A fever is a medical symptom or a complaint that usually is part of a complaints a patient can come to the hospital with. It is otherwise known as pyrexia and it normally refers to an abnormally high body temperature caused by a reset of the body’s normal temperature. It is almost as if someone reset the body’s thermostat. So, what is supposed to be just cold is perceived as very cold and what is supposed to be normal is perceived to be cold and we want to snuggle into a blanket. At a normal body temperature, the person with a fever begins to sweat. An abnormally high body temperature is read off on a thermometer as between 37.2 and 38.3 °C although this varies from country to country and from one hospital to another although it is pretty much around the same range. Fevers may indicate a mild systemic disease or may be indicative of something severe and also in young children it can cause a febrile seizure.
The mechanism of fever is not properly understood but seems to be our body’s way of fighting infections. Our body’s immune system produces pyrogens when we are invaded by bacteria and viruses that cause tissue injury as one of its means of defense. These pyrogens reach the brain through the blood and are sensed by the hypothalamus- where the thermostat is found.
What actually happens is that neurons that are sensitive to heat are inhibited and the cold-sensing ones are excited making us feel like it is colder than it actually is. Temperatures above normal are believed to help our body in fighting pathogens because the white blood cells (our body's defense) move faster and are more active, producing antibodies. Also, some bacterial and viral organisms do not properly grow in the temperature created by our bodies when we have a fever.
When our body’s thermostat re-sets in the hypothalamus our body thinks it is normal for our body to be hotter than normal. We start having abnormal responses to a normal temperature like we start feeling cold and shiver so that we can feel hotter. So, we have higher temperature readings on the thermometer.
Many conditions cause fevers, it can be seen when we are sick. Some diseases that cause a fever are cancers, infections like malaria, and many others. Sometimes we have a raised body temperature when we aren’t sick like after immunization with certain vaccines, when infants are teething, during ovulation in women, or after exercising.
Fevers are usually the symptom of an underlying condition and depending on the severity of the disease and the severity of the fever, the fever can be managed at home or the person should be brought to the hospital for management. Sometimes all the person might need is some bed rest and fluid rehydration.
When the fever comes with discomfort or dehydration reducing the body temperature may be helpful. You can start by making the room more comfortable for the person. Having a lukewarm bath is helpful to reduce body temperature. It is helpful to try Paracetamol, Tylenol, or any other acetaminophen-based drug or you could try Advil (ibuprofen).
When a fever is mild, it can be managed at home. Some cases are best handled by a doctor because of the severity of the condition.
Here are some helpful suggestions of when to seek medical attention:
An infant with a fever is best managed in a hospital if:
They are 3 months has a fever higher than 38°C, or if the infants are between 3 months and 6 months with a fever 38.9°C with signs of discomfort or is irritable. If they are between 6 months to 2 years with a 38.9°C fever lasting more than a day
A child should see the doctor if:
They have a fever greater than 39°C or if the fever has lasted more than three days. If the child makes poor eye contact or behaves irritably. If they had one or two immunizations recently. If the child has an immunity problem or a very serious medical problem. If they have been to a country with endemic infections.
An adult should seek medical care if:
They have a fever that is 39.4°C, or if they have had the fever for more than three days. And similar to the child, if they have a serious illness or are immune-compromised or have visited a country with endemic infections.
Anyone with a fever and the following symptoms should come to the hospital:
A severe headache, A swelling on the throat, a rash that is getting worse, photophobia, neck stiffness and or pain on the neck, pain on the abdomen, painful urination, vomiting, weakness, difficulty breathing, or chest pain or confusion.
A doctor’s responsibility is to conduct a physical examination and investigations to help narrow down the causes of the fever and plan proper management of whatever condition it might be.
You or your child need to see a doctor as soon as possible if you have a fever accompanied by seizures, hallucinations, confusion, difficulty walking, difficulty breathing, or an inconsolable cry in a child.
Treating a fever is not the main goal of any form of treatment but treating the cause of the fever. Causes of fevers are mostly due to infective causes but can be due to normal function as in exercise and ovulation or being in a hot environment. We have seen that the causes of fever are numerous.
Hope you learned a few new things. If you have any questions on the topic feel free to ask them.
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