FEVER

Group 3: Ahlam Ali

Sakarie Hassan
Mohamed Mohamoud
 WHAT IS FEVER ?
• Increase in body temperature over the
normal value of an individual
• Normal is 97-100° F on rectal
measurement.
• Fever when rectal temp >100.4° F (38 °C)
oral temp > 99.5° F (37.5 °C) axillary temp >
99 °F (37.2° C)
• Hyperpyrexia temp > 107 °F ( 41.5 °C)
 EVALUATION OF FEVER
Clinical examination
• Localize the fever to a particular system by
presenting complaints
• identify the probable etiology of fever
depending upon duration & type of fever, and
conduct a further clinical examination
 Types of fever
• Continuous fever
• Remittent fever
• Intermittent fever (Quotidian ,Tertian,
Quartan)
• Relapsing fever (Pel Ebstein fever)
 Localizing the focus of fever
• Exanthematous fevers: rash, erythema,
pustules , nodules
• URTI: cough, cold, throat pain, running
nose, dysphagia, earache, horse voice ,
stridor , regional lymphadenopathy
• LRTI: cough, difficulty & fast breathing ,
wheezing, crepitations, chest pain, sputum
• UTI (upper): pain abdomen,vomiting,renal
angle tenderness
(lower): burning micturition, urgency,
frequency, hematuria
• Hematological: pallor, bleeding spots ,
bleeding from any site, lymphadenopathy,
bone pain
• CVS: dyspnea, palpitation, pedal edema,
precordial pain & buldge, prominent neck
veins
• Hepatobiliary: jaundice, vomiting,
diarrhea, pain abdomen, abdominal
distension, hepato- spenomegaly
• CNS: vomiting, headache, seizures,
lethargy, altered sensorium, neck rigidity,
irritability, abnormal tone, abnormal
movement.
 Etiology of fever
Short duration fever
• lasting for less than 2 weeks
• Usually due to infection (bacteria, viral,
fungus, protozoa)
Prolonged duration fever
• lasting more than 2 weeks
• Both infectious & non-infectious causes
 Management of fever
Two methods of antipyresis

Non-pharmacological
• Environmental measures
• Hydration (fluids)
• Hydrotherapy (sponging)
Pharmacological therapy
• Drugs: paracetamol, ibuprofen,mefenemic
acid
 Fever of Unknown Origin
Definitions: Fever (rectal temp > 38° C)
more than 3 weeks duration documented by
health care provider, for which the diagnosis
could not be established even after 1 week
of investigations in a hospital setting.
Nosocomial unknown: pt developed fever
after hospital admission
Neutropenic unknown: fever in a pt with
Absolute Neutrophile Count< 500
 Etiology
Infections
Enteric fever, TB, HIV, chronic hepatitis,
occult abscess, osteomyelitis, infective
endocarditis , kala-azar , brucellosis
Malignancy: Leukemia, Hodgkins
lymphoma.
Autoimmune: Systemic Lupus
Erythematous, Poly Arthritis Nodosa,
Inflammatory Bowel Disease, Kawasaki
disease
 Approach to Unknown Fever
• Evaluation of fever -- onset, type,
duration , character, pattern, course of
illness
• Clinical examination
• Laboratory tests
1st LINE – CBC, peripheral smear,
malaria parasite, widal, CXR , ESR , urine
routine & cultute,blood culture, mantoux
test, LFT , RFT, USG abdomen, special
investigation depending on the clinical clue
2nd LINE – HIV , CT chest and
abdomen ,bone marrow examination , 2D
echo , check complement levels, Ig
levels,specific tissue biopsy, serological
tests for HBsAg , brucellosis, and infectious
mononucleosis
• Its usually possible to determine the
etiology in most cases
• In a small number of cases no cause is
found. In such cases periodic assessment is
done .
THANK YOU