Health and Education

FEVER: FAQS and ANSWERS

What Is Fever?

Fever, pyrexia or controlled hyperthermia is
when a human's body temperature goes
above the normal range of 36-37C (98-100F)
- it is a common medical sign. As the
individual's body temperature goes up, there
may be a sensation of cold until the
temperature plateaus (stops rising).
People's normal body temperatures may vary
and are affected by factors such as eating,
exercise, sleeping and what time of the day it
is. Our body temperature is usually at its
highest at around 6pm and at its lowest at
about 3am.
An elevated body temperature (fever) is one
of the ways our immune system attempts to
combat an infection. Usually the rise in body
temperature helps the individual resolve an
infection. However, sometimes it may rise too
high, in which case the fever can be serious
and lead to complications.
Physicians say that as long as the fever is
mild, we do not generally need to try and
bring it down - if the fever is not severe it is
probably having an effect in neutralizing the
bacterium or virus that is causing the
infection. Medications to bring down a fever
are called antipyretics . If the fever is causing
undue discomfort, an antipyretic may be
recommended. US and UK doctors say that
when the fever reaches or exceeds 38ºC
(100.4ºF) it is no longer mild and should be
checked a couple of hours later.
The temperatures mentioned above are when
they are taken in the mouth. For normal
armpit temperatures, you need to reduce
those numbers by about 0.2ºC to 0.3ºC.
According to Medilexicon's medical dictionary:

What are the signs and symptoms of fever?

A symptom is something the patient reports
and feels, while a sign is something other
people, including a doctor may detect. For
example, a headache may be a symptom
while a rash may be a sign.
When somebody has a fever, signs and
symptoms are linked to what is known as
sickness behavior, and may include:
Feeling cold when nobody else does
Shivering
Anorexia - lack of appetite
Dehydration - preventable if the patient
drinks plenty of fluids
Depression
Hyperalgesia - the individual is much
more sensitive to pain
Lethargy
Problems concentrating
Sleepiness
Sweating
If the fever is high there may also be extreme
irritability, confusion, delirium and
convulsions.

What are the causes of fever ?

An infection - such as strep throat , flu ,
chickenpox or pneumonia
Rheumatoid arthritis
Some medications
Over-exposure of skin to sunlight
(sunburn)
Heat stroke - may be caused either by
exposure to high temperatures
(nonexertional heat stroke) or prolonged
strenuous exercise.
Silicosis - a type of lung disease caused
by long-term exposure to silica dust.
Amphetamine abuse
Alcohol withdrawal

How is fever diagnosed?

Diagnosing a fever is straightforward - the
patient's temperature is taken, if the reading
is high, he/she has a fever. It is important to
take the person's temperature when they are
at rest, because physical activity can warm
us up.
A person is said to have a fever if:
The temperature in the mouth is over
37.7C (99.9F)
The temperature in the rectum (anus) is
over 37.5-38.3C (100-101F)
The temperature under the arm or ear is
over 37.2C (99F)
As a fever is a sign rather than a disease,
when the doctor has confirmed there is an
elevated body temperature, certain diagnostic
tests may be ordered, depending on what
other signs and symptoms exist, these may
include blood tests, urine tests, x-rays and
other imaging scans.

What is the treatment for fever ?

NSAIDs (non-steroidal anti-inflammatory
drugs) such as Tylenol (paracetamol) or
ibuprofen can help bring a fever down.
However, a mild fever may be helping combat
the source of the infection (bacterium/virus)
- it may not be ideal to bring it down.
If the fever has been caused by a bacterial
infection the doctor may prescribe an
antibiotic.
If a fever has been caused by a cold, which is
caused by a viral infection, NSAID's may be
used to relieve uncomfortable symptoms.
Antibiotics have no effect against viruses, but
may sometimes be prescribed to prevent
secondary infections.
Fluid intake - the patient with a fever should
consume plenty of fluids (liquids) to prevent
dehydration.
Heat stroke - NSAIDs will not be effective if
the person's fever was caused by hot weather
or sustained strenuous exercise. The patient
needs to be cooled. If they are confused or
unconscious they should be treated by a
doctor straight away.

How to prevent fever ?

Hygiene - fevers are commonly caused by
bacterial/viral infections. Good hygiene
practices help reduce the risk of developing
an infection. This includes hand washing
before and after meals, and after going to the
toilet.
A person with a fever caused by an infection
should have as little contact as possible with
other people, to prevent the infection from
spreading. Whoever is caring for the patient
should regularly wash their hands with warm
soap and water.

By Dr Aurora Polaris, A Medicine Student at SSMC, Dhaka