Scribd
Upload
7 views13 pages

Understanding Fever: Causes and Treatment

Fever is defined as an elevation of body temperature above the normal range of 36.5-37.5°C. The hypothalamic thermoregulatory center balances heat production and dissipation to maintain core temperature. Fever results when the thermoregulatory set point is increased, triggering vasoconstriction, shivering, and behavioral adjustments to reduce heat loss. A fever's cause can be determined by considering its duration and pattern, the patient's medical history and associated symptoms, and results of diagnostic tests. The objectives in treating fever are to reduce the elevated set point and facilitate heat loss, with acetaminophen preferred over NSAIDs due to safety risks.

Uploaded by

IVANY
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
7 views13 pages

Understanding Fever: Causes and Treatment

Fever is defined as an elevation of body temperature above the normal range of 36.5-37.5°C. The hypothalamic thermoregulatory center balances heat production and dissipation to maintain core temperature. Fever results when the thermoregulatory set point is increased, triggering vasoconstriction, shivering, and behavioral adjustments to reduce heat loss. A fever's cause can be determined by considering its duration and pattern, the patient's medical history and associated symptoms, and results of diagnostic tests. The objectives in treating fever are to reduce the elevated set point and facilitate heat loss, with acetaminophen preferred over NSAIDs due to safety risks.

Uploaded by

IVANY
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

DEMAM

Ivana
406172126
Definition
• Fever is an elevation of body temperature that exceeds the normal daily
variations
• In normal temperature environment  human metabolic rate produces more heat
than is necessary to maintain core body temperature in the range of 36.5 – 37.5o C
• Hypothalamic thermoregulatory center balances excess heat production (derived from
metabolic activity in muscle and liver) with heat dissipation (from skin and lungs)
• Oral temperature (36.8 ±0.4), rectal temperature 0.4 higher, axillary temperature 0.5
lower
• > 41,5 ºC  hyperpyrexia (severe infections , CNS hemorrhages)
• Hyperthermia  characterized by an uncontrolled ↑ in body temperature that exceeds
the body ability to lose heat
• Normal daily variation is typically 0.5ºC
• Elderly  ↓ ability to develop fever, with modest fever event in severe infections
• Set point ↑  neurons in vasomotor activated  vasoconctriction
commences (shunting blood away from periphers to the internal organs), (↓
heat loss from skin)
• Shivering  ↑ heat production from muscles (not required if heat
mechanisms ↑ blood temperature sufficiently
• Behavioural adjustments  putting more clothing (↓ heat loss)
History
• Duration, pattern
• Chronology events preceding fever, including exposure to other infected
individuals / to vectors of disease
• Associated symptoms
• Travel within past year
• Recent hospitalizations
• Chemotherapy
• Same site should be used
consistently to monitor a febrile
disease
• *{newborns, elderly patients,
patient taking glucocorticoids,
treated with anticytokine  may
have infection in the absence of
fever due to a blunted febrile
response}
Diagnostic studies
• Laboratory test : CBC, CRP, ESR
• Imaging
• The objectives in treating fever are first to reduce the elevated hypothalamic set
point and second to facilitate heat loss
• Reducing fever with antypyretics also reduces systemic symptoms of headache,
myalgias, and arthralgias
• Oral aspirin and NSAID effectively reduce fever but can adversely affect plateles
and gastrointestinal tract, therefore acetaminophen is preferred
• Treatment of fever in some patients is highly recommended
• Fever increases the demand for oxygen ( 13% O2 consumption, for every 1ºC over
37ºC) and can aggravate the condition of patients with preexisting impairment of
cardiac, pulmonary, or CNS function.
• ↑ 1ºC  ↑ HR 10 bpm, ↑ RR 2-4 bpm
Non infectious causes include :

• Pulmonary embolism
• Intracranial hemorrhage
• Cerebrovascular accident
• Neuroleptic malignant
syndrome
• Malignant hyperthermia
• Thyroid storm
• Transfusion reaction
• Malignancy
• Autoimmune disorders
• Drug fever

You might also like