is a fever with an extreme elevation of body temperature greater than or equal to [13] 41. Intermittent fever: The temperature elevation is present only for a certain period. kala-azar. typical of Plasmodium falciparum or Plasmodium knowlesi malaria   Tertian fever (48 hour periodicity). infective endocarditis. and thyroid [14] storm. e. typical of Plasmodium vivax or Plasmodium ovale malaria Quartan fever (72 hour periodicity). Hyperpyrexia differs from hyperthermia in that in hyperpyrexia the body's temperature regulation mechanism sets the body temperature above the normal temperature. with a periodicity of 24 hours.0 °F) has been found to improve survival. Febricula is an old term for a low-grade fever.5 °C (106. a bacterial infection can spread rapidly. Other possible causes include sepsis.9 °C (102. The most common cause is [13] anintracranial hemorrhage. therefore.   Remittent fever: Temperature remains above normal throughout the day and fluctuates more than 1 °C in 24 hours. while in hyperthermia the [13] body temperature rises above its set point due to an outside source. no other symptoms [12] are present. however as the temperature rises other [14] causes become more common.g. usually considered to require urgent medical attention. Such a high temperature is considered a medical emergency as it may indicate [14] a serious underlying condition or lead to significant side effects. being high for one week and low for the next week and so on.