FEVER

DR.NILESH S. YADAV
BAMS,MD(MUMBAI)
PGDEMS,PGDIHM(PUNE)
CCH,CGO,CSD(MUMBAI)
 FEVER
• An elevation in body temperature with an
increase in hypothalamic set point.
• Body temperature:- Degree of hotness or
coldness of body.
Amount of heat produced – amount of heat
loss to external environment.
 TYPE OF TEMPERATURE
• Core temperature : Temperature of internal
body tissue below skin and sub cutaneous
tissue. Eg: Rectum, Tympanic membrane,
oesophagus, urinary bladder.
• Surface temperature : Temperature of external
body tissue at the surface.(skin and
subcutaneous).
 NORMAL BODY TEMPERATURE
• Normal body temperature – 37°C (98.6°F)
• Oral temperature – 35.7-37.7°C (>37.8°C)
• Rectal temperature – 36.7-37.5°C (>38°C)
• Tympanic membrane – 35.5-37.5°C (>38°C)
• Axillary – 35.5-37.0°C (>37.2°C)
 GRADE OF FEVER
• Low grade fever (37.1-38.2°C)(98.8-100.6°F)
• High grade fever (38.2-40.5°C)(100.6-104.9°F)
• Hyperpyrexia (>40.5°C)(>104.9°F)
 WORK OF FEVER IN BODY
• Slow down growth of pathogen
• Boost immune response (increase production
of inflammatory mediator,neutrophil)
• Increase metabolic rate (increase tissue repair)
 WORK OF HYPOTHALAMUS
• Hypothalamus maintain the body temperature
• When body is hot, hypothalamus send signal to cool
down the body by sweating.
• When body is cold, hypothalamus send signal to release
norepinephrine so that hotness of body is maintained.
• Immune cell detect pathogen and produce
inflammatory cytokines(IL-6,IL-1) which induce
synthesis of PGE2(fever inducer) which act on
thermoregulatory nerve of hypothalamus to raise body
temperature at the set point.
 CAUSE OF FEVER
• Hot environment
• Excessive exercise
• Injury to hypothalamus
• Undesired side effect of therapeutic drugs
• Chemical substance (injected in bloodstream)
• Infectious disease and inflammation
• Severe haemorrhage
 TYPE OF FEVER
• Continuous fever: temperature remain
constantly elevated.
• Remitent fever: fever spike and fall without
restoring to normal temperature.
• Intermitent fever: temperature return to
normal value once in 24hrs.
• Relapsing fever: period of fever are
interspersed with the period of normal
temperature.
 LOCALIZING THE FOCUS OF FEVER
• Exanthematous fever- rash, erythema, pustules,
nodules.
• URTI- cough, cold, throat pain, earache, horse
voice, stridor, regional lymphadenopathy.
• LRTI- cough, difficulty and fast breathing,
wheezing, crepitation, chest pain,sputum.
• UTI(upper)- pain in abdomen, vomiting, renal
angle tenderness (lower)- burning micturation,
urgency, frequency, hematuria.
• Hematological-pallor,bleeding spots, bleeding from
any site, lymphadenopathy, bone pain.
• CVS- dyspnea, palpitation, pedal oedema, precordial
pain and buldge, prominent neck veins.
• Hepatobiliary- jaundice, vomiting, diarrhea, pain
abdomen, abdominal distension,
hepatosplenomegaly.
• CNS- vomiting, headache, seizure, lethargy, altered
sensorium, neck rigidity, irritability,abnormal tone,
abnormal movement.
TREATMENT
 THANK YOU

FEVER IS NOT A DISEASE, JUST A SYMPTOM

OF UNDERLYING ILLNESS.
TREAT THE UNDERLYING DISEASE, NOT THE
THERMOMETER.