Fever let's learn all about it

During my practice of medicine for 25 years I have seen that most annoying sign for most of us is Fever.

Although fever is a sign and not a disease itself , but we will see all about fever and learn few tricks and remedies of fever in this blog.

DEFINITION:

A fever is a temporary increase in body temperature, usually caused by an Infection or other illness. A normal body temperature is around 98.6°F (37°C), but a fever is generally considered to be a body temperature of 100.4°F (38°C) or higher.

TYPES OF FEVER:

There are several types of fever, each with its own set of causes and symptoms. Here are a few examples:

Acute fever: 

A fever that comes on suddenly and lasts for a short period of time, usually less than a week. Acute fever is typically caused by Infections, such as the common cold, the flu, and pneumonia.

Subacute fever:

 A fever that lasts for a period of time between a week and a month, it can be caused by a variety of conditions such as infections, autoimmune disorders, and cancer.

Chronic fever: 

A fever that lasts for more than a month and is typically caused by conditions such as chronic infections, autoimmune disorders, and certain types of cancer.

Intermittent fever:

 A fever that comes and goes, with periods of normal temperature between episodes of fever. This type of fever can be caused by conditions such as malaria, tuberculosis, and certain types of cancer.

Remittent fever:

 A fever that fluctuates during the day, but the body temperature never returns to normal. This type of fever can be caused by conditions such as sepsis, rheumatoid arthritis, and certain types of cancer.

Recurrent fever: 

A fever that returns at regular intervals, usually every few days or weeks. This type of fever can be caused by conditions such as periodic fever syndromes, such as familial Mediterranean fever, and certain types of cancer.

Hyperpyrexia: 

A fever that is extremely high, typically above 104 degrees Fahrenheit (40 degrees Celsius). It can be caused by conditions such as heat stroke, meningitis, and certain types of infection or drug reactions.

TYPES BY TEMPERATURE:

There are several types of fever, classified primarily by the level of body temperature:

Low-grade fever:

 A body temperature between 99-100.4 °F (37.2-38.0 °C) is considered a low-grade fever.

High-grade fever: 

A body temperature above 103 °F (39.4 °C) is considered a high-grade fever.

Intermittent fever:

 A fever that comes and goes.

Remittent fever:

 A fever in which the temperature fluctuates but never returns to normal.

Continuous fever:

 A fever that lasts for an extended period of time without any break.

Hyperpyrexia:

 A fever with a temperature above 106.7 °F (41.5 °C) is considered hyperpyrexia.

CAUSES OF FEVER:

There are many possible causes of fever, including:

Infections:

 Fevers are a common symptom of infections, such as the flu, colds, pneumonia, and urinary tract infections.

Bacterial infections: 

Bacterial infections such as strep throat, meningitis, and sepsis can also cause fever.

Viral infections: 

many viral infections can cause fever, such as the common cold, the flu, and COVID-19.

Parasitic infections: 

Parasitic infections such as malaria and toxoplasmosis can cause fever.

Autoimmune disorders:

 Autoimmune disorders such as lupus and rheumatoid arthritis can cause fever.

Cancer: 

Some cancers, such as leukemia and lymphoma, can cause fever.

Medications:

 Certain medications, such as antibiotics and antipsychotics, can cause fever as a side effect.

Environmental factors: 

Exposure to extreme temperatures or certain chemicals can cause fever.

Idiopathic fever: 

In some cases, the cause of fever may not be able to be determined, known as Idiopathic fever.

PYREXIA OF UNKNOWN ORIGIN:

Pyrexia of unknown origin (PUO) refers to a fever that lasts for more than three weeks and for which the cause cannot be immediately determined by the patient's history, physical examination, or routine laboratory tests. In other words, it's an ongoing fever with no obvious cause after initial diagnostic evaluations. This condition can be caused by a wide range of underlying conditions, including infections, cancers, and autoimmune disorders.

The diagnosis of PUO requires a thorough work-up, including a complete medical history, physical examination, and various laboratory tests to rule out common causes of fever. Additional tests such as imaging, bone marrow biopsy, and other specialized tests may also be needed.

Treatment for PUO will depend on the underlying cause, once it is determined. It may include antibiotics, antiviral medications, or other treatments as appropriate. In some cases, the cause of PUO may not be found and treatment may focus on managing symptoms.

VIRAL CAUSES:

There are many viral infections that can cause fever, here are some examples:

Influenza (the flu): a contagious respiratory illness caused by the influenza virus.

The common cold: a viral infection of the upper respiratory tract that can cause fever, sore throat, and runny nose.

COVID-19: a highly contagious respiratory illness caused by the novel coronavirus.

Measles: a highly contagious viral infection that causes fever, rash, and cough.

Mumps: a viral infection that causes fever, swollen glands, and headache.

Chickenpox: a highly contagious viral infection that causes fever, rash, and itchy blisters.

Mononucleosis (mono): a viral infection that causes fever, sore throat, and swollen lymph nodes.

Rubella: a viral infection that causes mild fever, rash, and swollen lymph nodes.

9.Hepatitis A: a viral infection that causes inflammation of the liver, fever, and jaundice.

10.Hepatitis B & C: both are viral infection that causes inflammation of the liver, fever, and jaundice.

BACTERIAL CAUSES:

There are many bacterial infections that can cause fever, here are some examples:

Pneumonia: an infection of the lungs that can be caused by a variety of bacteria, including Streptococcus pneumoniae, Haemophilus influenzae, and Legionella pneumophila.

Strep throat: a bacterial infection of the throat caused by Streptococcus pyogenes.

Meningitis: an infection of the membranes that surround the brain and spinal cord, can be caused by a variety of bacteria, including Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae.

Septicemia (blood poisoning): a serious bloodstream infection caused by bacteria, such as Escherichia coli and Staphylococcus aureus.

Cellulitis: a skin infection caused by bacteria such as Staphylococcus aureus and Streptococcus pyogenes.

Urinary tract infections (UTIs): infections of the urinary tract, such as cystitis (bladder infection) and pyelonephritis (kidney infection), caused by bacteria such as Escherichia coli and Proteus mirabilis.

Tuberculosis (TB): a bacterial infection that primarily affects the lungs but can also affect other parts of the body.

Diphtheria: a bacterial infection that affects the nose and throat, caused by Corynebacterium diphtheriae.

Syphilis: a sexually transmitted infection caused by Treponema pallidum.

Lyme disease: a bacterial infection transmitted by ticks, caused by Borrelia burgdorferi.

It is important to consult with a doctor if you have an unexplained fever that lasts more than a few days and get a proper diagnostic evaluation.

WORK UP PLAN FOR FEVER:

Medical history: The healthcare provider will ask about the patient's medical history, including any underlying conditions, recent illnesses or infections, and any medications they are taking.

Physical examination: The healthcare provider will perform a physical examination, checking the patient's vital signs (temperature, heart rate, blood pressure, etc.) and looking for signs of infection or inflammation.

Laboratory tests: Blood tests, such as a complete blood count (CBC) and a blood culture, may be ordered to help identify the cause of the fever. Other tests, such as a urinalysis or a chest x-ray, may also be ordered depending on the patient's symptoms.

Imaging studies: Imaging studies such as CT or MRI may be ordered to check the patient's organs, bones, and other internal structures for any signs of infection or inflammation.

Treatment: Once the cause of the fever is identified, the healthcare provider will recommend appropriate treatment. This may include antibiotics, antivirals, or other medications to help fight the underlying infection or inflammation.

SIGNS OF VARIOUS TYPES OF FEVER ON EXAMINATION

The signs of fever on examination can vary depending on the underlying cause of the fever. Here are some examples of signs that may be present with different types of fever:

Infections: General signs of infection such as swollen lymph nodes, redness or tenderness at the site of infection, and other symptoms specific to the type of infection (e.g. cough, sore throat, runny nose) may be present.

Bacterial infections: In addition to the signs of infection, there may be signs of sepsis, such as decreased urine output, confusion, and rapid breathing.

Viral infections: In addition to the signs of infection, there may be viral exanthema (rash) or conjunctivitis (pink eye)

Parasitic infections: In addition to the signs of infection, there may be specific signs depending on the type of parasitic infection. For example, in malaria, there may be jaundice (yellowing of the skin and eyes) and anemia (low red blood cell count)

Autoimmune disorders: In addition to fever, there may be signs of inflammation, such as joint pain and swelling, and skin rash.

Cancer: In addition to fever, there may be signs of weight loss, fatigue, and signs of the specific type of cancer (e.g. a lump or mass).

Medications: In addition to fever, there may be signs of an allergic reaction such as hives, rash, or difficulty breathing.

Environmental factors: In addition to fever, there may be signs of heat stroke or heat exhaustion such as confusion, dizziness, and nausea.

LIST OF INVESTIGATION PLAN FOR VARIOUS TYPES OF FEVER: 

The investigation plan for various types of fever can vary depending on the underlying cause of the fever and the individual's symptoms. Here are some examples of investigations that may be considered for different types of fever:

Infections: Blood tests (complete blood count, blood culture), urinalysis, throat swab, sputum culture, chest X-ray, and other specific tests depending on the type of infection suspected.

Bacterial infections: Blood tests (complete blood count, blood culture), urinalysis, throat swab, sputum culture, chest X-ray, and other specific tests depending on the type of bacterial infection suspected.

Viral infections: Blood tests (complete blood count, viral serology), urinalysis, throat swab, sputum culture, chest X-ray, and other specific tests depending on the type of viral infection suspected.

Parasitic infections: Blood tests (complete blood count, malaria smear), stool examination, and other specific tests depending on the type of parasitic infection suspected.

Autoimmune disorders: Blood tests (complete blood count, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor), joint X-rays, and other specific tests depending on the type of autoimmune disorder suspected.

Cancer: Blood tests (complete blood count, tumor markers), imaging tests (CT scan, MRI, PET scan), biopsy and other specific tests depending on the type of cancer suspected.

Medications: Blood tests (complete blood count, liver function tests, kidney function tests) and other specific tests depending on the medication suspected.

Environmental factors: Blood tests (complete blood count, electrolyte levels), imaging tests (CT scan, MRI), and other specific tests depending on the environmental factor suspected.

TREATMENT OF VARIOUS TYPES OF FEVER:

The treatment of fever depends on the underlying cause of the fever. Here are some examples of treatments for different types of fever:

Infections: Treatment for infections typically involves antibiotics for bacterial infections, antiviral medications for viral infections, and antiparasitic medications for parasitic infections.

Bacterial infections: Treatment typically involves antibiotics such as penicillin, amoxicillin, and cefuroxime.

Viral infections: Treatment for viral infections typically includes supportive care, such as rest, fluids, and over-the-counter pain relievers to reduce fever and relieve symptoms.

Parasitic infections: Treatment typically involves antiparasitic medications such as chloroquine, mefloquine, and atovaquone-proguanil.

Autoimmune disorders: Treatment typically involves immunosuppressive medications such as corticosteroids, methotrexate, and azathioprine to reduce inflammation and suppress the immune system.

Cancer: Treatment for cancer-related fever typically involves the treatment of the underlying cancer, such as surgery, radiation therapy, or chemotherapy.

Medications: Treatment for medication-related fever typically involves stopping the medication, and in some cases, treating the symptoms.

Environmental factors: Treatment for fever caused by environmental factors typically involves cooling the body and rehydration.

LIST OF COMMON MEDICINE BRANDS FOR FEVER TYPES:

The specific medications used to treat fever will depend on the underlying cause of the fever and can be prescribed by a healthcare professional. Here are some examples of common medications used to treat different types of fever.

Infections: Antibiotics such as Amoxicillin, Cefuroxime, and Azithromycin for bacterial infections, antiviral medications such as Oseltamivir (Tamiflu) and Zanamivir (Relenza) for viral infections, and antiparasitic medications such as chloroquine and mefloquine for parasitic infections.

Bacterial infections: Antibiotics such as penicillin, amoxicillin, and cefuroxime.

Viral infections: Antiviral medications such as oseltamivir (Tamiflu) and zanamivir (Relenza) for influenza, and Acyclovir for herpes simplex virus.

Parasitic infections: Antiparasitic medications such as chloroquine, mefloquine, and atovaquone-proguanil.

Autoimmune disorders: Immunosuppressive medications such as corticosteroids (prednisone), methotrexate, and azathioprine.

Cancer: Chemotherapy and other cancer-specific medications, such as targeted therapies and immunotherapies.

Medications: Symptomatic

LIST OF USEFUL HOME REMIDIES FOR FEVER:

Here are some home remedies that may help to reduce fever and relieve symptoms:

Rest: Getting plenty of rest can help your body fight off the infection or illness that is causing the fever.

Hydration: Drinking fluids can help to keep you hydrated and can help to reduce fever by making you sweat.

Over-the-counter pain relievers: Acetaminophen (Tylenol) and ibuprofen (Advil) can help to reduce fever and relieve symptoms such as headaches and body aches.

Cool compresses: Placing a cool, damp cloth on your forehead can help to bring down your body temperature.

Lukewarm bath or shower: A lukewarm bath or shower can help to reduce body temperature and make you feel more comfortable.

Humidity: Adding humidity to the air with a humidifier can help to relieve symptoms such as a dry throat and cough.

Ginger: Ginger has anti-inflammatory properties and can help to reduce fever and relieve symptoms such as nausea and vomiting.

Honey and lemon: Honey and lemon can help to soothe a sore throat and reduce fever.

FOOD THAT SHOULD BE AVOIDED IN VARIOUS TYPES:

The foods that should be avoided during a fever can vary depending on the underlying cause of the fever and the symptoms being experienced. Here are some general guidelines:

Infections: Avoid foods that are high in sugar, as they can weaken the immune system and make it harder for your body to fight off the infection.

Bacterial infections: Avoid foods that are high in sugar and processed foods, as they can promote inflammation and make it harder for your body to fight off the infection.

Viral infections: Avoid foods that are high in sugar, as they can weaken the immune system and make it harder for your body to fight off the virus.

Parasitic infections: Avoid undercooked meats, as they may contain parasites.

Autoimmune disorders: Avoid foods that are known to trigger inflammation, such as processed foods, fried foods, and foods high in sugar and saturated fat.

Cancer: Avoid foods that are known to promote cancer growth, such as processed foods, fried foods, and foods high in sugar and saturated fat.

Medications: Avoid foods that may interact with the medications you are taking, such as grapefruit and grapefruit juice, as they can affect how the medication is metabolized.

Environmental factors: Avoid foods that may be contaminated by bacteria or other harmful microorganisms, such as undercooked meats, raw eggs, and unpasteurized dairy products.

FOODS THAT CAN HELP DURING FEVER:

There are certain foods that can be beneficial to eat during a fever as they can help to boost the immune system, reduce inflammation, and provide essential nutrients for healing. Here are some examples:

Fruits and vegetables:

 Fruits and vegetables are high in vitamins, minerals, and antioxidants, which can help to boost the immune system and reduce inflammation.

Garlic:

 Garlic has antimicrobial and anti-inflammatory properties, and can help to boost the immune system and fight off infections.

Ginger:

 Ginger has anti-inflammatory properties, can help to reduce fever, and relieve symptoms such as nausea and vomiting.

Turmeric:

 Turmeric contains a compound called curcumin, which has anti-inflammatory properties, and can help to reduce fever and relieve symptoms such as joint pain and swelling.

Yogurt:

 Yogurt is a good source of probiotics, which can help to boost the immune system and fight off infections.

Chicken soup:

 Chicken soup can help to relieve symptoms such as a sore throat and chest congestion, and may also have anti-inflammatory properties.

Broth: 

Broth made from bone or vegetable can provide hydration, electrolytes, and nutrition.

Water: 

Drinking water can help to keep you hydrated, reduce fever by making you sweat and ease the symptoms of a fever such as dry throat and mouth.

COMPLICATIONS:

Fever, while a common symptom, can also lead to several complications, depending on the underlying cause and duration of the fever. Here are some examples of potential complications associated with fever:

Dehydration: Prolonged fever can cause sweating and increased urination, which can lead to dehydration.

Organ damage: Some types of infections can cause organ damage, such as pneumonia leading to lung damage, and meningitis leading to brain damage.

Sepsis: A severe bacterial infection that can cause organ failure and be life-threatening if left untreated.

Tissue damage: Autoimmune disorders such as lupus can cause tissue damage to organs such as the kidney and heart.

Delayed treatment: If the underlying cause of the fever is not identified and treated in a timely manner, it can lead to complications and prolong recovery.

Fatigue: Prolonged fever can cause weakness and fatigue, which can make it difficult to perform daily activities.

Loss of appetite: Fever can cause loss of appetite and weight loss.

Delirium: High fever can cause delirium and confusion.

COMMON FEVER IN CHILDRENS:

Fever is a common symptom in children and can be caused by a variety of conditions. Here are some examples of common causes of fever in children:

Viral infections: The most common cause of fever in children is viral infections, such as the common cold, the flu, and roseola.

Bacterial infections: Bacterial infections such as strep throat, ear infections, and urinary tract infections can also cause fever in children.

Vaccinations: Some children may develop a low-grade fever after receiving certain vaccinations, such as the measles-mumps-rubella (MMR) vaccine.

Teething: Some babies may develop a low-grade fever during the teething process.

Other causes: Children may also develop fever as a result of other causes such as febrile seizures, Kawasaki disease, and rheumatoid arthritis.

DIFFERENCES OF CHILD FEVER:

Children tend to have higher fevers than adults with the same illness.

Children may experience more severe symptoms such as dehydration and seizures in association with fever.

Children's immune system is not fully developed, so they are more susceptible to infections and illnesses.

Children's body temperature regulation system is not as mature as adults, making it harder for them to bring down a fever.

Children's fevers often spike higher and last longer than adults.

Children's fevers may be accompanied by other symptoms such as vomiting, diarrhea, and rashes.

Children may be more likely to experience complications from fever such as febrile seizures.

Children may have trouble communicating how they are feeling and may not be able to accurately report their symptoms to a healthcare provider.

COMMON FEVER IN OLD AGED:

Fever is a common symptom in older adults, and can be caused by a variety of conditions. Here are some examples of common causes of fever in older adults:

Infections: 

Older adults are more susceptible to infections such as pneumonia, urinary tract infections, and sepsis.

Cancer: 

Cancer can also cause fever, especially in older adults.

Medications: 

Certain medications can cause fever as a side effect, particularly those that affect the immune system.

Autoimmune disorders: 

Autoimmune disorders such as rheumatoid arthritis and lupus can cause fever in older adults.

Environmental factors: 

Exposure to extreme heat or cold can cause fever in older adults.

Chronic diseases: 

Chronic diseases such as heart failure, kidney disease, and diabetes can also cause fever in older adults.

Cognitive or functional impairment: 

Older adults with cognitive or functional impairment (e.g. dementia, stroke) may have difficulty communicating their symptoms and identifying the cause of fever.

DIFFERENCE IN FEVER OF OLD AGE GROUPS:

Fever can affect people of all ages, but older adults may have different experiences with fever compared to younger people. Here are some examples of ways that fever may differ in older adults:

Lower threshold for fever:

 Older adults may have a lower threshold for developing a fever, and a temperature that would be considered normal in a younger person may be considered a fever in an older adult.

Less specific symptoms:

 Older adults may experience less specific symptoms of fever, such as weakness, confusion, and falls, rather than the more common symptoms of fever such as chills and sweating.

Delayed response to fever: 

Older adults may have a delayed response to fever, meaning that it takes longer for their body temperature to return to normal after an episode of fever.

Increased risk of complications:

 Due to age-related changes in the immune system and other health conditions, older adults may be at a higher risk of complications associated with fever such as dehydration, organ damage, and sepsis.

Difficulty in communication: 

Older adults, especially those with cognitive decline, may have difficulty communicating their symptoms, making it harder for healthcare professionals to identify the cause of the fever.

Multiple underlying causes:

 Older adults are more likely to have multiple underlying causes of fever such as chronic diseases, infections, and medications that can interact with each other.