nandini rameshchandra

1. Effective treatment & remedies for Fever
Also known as pyrexia or controlled hyperthermia is a common medical
sign characterized by an elevation of temperature above the normal range of
36.5–37.5 °C (98–100 °F) due to an increase in the body temperature
regulatory set-point. A fever is one of the body's immune responses that
attempts to neutralize a bacterial, viral or other microbiological agents.
As a temperature increases, there is general feeling of cold despite an
increasing body temperature. With the exception of very high temperatures,
treatment to reduce fever is often not necessary.
Types
The pattern of temperature changes may occasionally hint at the diagnosis:
• Intermittent fever: Elevated temperature is present only for some
hours of the day and becomes normal for remaining hours, e.g.,
malaria, kala-azar, pyaemia, or septicemia.
• Pel-Ebstein fever: A specific kind of fever associated with Hodgkin's
lymphoma,
• Continuous fever: Temperature remains above normal throughout
the day and does not fluctuate more than 1 °C in 24 hours, e.g. lobar
pneumonia, typhoid, urinary tract infection, brucellosis, or typhus.
• Remittant fever: Temperature remains above normal throughout the
day and fluctuates more than 1 °C in 24 hours, e.g., infective
endocarditis.
• A neutropenic fever, Because of the lack of infection-fighting
neutrophils, a bacterial infection can spread rapidly; this fever is,
therefore, usually considered a medical emergency. Commonly seen
in people receiving immune-suppressing chemotherapy than in
apparently healthy people.
• Febricula is a mild fever of short duration, of indefinite origin, and
without any distinctive pathology.
Hyperpyrexia
Hyperpyrexia is a fever with an extreme elevation of body temperature
greater than or equal to 41.5 °C (106.7 °F). Such a high temperature is
considered a medical emergency as it may indicate a serious underlying
condition or lead to significant side effects.
Causes:
1. intracranial hemorrhage
2. sepsis
3. Kawasaki syndrome

2. 4. neuroleptic malignant syndrome
5. drug effects
6. serotonin syndrome
7. Thyroid storm.
Infections commonly associated with hyperpyrexia include:
1. roseola
2. rubeola
3. enteroviral infections
A fever is usually accompanied by sickness behavior, which consists of
lethargy, depression, anorexia, sleepiness, hyperalgesia, and the inability to
concentrate.
Differential diagnosis
Fever is a common symptom of many medical conditions:
• Infectious disease, e.g., influenza, HIV, malaria, infectious
mononucleosis, or gastroenteritis
• Various skin inflammations, e.g., boils, or abscess
• Immunological diseases, e.g., lupus erythematosus, sarcoidosis,
inflammatory bowel diseases, Kawasaki disease
• Tissue destruction, which can occur in hemolysis, surgery, infarction,
crush syndrome, rhabdomyolysis, cerebral hemorrhage, etc.
• Reaction to incompatible blood products
• Cancers, most commonly kidney cancer and leukemia and
lymphomas
• Metabolic disorders, e.g., gout or porphyria
• Thrombo-embolic processes, e.g., pulmonary embolism or deep
venous thrombosis
Persistent fever that cannot be explained after repeated routine clinical
inquiries is called fever of unknown origin.
Temperature is ultimately regulated in the hypothalamus. A trigger of the
fever, called a pyrogen, causes a release of prostaglandin E2 (PGE2). PGE2
then in turn acts on the hypothalamus, which generates a systemic response
back to the rest of the body, causing heat-creating effects to match a new
temperature level.
.Pyrogens
A pyrogen is a substance that induces fever.
1. internal (endogenous)

3. 2. Cytokines produced by phagocytic cells, are a part of the innate
immune system.
3. interleukin 1 (α and β)
4. interleukin 6 (IL-6)
5. Tumor necrosis factor-alpha.
6. interleukin-8,
7. tumor necrosis factor-β
8. macrophage inflammatory protein-α
9. Macrophage inflammatory protein-β
10. interferon-α
11. interferon-β
12. Interferon-γ.
13. External (exogenous)
• The bacterial substance lipopolysaccharide (LPS), present in the cell
wall of some bacteria, is an example of an exogenous pyrogen.
Pyrogenicity can vary. superantigens
Body response after hypothalamic effect:
• Increased heat production by increased muscle tone, shivering, and
hormones like epinephrine
• Prevention of heat loss, such as vasoconstriction.
fever has several important functions in the healing process:
• Increased mobility of leukocytes
• Enhanced leukocytes phagocytosis
• Endotoxin effects decreased
• Increased proliferation of T cells
[28]
Management
Fever should not necessarily be treated. Most people recover without
specific medical attention. In general, people are advised to keep adequately
hydrated. Oral rehydration solutions or water are generally used for this
purpose. Excessive water may lead however to hyponatremia. If the
temperature reaches the level of hyperpyrexia aggressive cooling is required.
Medications
The antipyretic : acetaminophen / paracetamol in children however both may
be used together.
Document Source: http://www.mindheal.org

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