Fever (Pyrexia) : Type, Symptom, Cause, Temperature, Diagnosis, Treatment, And Drug

Fever (Pyrexia) is a condition that has a temperature above the normal range due to an increase in the body's temperature set-point.Normal body temperatures vary depending on many factors, including age, sex, time of day, ambient temperature, and activity level.Harrison's textbook of internal medicine defines a fever as a morning oral temperature of over 37.2 C (over 98.9 F) or an afternoon oral temperature of over 37.7 C (over 99.9 F) while the normal daily temperature variation typically 0.5 C (0.9 F).Hyperpyrexia is a fever with an extreme elevation of body temperature greater than or equal to 41.5 C (106.7 F)

Children with a high temperature can develop a febrile seizure.It is known as a Febrile convulsion.It may cause ear infection, gastroenteritis, and cold.Fabrile seizure occurs in the age of children between six months to six years old.It affects commonly boys than girls.The children with febrile seizure do not need the treatment.The temperature can be controlled by Acetaminophen (Paracetamol), sponging and sodium valproate or clonazepam (anticonvulsant).

There are two types of Febrile seizure

1. Simple Febrile Seizure is the seizure that lasts no longer than fifteen minutes and does not occur again during a 24-hour period.In most cases it happens less than five minutes.The symptoms of simple febrile seizure include the stiff body and arm, twitched leg, vomiting, urinating, defecating, and the loss of conciousness but the eyes open.
2. Complex Febrile Seizure is the seizure that lasts longer, comes back more often and affects the part of body.

Types of Fever

• Continuous fever is a body temperature greater than 37.7 C (100 F) that continues to persist for twenty four hours or more.
• Remitten fever is a fever pattern in which temperature varies during each 24-hour period but never reaches normal.
• Intermitten fever is an attack of fever, with recurring paroxysms of elevated temperature separated by intervals during which the temperature is normal.It can be divided into three types.Quotidian fever is a fever with a periodicity of 24 hours and it is typical of Plasmodium falciparum.Tertian fever is a fever with a periodicity of 48 hours and it is typical of Plasmodium vivax.Quartan fever is a fever with periodicity of 72 hours and it is typical of Plasmodium malariae.
• Undulant fever is a fever that is typically undulant rising and falling like a wave.It is an infectious disease due to the bacteria Brucella that characteristically causes rising and falling fevers, sweat, malaise, weakness, anorexia, headache, muscle pain, and back pain.
• Relapsing fever is a vector-borne disease caused by infection with certain bacteria in genus Borrelia, which are transmitted through the bites of lice or soft-bodied ticks (genus Ornithodoros).

The Symptoms of Fever

• Feeling cold
• Sweating
• Shivering
• Dehydration
• Headache
• Muscle pain
• Loss of appetite
• General weakness
• Lethargy
• Sleepiness
• Depression
• Inability to concentrating

High fever between 39.4 C (103 F) and 41.1 C (106 F) can cause

• Hallucination
• Confusion
• Extreme Irritability
• Convulsion
• Delirium

Causes of Fever

• Viral, bacterial, and parasitic infections , such as malaria, urinary tract infection, meningitis
• Medications, such as antibiotics
• Rheumatoid arthritis
• Over-exposure of the skin to sunlight
• Silicosis
• Heat stroke
• Alcohol withdrawal
• Amphetamine abuse
• Some immunizations, such as tetanus, diphtheria, acellular pertussis or pneumococcal vaccine

Temperatures of Fever

• Temperature in the anus (rectum/rectal) is at or over 37.5 - 38.3 C (99.5 - 100.9 F).
• Temperature in the mouth (oral) is at or over 37.7 C (99.9 F).
• Temperature under the arm (Axillary) is at or over 37.2 C  (99.0 F).

The Normal Temperatures in Healthy Adult Men and Women

• Temperature in the anus (rectum/rectal) is at 34.4 - 37.8 C (93.9 - 100.0 F).
• Temperature in the mouth (oral) is at 33.2 - 38.2 C  (91.8 - 100.8 F).
• Temperature under the arm (Axillary) is at 35.5 -  37.0 C (95.9 - 98.6 F).
• Temperature in the ear drum (tympanic membrane) is at 35.4 - 37.8 C (95.7 - 100.0 F).

Temperatures of Fever in Infants

• A new born is at less than 36.1 C (97.0 F).
• Younger than Age 3 months in the anus (rectal) is at  or over 38.0 C (100.4 F).
• Between Age 3 to 6 months is at or over 38.9 C (102 F).
• Between Age 6 to 24 months is at or over 38.9 C (102 F).

Diagnosis of Fever

Some tests are done to diagnose fever depending on the signs and symptoms of fever.The temperature of the patient is taken.

• Blood Test is a laboratory analysis performed on a blood sample that is usually extracted  from a vein in the arm using a needle or via fingerprick.It is used to determine physiological and biochemical states, such as disease, mineral contents, pharmaceutical drug effectiveness and organ function.
• Urine Test is to check  different components of urine, a waste product made by the kidneys.
• X-Ray is to create pictures of the inside of the body.

Treatment  and Drugs for Fever

1.  Sponging or bathing feverish children with tepid water.
2. The use of a fan or air conditioning may reduce temperature and increase comfort.Aggressive cooling is needed If the temperature reaches the extremely high level of hyperpyrexia.
3. Keeping adequately hydrated

Drugs for Fever :

• Antipyretics such as Ibuprofen (Advil, Motrin IB) and Acetaminophen are used for children.Ibuprofen and acetaminophen are to reduce fever.Ibuprofen is more effective than acetaminophen (paracetamol).The consumption of Acetaminophen (Tylenol) in high doses or long-term use can cause kidney or liver damage.
• Aspirin is used for adults.