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fever
·Fever (pyrexie) refers to a pathological increase in body temperature, which is caused by the human body's action on pyrogens that shifts the set point of the temperature regulation center upward. ·It is the most common clinical symptom and an important clinical manifestation in the progression of the disease. Can be found in a variety of infectious and non-infectious diseases. ·Drawing is not easy, I hope you enjoy it, thank you!
Edited at 2024-01-19 17:18:20
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fever
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- Outline
fever
Overview
·The normal range of temperature measurement under the armpit is 36~37℃. If it exceeds 37℃, it is called fever. ·The body temperature of women is slightly higher than that of men, and the body temperature of young adults is higher than that of the elderly ·Generally, body temperature does not fluctuate by more than 1°C within a day. ·After the cause of the fever is identified, the body temperature can be lowered through drugs, physical methods, etc.
Fever refers to when the body is under the action of pyrogens or when the function of the hypothalamic temperature regulation center is changed due to various reasons. The body temperature rises beyond the normal range. Generally speaking, when the armpit, oral, and rectal temperatures exceed 37°C, 37.3℃ and 37.6℃, or the temperature fluctuation exceeds 1.2℃ within 24 hours, it is called fever.
Under-armpit temperature measurement (axillary measurement) is the most commonly used method of measuring body temperature. Oral temperature measurement The results of (oral measurement method) are more accurate, and the results of transanal temperature measurement (anal measurement method) are stable. The ear measurement method is mostly used for infants and young children, while the forehead measurement method measures forehead temperature and is only used for body temperature screening.
In general, the normal body temperature of different people varies slightly. Women are slightly taller than men, The body temperature is slightly higher than normal before menstruation and during pregnancy; it is higher in young adults than in the elderly.
Time, activities, environment, etc. may also affect body temperature. For example, body temperature in the afternoon is higher than in the morning, strenuous exercise, The body temperature may rise slightly after labor and eating, and generally the fluctuation does not exceed 1°C; the body temperature may also rise in high-temperature environments.
What are the types of fever?
Classification according to heating temperature
It can be divided into low heat, moderate heat, high heat and ultra-high heat. (Based on oral temperature, the range is as follows:)
·Low fever: 37.3~38
·Medium heat: 38.1~39℃
·High fever: 39.1~41℃
·Ultra high heat: above 41℃
Classification according to body temperature change characteristics
Fever:
It means that the body temperature is constantly maintained at a high level above 39~40℃. For days or weeks, the body temperature does not fluctuate more than 1°C in 24 hours. Common in lobar pneumonia, typhus and typhoid fever.
Relaxation fever:
Also known as septicemia fever, the body temperature is often above 39°C with a wide range of fluctuations. The 24-hour internal body temperature fluctuation range is more than 2°C, but all are above the normal range. Commonly seen in sepsis, rheumatic fever, severe pneumonia and purulent inflammation.
Intermittent heat:
The body temperature suddenly rises to a fever peak, lasts for several hours, and then quickly drops to normal levels. The intermittent period can last for 1 day or even several days, and the high fever period and intermittent period alternate repeatedly. Commonly seen in malaria, acute pyelonephritis, etc.
Wave fever:
The body temperature rises rapidly to above 39°C and gradually drops to normal levels after a few days. It lasted for several days and then gradually increased again, repeated many times. Common in brucellosis.
Relapsing fever:
The body temperature rises sharply to 39°C or above, lasts for several days, and then drops suddenly to normal levels. The period of high fever and no fever lasts for several days and then alternates regularly. Seen in Hodgkin's disease.
Irregular heat:
The body temperature curve of fever has no certain rules. It can be seen in tuberculosis, rheumatic fever, bronchopneumonia, exudative pleurisy, etc.
How does fever appear?
Normal body temperature and body temperature rising mechanism
The body temperature of normal people is controlled by the thermoregulatory center, and the body's body temperature is controlled by nerve and humoral factors. The heat production and heat dissipation processes are in dynamic balance, keeping the body temperature within a relatively constant range.
The temperature regulation center is located in the hypothalamus and has a set point similar to that of an air conditioner temperature controller. The set point determines the body temperature level. When the set point moves upward, the body will undergo a series of changes, increasing heat production, reducing heat dissipation, and eventually generating fever.
The process of body temperature changes
Fever is generally divided into three stages: body temperature rising period, high fever period, and body temperature dropping period.
temperature rise period
During the period of rising body temperature, fatigue, muscle aches, pale skin, Symptoms such as chills or chills. There are two ways of body temperature rising: sudden rise and slow rise.
·Sudden rise: body temperature reaches 39~40℃ or above within a few hours, often accompanied by chills. Children are prone to convulsions. Common in malaria, lobar pneumonia, sepsis, Influenza, acute pyelonephritis, infusion, or reactions to certain medications.
·Slow rise: The body temperature gradually rises and reaches a peak within a few days, usually without chills. Such as fever caused by typhoid fever, tuberculosis, brucellosis, etc.
high fever period
After the body temperature rises to the peak, it remains for a period of time, which is called the hyperthermia period. The duration varies depending on the cause. At this stage, the chills disappear, the skin becomes red and a burning sensation occurs, breathing becomes deeper and faster, and sweating begins and gradually increases.
hypothermia period
After the cause of the disease is eliminated, the set point of the body temperature center can gradually drop to the normal level, and the body temperature will also decrease. Gradually decreases, sweating increases, and the skin becomes moist. There are two ways for body temperature to drop: sudden drop and gradual drop.
Sudden drop: The body temperature drops rapidly to normal levels within a few hours, sometimes slightly lower than normal. Often accompanied by profuse sweating. Commonly seen in malaria, acute pyelonephritis, lobar pneumonia and infusion reactions.
·Gradual drop: refers to the body temperature gradually falling to normal within a few days, such as typhoid fever, rheumatic fever, etc.
reason
The main causes of fever are infectious diseases and non-infectious diseases, and some drugs can also cause fever.
What diseases may be associated with fever?
There are many causes of fever, which can be clinically divided into two categories: infectious and non-infectious. Acute fever is more common in the former.
Infectious diseases
Various pathogens such as viruses, bacteria, mycoplasma, rickettsiae, Infections caused by spirochetes, fungi, parasites, etc., whether acute or Fever can occur subacute or chronic, local or systemic.
non-infectious diseases
·Hematological diseases: such as leukemia, lymphoma, malignant histiocytosis, etc.
·Connective tissue diseases: such as systemic lupus erythematosus, dermatomyositis, scleroderma, rheumatoid arthritis and polyarteritis nodosa, etc.
·Allergic diseases: such as rheumatic fever, drug fever, serum sickness, hemolytic reaction, etc.
·Endocrine and metabolic diseases: such as hyperthyroidism, thyroiditis, gout and severe dehydration.
·Thrombus and embolism diseases: such as myocardial infarction, pulmonary infarction, splenic infarction and limb necrosis, usually due to heat absorption.
·Intracranial diseases: such as cerebral hemorrhage, concussion, brain contusion, etc., which are central fever. Status epilepticus can cause fever, which is caused by excessive heat production.
·Skin lesions: Extensive skin lesions cause the skin to reduce heat dissipation and cause fever, which is seen in generalized Dermatitis, ichthyosis, etc. Chronic heart failure can also cause fever by reducing heat dissipation from the skin.
·Malignant tumors: Various tumors can cause fever.
·Physical and chemical damage: such as heatstroke, after major surgery, internal bleeding, fractures, large area burns and severe sleeping pill poisoning.
·Autonomic nervous system disorder: Autonomic nervous system disorder affects the normal body temperature regulation process. The heat production is greater than the heat dissipation, and the body temperature rises, mostly low fever. Common functional low fevers include the following.
·Primary low fever: It can last for several years, the heat pattern is more regular, and the temperature fluctuation range is small, mostly within 0.5℃.
·Low fever after infection: After fever caused by infection such as viruses and bacteria, the high fever subsides but the low fever persists, accompanied by fatigue, loss of appetite, etc.
·Summer low-grade fever: Low-grade fever only occurs in summer. It subsides on its own after the coolness of autumn. It recurs every year and usually heals on its own after several consecutive years. It is more common in young children, whose body temperature regulation center function is imperfect, who are weak in summer, and more likely to occur in people with malnutrition or brain hypoplasia.
·Physiological low fever: Low fever can occur after mental stress or strenuous exercise. Low fever can occur before menstruation and during pregnancy.
What medications may cause fever?
Fever caused by drugs may not cause other symptoms and is often related to personal constitution. Drugs that may cause fever include amphotericin B, beta-lactam drugs, procaine, quinidine, Carbamazepine, phenytoin, bleomycin, interferon-α, interleukin-2, etc.
Seek medical advice
Although fever is generally not life-threatening, unexplained fever Children, the elderly, pregnant women and other people should seek medical treatment promptly when they develop fever.
If you have fever, you can go to the fever clinic, emergency department, infectious disease department, respiratory department, etc.
Because fever is often caused by some infectious diseases (such as new coronavirus pneumonia, etc.) important manifestations, so when people at risk of exposure develop fever, You should take precautions and communicate promptly before seeking medical treatment to avoid spreading it to others.
What preparations should be made before seeking medical treatment for fever?
When your child has high fever and convulsions while waiting for medical rescue or on the way to the hospital on his own, Turn the child's head to one side to avoid choking vomit into the trachea. Keep your airway open and do not put anything into your mouth.
If you have fever and convulsions, you need to tell your doctor whether this has happened in the past. Does anyone else in your family have similar symptoms or have been diagnosed?
Provide whether there is a long-term medication history and whether there are underlying diseases such as tumors, hyperthyroidism, etc.
When does a fever require emergency treatment?
Although fever is generally not life-threatening, some causes of fever can often cause Irreversible injuries, such as repeated febrile convulsions and persistent epileptic convulsions in children, are indications for emergency treatment. If the following situations occur, you should consider going to the emergency room or calling 120 for treatment immediately.
·Children need to seek medical attention promptly when they develop convulsions due to persistent high fever, which often manifest as: Rigid limbs, staring eyes, unresponsiveness, foaming at the mouth, generally not accompanied by Incontinence of urine and feces, convulsions can stop on their own, and consciousness can return to normal.
·Sustained high fever or ultra-high fever, that is, body temperature exceeding 39°C, If you have unclear consciousness and talk nonsense, you need to seek medical treatment in time.
·Severe dehydration or circulatory disorder caused by high fever requires prompt medical treatment. Common symptoms in children are: No tears when crying, dry skin, sunken eye sockets, oliguria, cold limbs, When symptoms such as spots on the skin appear, be aware that it may be a sign of shock.
Adults who have a body temperature of 39°C or higher and are accompanied by the following symptoms should rush to the hospital emergency department immediately.
·Severe headache.
·Unusual rash, especially if the rash worsens rapidly.
·Exceptionally sensitive to strong light.
·Stiffness in the neck and pain when the head is tilted forward.
· Mental confusion.
·Persistent vomiting.
·Trouble breathing or chest pain.
·Abdominal pain or pain when urinating.
·Convulsions or seizures.
Which department do I usually go to for treatment when I have a fever?
·All patients with fever can go to the fever clinic for treatment.
·Children can also go to the Department of Pediatrics and Pediatric Internal Medicine for treatment.
·Adults can visit internal medicine or respiratory departments.
What tests are needed for fever?
Physical examination
Sight, touch and hearing
·Inspection: observe expressions and mental conditions, And whether there are skin lesions and rashes on the skin, whether there are symptoms of rapid breathing and labored breathing.
·Palpation: Whether the skin is dry, whether there is enlargement of the thyroid gland or lymph nodes (Anterior cervical lymph nodes, posterior cervical lymph nodes, submandibular lymph nodes, submental lymph nodes, inguinal lymph nodes, etc.), Whether there is tenderness or rebound tenderness in the abdomen, whether there is hepatosplenomegaly, etc.
·Percussion: The percussion content of patients with fever is less, and the main purpose is to discover the original cause or secondary disease through percussion. For example, percuss the chest to see if there are lumps and effusions; percuss the abdomen to see if there are ascites effusions and lumps; percuss the kidney area to see if there is pain, etc.
·Auscultation: Auscultate heart rate, rhythm, and heart sounds to determine heart-related problems; Auscultate lung breath sounds to determine whether there is pneumonia, pleural effusion, pleurisy, pneumothorax, etc.
laboratory tests
·Routine blood examination: Routine blood examination is the most commonly used method to determine the cause of fever. The white blood cell count in the blood routine can help determine whether there is infection, through lymphocytes The ratio to neutrophils roughly determines whether it is a bacterial infection or a viral infection.
·C-reactive protein, procalcitonin measurement: C-reactive protein (CRP), Two indicators of procalcitonin (PCT) can reflect the severity of inflammation in the body.
·Etiological examination: smear, culture, specific antigen and antibody detection, etc.
·Blood culture: Blood culture should be done for patients with chills and high fever. For example, in patients with sepsis, the culture results can guide subsequent treatment and medication.
·Others: Thyroid function testing can help diagnose diseases such as hyperthyroidism, and testing of immune-related indicators Autoimmune diseases can be checked, and tumor marker testing can be performed if tumors are suspected.
Film degree exam
·Chest X-ray: Chest X-ray can quickly determine whether there are lesions in the lungs. At the same time, the condition of the heart and lungs can be indirectly judged through the projection of the heart and great blood vessels.
·Chest CT: If fever is accompanied by cough, sputum, hemoptysis, chest tightness, etc., Doctors generally recommend a chest CT to check the specific conditions of chest inflammation and guide further treatment and drug selection. Chest CT can provide more detailed observation and more accurate judgment for pneumonia, tuberculosis, lung cancer, etc.
Invasive examination
· Lumbar puncture: Patients with fever accompanied by headache and vomiting need to perform lumbar puncture if necessary. Examine the cerebrospinal fluid to determine whether there is intracranial infection.
· Bone marrow aspiration: Fever accompanied by abnormal blood routine, or fever accompanied by special travel history, If necessary, complete bone marrow puncture and determine whether there are
·Others: If a primary disease is found while searching for the cause of fever, some tests for the primary disease may be done. If a space-occupying lesion is found, biopsy or contrast-enhanced imaging of the lesion may be performed to consider the tumor.
diagnosis
There are many causes of fever, The doctor will make a clear diagnosis based on medical history, physical examination, auxiliary examinations, etc.
Fever is more common due to infectious diseases and often needs to be differentiated from non-infectious fever.
How are illnesses causing fever diagnosed?
For patients with fever, emergency, critical, and fatal diseases need to be ruled out first to ensure that critical illness
After that, detailed medical history collection, physical examination, auxiliary examination, etc. are required. The diagnosis is confirmed after careful identification. Here are some diseases that may cause fever.
common cold
influenza
Coronavirus disease
Hyperthyroidism
septicemia
What conditions need to be distinguished for fever?
The identification of fever mainly depends on the identification of different causes. Preliminary identification can be based on heat type and accompanying symptoms.
Identification based on heat type
·Resident fever: common in lobar pneumonia, typhus and typhoid fever.
·Tlaxotic fever: common in sepsis, rheumatic fever, severe pneumonia and purulent inflammation.
·Intermittent fever: common in malaria, acute pyelonephritis, etc.
· Undulant fever: common in brucellosis.
·Relapsing fever: seen in Hodgkin's disease.
·Irregular fever: The body temperature curve of fever has no certain rules. It can be seen in tuberculosis, rheumatic fever, bronchopneumonia, exudative pleurisy, etc.
Identification based on accompanying symptoms
Fever with headache
Fever with abdominal pain (vomiting)
Fever with convulsions
Fever with chills
Fever with rash
Fever with swollen lymph nodes
treat
The treatment of fever is divided into symptomatic treatment and etiological treatment.
Symptomatic treatment mainly uses drugs and physical methods to cool down. Treatment of the cause is the key to relieving fever.
home care
·For fever caused by infectious diseases, attention should be paid to the fever process Patients lose water due to elevated body temperature, so pay attention to drinking water and rehydration.
·Infectious diseases may be contagious, such as influenza, tuberculosis, COVID-19, etc., need to be isolated as required to avoid spreading to others. Those who have just recovered from the disease should avoid crowded places and closed environments to avoid reinfection.
·If there are patients with fever caused by endocrine diseases, they need to take medication regularly and follow the doctor's advice, and review at the appropriate time.
·When fever is obvious, physical cooling can be provided, such as warm water bath, ice compress, etc. Loosen your clothes appropriately to dissipate heat. It is not recommended to use alcohol wipes to reduce fever.
What are the professional treatments for fever?
The treatment of fever includes symptomatic treatment and etiological treatment. The specific treatment varies according to the cause.
Symptomatic treatment
·Drugs to reduce fever: Oral acetaminophen, ibuprofen, etc. are commonly used.
·Physical cooling: Warm water baths and ice compresses are good physical cooling methods. Cooling blankets are commonly used to control the body temperature of patients with persistent high fever during hospitalization.
Cause treatment
·Fever due to infection
·Fever caused by endocrine diseases
·Fever caused by tumors
·Fever due to other reasons
daily
During fever, it is recommended to rest, reduce physical exertion, and properly replenish water and other nutrients.
After recovery, it is recommended to gradually resume normal exercise, continue to exercise, and improve physical fitness.
What should you pay attention to when eating for fever?
For patients with fever, pay attention to a light diet and adequate protein and vitamin supplements. Eat less foods high in fat and spicy foods, such as spicy hot pot and hot pot; In addition, meals should not be overly full, which will increase the burden on the gastrointestinal tract and is not conducive to disease recovery.
For patients with prolonged fever, foods with more soup can be used to supplement the loss of water caused by fever.
Avoid drinking alcohol while taking treatment medications.
What should you pay attention to when living with fever?
·During fever, you should take appropriate rest, reduce physical exertion, avoid overexertion, and maintain a good mood.
·After recovery, you can perform appropriate low-intensity exercise every day, such as walking, slow walking, swimming, etc., and gradually return to normal activities.
What are the precautions for fever?
Some patients follow the doctor's requirements for regular follow-up visits to evaluate the treatment of the disease that caused the fever.