FEVER

John Korsah from ACCRA-Ghana
Lab scientist

FEVER

Ξ What is fever?

Fever, also known as pyrexia, is a medical condition characterized by an elevation in body temperature above the normal range. In most adults, a fever is typically considered to be present when the body temperature rises to 100.4°F (38°C) or higher. However, the definition of fever can vary depending on factors such as age, underlying health conditions, and the method used to measure body temperature.

Fever is a natural response by the body's immune system to various conditions, such as infections, inflammation, or certain medical conditions.

It is often associated with symptoms like sweating, chills, headache, muscle aches, fatigue, and increased heart rate. Fever itself is not a disease but rather a symptom indicating that the body is fighting off an infection or reacting to an underlying condition.

Fevers are commonly caused by viral or bacterial infections, such as the flu, common cold, urinary tract infections, or pneumonia. Other factors that can contribute to fever include certain medications, vaccinations, heat exhaustion, autoimmune disorders, and some cancers.

In most cases, treating the underlying cause of the fever is the primary approach. Over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil) can help reduce fever and alleviate associated symptoms.

However, it's important to note that fever itself is not always harmful and can actually be beneficial as it helps the body fight off infections. If a fever persists for an extended period, is accompanied by severe symptoms, or occurs in infants, young children, or individuals with weakened immune systems, it is advisable to seek medical attention for proper evaluation and treatment.

Ξ  Types of fever

Fever can be categorized into different types based on their underlying causes or characteristics.

Here are some common types of fever:

1. Infectious Fever: This type of fever is caused by an infection, such as a viral or bacterial infection. Examples include the flu, common cold, pneumonia, urinary tract infections, and strep throat.

2. Inflammatory Fever: Inflammation in the body can lead to a fever. Conditions such as rheumatoid arthritis, inflammatory bowel disease, and certain autoimmune disorders can cause inflammatory fever.

3. Drug-induced Fever: Some medications or drugs can trigger a fever as a side effect. Certain antibiotics, antihistamines, and seizure medications are known to cause drug-induced fevers.

4. Neoplastic Fever: Fevers that are associated with cancers or tumors are referred to as neoplastic fevers. They can occur due to the body's immune response to the presence of cancer cells or as a result of the release of chemicals by the tumor.

5. Recurrent Fever: This type of fever is characterized by recurring episodes of fever that last for a certain period and then resolve, only to return later. Conditions like familial Mediterranean fever, periodic fever syndromes, and certain autoimmune disorders can cause recurrent fevers.

6. Pel-Ebstein Fever: This specific pattern of fever is observed in some cases of Hodgkin's lymphoma, where patients experience alternating periods of fever and normal temperature.

7. Continuous Fever: Continuous fever refers to a sustained fever that remains elevated throughout the day without significant fluctuations.

8. Remittent Fever: This type of fever fluctuates throughout the day but does not return to normal temperature. The variation in temperature is usually more than 2°C (3.6°F).

9. Intermittent Fever: Intermittent fever is characterized by episodes of fever that occur at regular intervals, with temperature returning to normal between episodes. Malaria is a notable example of a disease that causes intermittent fever.

These are just a few examples of the types of fever. It's important to note that the specific type and characteristics of a fever can provide valuable information to healthcare professionals for diagnosing and treating the underlying condition.

Ξ Causes of each fever

Here are some common causes associated with different types of fevers:

1. Infectious Fever:

▪️Viral Infections: Influenza (flu), common cold, viral gastroenteritis, dengue fever, viral hepatitis.
▪️Bacterial Infections: Streptococcal infections (e.g., strep throat), urinary tract infections, pneumonia, tuberculosis, bacterial meningitis.
Inflammatory Fever:

2. Rheumatoid Arthritis: An autoimmune disease that causes joint inflammation and fever.

▪️Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can lead to fever during flare-ups.
▪️Systemic Lupus Erythematosus (SLE): An autoimmune disease that can cause inflammation in various organs and result in fever.

3. Drug-induced Fever:

▪️Antibiotics: Some antibiotics like penicillins, sulfonamides, and cephalosporins can cause drug-induced fever.
▪️Antihistamines: Certain antihistamines used for allergies can trigger a fever as a side effect.
▪️Antiepileptic Drugs: Medications used to treat seizures, such as phenytoin and carbamazepine, may cause fever in some individuals.

4. Neoplastic Fever:

▪️Cancers: Various types of cancers, such as lymphomas, leukemias, and solid tumors, can cause fever. Fever may occur due to immune response to cancer cells or chemicals released by tumors.

5. Recurrent Fever:

▪️Familial Mediterranean Fever: A hereditary autoinflammatory disorder characterized by recurrent episodes of fever and inflammation.
▪️Periodic Fever Syndromes: Conditions like familial Hibernian fever, tumor necrosis factor receptor-associated periodic syndrome (TRAPS), and hyper-IgD syndrome can cause recurrent fevers.

6. Pel-Ebstein Fever:

▪️Hodgkin's Lymphoma: Some individuals with Hodgkin's lymphoma may experience fevers that alternate between high and normal temperatures.

It's important to note that these are general examples, and each individual's case may vary. Fever can have various causes, and a healthcare professional should evaluate the specific symptoms and medical history to determine the underlying cause accurately.

Ξ Effects of fever

Fever is a natural response of the body's immune system to fight off infections and other underlying conditions. While fever itself is not typically harmful, it can have certain effects on the body. Here are some common effects of fever:

1. Increased Metabolic Rate: Fever causes an increase in the metabolic rate of the body. This means that the body's processes, such as heart rate, breathing rate, and energy expenditure, are elevated during a fever.

2. Accelerated Immune Response: Fever stimulates the immune system, enhancing the body's defense mechanisms against infections. It can activate immune cells, increase the production of antibodies, and promote the release of cytokines, which aid in fighting off pathogens.

3. Inhibition of Pathogen Growth: Higher body temperatures can inhibit the growth and replication of certain bacteria and viruses. Fever creates an unfavorable environment for pathogens, making it more difficult for them to survive and spread.

4. Increased Heart Rate: Fever can cause an increase in heart rate as the body works to circulate blood and distribute heat evenly throughout the body.

5. Vasodilation: Fever can lead to the dilation of blood vessels in the skin, resulting in flushing or redness. This helps dissipate heat from the body and can contribute to feelings of warmth.

6. Fluid Loss: Fever increases the body's fluid requirements as it can lead to fluid loss through sweating and increased respiratory rate. It is important to stay hydrated during a fever to prevent dehydration.

7. Fatigue and Weakness: Many individuals experience feelings of fatigue, weakness, and decreased energy levels during a fever. This is a natural response as the body redirects its resources to fighting off the underlying cause of the fever.

8. Discomfort and Pain: Fever can be accompanied by symptoms such as headache, muscle aches, and general discomfort. These symptoms are often associated with the underlying condition causing the fever, rather than the fever itself.

It's important to note that in most cases, fever is a temporary and self-limiting condition that resolves as the underlying cause is treated or the infection clears. However, high or persistent fevers, especially in certain vulnerable populations such as young children or individuals with weakened immune systems, may require medical attention.

Ξ How to run lab tests on fever :

1. Purpose

Running lab tests on a person with a fever can help identify the underlying cause of the fever and guide appropriate treatment. The purpose of conducting lab tests is to gather specific information about the patient's condition. Here are some common lab tests that may be conducted during a fever:

▪️Complete Blood Count (CBC): A CBC provides information about the different types of blood cells, including red blood cells, white blood cells, and platelets. It can help identify indicators of infection, inflammation, or anemia.

▪️Blood Culture: This test involves collecting a blood sample and incubating it in a laboratory to check for the presence of bacteria or fungi in the bloodstream. Blood cultures help identify a potential bloodstream infection, which could be the cause of the fever.

▪️Urinalysis: A urinalysis involves examining a urine sample to check for signs of infection or inflammation in the urinary tract, which can be a potential source of fever.

▪️Chest X-ray: A chest X-ray can be performed to evaluate the condition of the lungs and identify any signs of pneumonia or other respiratory infections, which may cause a fever.

▪️C-reactive Protein (CRP) or Erythrocyte Sedimentation Rate (ESR): These tests measure markers of inflammation in the body. They can help determine the severity of the infection or inflammation contributing to the fever.

▪️Viral Panel: In cases where a viral infection is suspected, specific tests can be conducted to identify the presence of certain viral pathogens, such as influenza, dengue, or respiratory viruses.

▪️Cultures: Depending on the symptoms and suspected source of infection, cultures may be taken from various sites, such as throat swabs, sputum samples, wound swabs, or cerebrospinal fluid, to identify the specific bacteria or fungi causing the infection.

The specific lab tests ordered may vary based on the individual's symptoms, medical history, and clinical presentation. It is important for a healthcare professional to evaluate the patient and determine which tests are necessary to reach a diagnosis and guide appropriate treatment.

2. Procedure

The procedure for conducting lab tests during a fever can vary depending on the specific tests being performed. However, here is a general outline of the steps involved:

▪️Medical History and Evaluation: The healthcare professional will first take a detailed medical history, including information about the patient's symptoms, duration of the fever, and any other relevant information. They will also perform a physical examination to assess the patient's overall condition.

▪️Test Ordering: Based on the medical history, evaluation, and initial assessment, the healthcare professional will determine which lab tests are necessary. They will write an order for the specific tests to be conducted.

▪️Sample Collection: The patient will be directed to the laboratory or a designated collection center for sample collection. The types of samples required may include blood, urine, throat swabs, sputum, or other relevant samples based on the suspected source of infection.

▪️Sample Processing: Once the samples are collected, they are processed in the laboratory according to the specific requirements of each test. This may involve centrifugation, culturing, staining, or other techniques, depending on the test being conducted.

▪️Laboratory Analysis: The collected samples are analyzed using various laboratory techniques and equipment. For example, blood samples may undergo automated analysis, while cultures are incubated to allow for the growth of microorganisms.

▪️Result Interpretation: After the analysis is complete, the results are interpreted by laboratory professionals who generate a report. The report includes the findings for each test conducted, including reference ranges and any abnormalities detected.

▪️Result Communication: The healthcare professional receives the lab report and interprets the results in the context of the patient's clinical presentation. They communicate the results to the patient, explaining any abnormalities or findings and discussing the next steps, such as further diagnostic tests or treatment options.

It is important to note that the specific procedure and timeline for lab tests may vary depending on the healthcare facility, the urgency of the situation, and the specific tests being conducted. The healthcare professionals involved will guide the patient through the process and ensure that the necessary tests are conducted accurately and efficiently.

3. Risks

While lab tests conducted during a fever are generally considered safe, there are some potential risks and considerations to be aware of:

▪️Discomfort or Pain: Certain sample collection procedures, such as blood draws or throat swabs, may cause temporary discomfort or mild pain. However, healthcare professionals aim to minimize any discomfort and ensure patient comfort during the process.

▪️Bleeding or Bruising: In some cases, blood draws may result in minor bleeding at the puncture site or bruising. Healthcare professionals take precautions to minimize these risks, such as using appropriate techniques and applying pressure after sample collection.

▪️Infection: There is a very low risk of infection associated with sample collection, particularly if proper aseptic techniques are not followed. However, healthcare professionals adhere to strict infection control protocols to minimize the risk of infection.

▪️Sample Contamination: Improper handling or contamination of samples can lead to inaccurate results. Laboratory professionals take precautions to ensure proper sample handling, transportation, and storage to minimize the risk of contamination.

▪️Allergic Reactions: Some individuals may have allergies or sensitivities to certain materials or substances used during sample collection or testing, such as adhesive tapes, antiseptics, or latex gloves. Informing healthcare professionals about known allergies or sensitivities can help mitigate this risk.

▪️Psychological Distress: For some individuals, undergoing lab tests may cause anxiety or psychological distress. It is important to communicate any concerns or anxieties to healthcare professionals, who can provide support and address these concerns.

▪️False-Negative or False-Positive Results: Lab tests have a certain degree of sensitivity and specificity. However, false-negative or false-positive results are possible, which means that the test may incorrectly indicate the presence or absence of a condition. Interpretation of test results should always be done in conjunction with the patient's clinical presentation and other diagnostic information.

It is essential to communicate openly with healthcare professionals about any concerns or questions you may have about the lab tests being conducted. They can provide you with information, address your concerns, and help ensure a safe and effective testing process.

4. Medication both in Medicine and  Natural ways

Medication can be used to manage various health conditions and symptoms, including fever. It's important to note that specific medications should be prescribed by a healthcare professional based on the underlying cause of the fever and the individual's medical history. Here are some common medications used to treat fever:

▪️Antipyretics: These medications are used to reduce fever by lowering body temperature. Common antipyretics include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) or naproxen (Aleve).

▪️Antibiotics: If the fever is caused by a bacterial infection, antibiotics may be prescribed to target and eliminate the bacteria. However, antibiotics are ineffective against viral infections.

▪️Antiviral Medications: In cases where the fever is caused by a viral infection, specific antiviral medications may be prescribed to help control the viral replication and reduce symptoms.

▪️Anti-inflammatory Drugs: In certain cases, such as fever associated with autoimmune diseases or inflammation, corticosteroids or other anti-inflammatory drugs may be used to manage symptoms and reduce fever.

▪️Other Medications: Depending on the underlying cause of the fever, additional medications may be prescribed to address specific symptoms or conditions. For example, antimalarial drugs may be used to treat fever caused by malaria.

While medications prescribed by healthcare professionals are often effective in managing fever, there are also some natural ways to help alleviate fever symptoms:

▪️Rest: Getting plenty of rest allows the body to conserve energy and focus on fighting the underlying cause of the fever.

▪️Stay Hydrated: Drink plenty of fluids, such as water, herbal teas, or clear broths, to stay hydrated and prevent dehydration.

▪️Sponge Bath or Cooling Measures: Applying a damp cloth or sponge soaked in lukewarm water to the forehead, wrists, and ankles can help cool the body. Avoid using cold water or ice as it can cause shivering and may actually increase body temperature.

▪️Room Temperature: Keep the room temperature comfortable and not excessively warm. A cooler environment can help promote comfort during a fever.

▪️Wear Lightweight Clothing: Dress in lightweight and breathable clothing to facilitate heat dissipation from the body.

▪️Herbal Remedies: Some herbal remedies, such as chamomile or peppermint tea, may have mild fever-reducing properties. However, it's essential to consult with a healthcare professional or herbalist before using herbal remedies, especially if you have any underlying health conditions or are taking medications.

It is crucial to consult with a healthcare professional for an accurate diagnosis and appropriate treatment options for fever. They can provide guidance on the most suitable medications or natural remedies based on individual circumstances.