nA.M. temperature of >37.2°C (>98.9°F) or a P.M. temperature of >37.7°C (>99.9°F) would define a fever
nThe normal daily temperature variation is typically 0.5°C (0.9°F).
Temperature measurement
nTo detect fever, oral, rectal, tympanic membrane, and pulmonary artery measurements are more reliable than axillary temperatures
nRectal temperatures are generally 0.4°C (0.7°F) higher than oral readings
nTympanic membrane (TM) thermometers
nLower-esophageal temperatures closely reflect core temperature
Sources of Fever
Physiologic Fever States:
ndigestion
nexercise
novulation
npregnancy
nwarm environment
nemotion
Pathologic causes:
nInfection
nInflammation e.g.connective tissue disease
nNeoplasms
nVaccines
Symptoms
nFever is associated with other symptoms that cause considerable discomfort, such as muscle pains, headache, nausea, aches, a feeling of nausea and noticeable tiredness.
nThe fever is markedly high (over 39 - 39.5ºC).
PRESENTATION OF FEVER
nFeeling hot
A feeling of heat does not necessarily imply fever
nRigors.
profound chills accompanied by chattering of the teeth and severe shivering and implies a rapid rise in body temperature. Can be produced by :
1) brucellosis and malaria
2) sepsis with abscess
3) lymphoma
Excessive sweating.
Night sweats are characteristic of tuberculosis, but sweating from any cause is usually worse at night.
nHeadache.
Fever from any cause may provoke headache.
Severe headache and photophobia, may suggests meningitis
nDelirium.
Mental confusion during fever is well described and relatively more common in young children and in old age.
nMuscle pain. Myalgia is characteristic of
Viral infections such as influenza
Malaria and brucellosis
Continuous fever
nTemperature remains above normal throughout the day and does not fluctuate more than 1 °C in 24 hours,
ne.g. lobar pneumonia, typhoid, urinary tract infection, brucellosis, or typhus.
nTyphoid fever may show a specific fever pattern, with a slow stepwise increase and a high plateau.
Remittant fever
nTemperature remains above normal throughout the day and fluctuates more than 1 °C in 24 hours, e.g., infective endocarditis.
Physical Examination
n Vital signs:HR, BP, RR, Temp, O2 sat
n Lymphadenopathy
n H&N
n Chest
n CVS
n Abd
n Ext
n Skin
n CNS
nFever may sometimes be absent:
nseriously ill newborns
n elderly patients,
nuremic patient,
nsignificantly malnourished individuals,
nreceiving corticosteroids or
ncontineous treatment with anti-inflammatory or antipyretic agents.
HEAT STROKE:http://heatstrokeinhuman.blogspot.com/
