Acute Fever
Acute Fever Common conditions The overall mean oral temperature for healthy adult individuals is 36.
8 + 0.
4ºC, with a nadir at 6 AM and a peak at 4-6 PM.
An AM temperature of greater than 37.
2ºC and a PM temperature of greater than 37.
7ºC is defined as fever.
Fever may be continuous, intermittent or remittent.
However, with frequent self-medication with antipyretics, classic patterns are not generally seen.
Diagnosis It is important to work towards finding the cause of fever.
A meticulous history of chronology of symptoms, any associated focal symptom(s), exposure to infectious agents and occupational history may be useful.
A thorough physical examination repeated on a regular basis may provide potentially diagnostic clues.
Diagnostic tests A large range of diagnoses may possibly be the cause of fever.
If the history and physical examination suggest that it is likely to be more than a simple URI or viral fever, investigations are indicated.
The extent and focus of diagnostic work-up will depend upon the extent & pace of illness, diagnostic possibilities and the immune status of the host.
If there are no clinical clues, the work-up should include a complete haemogram with ESR, smear for malarial parasite, blood culture, Widal test, urine analysis including urine culture.
If the febrile illness is prolonged to more than 2 weeks, an x-ray chest is indicated even in the absence of respiratory symptoms.
Any abnormal fluid collection should be sampled.
Treatment Routine use of antipyretics in low-grade fever is not justified.
This may mask important clinical indications.
However, in acute febrile illnesses suggestive of viral or bacterial cause, fever should be treated.
Nonpharmacological Hydrotherapy and rest.
Pharmacological Non-Specific Tab.
Paracetamol 500-1000 mg 6-8 hourly.
Or Tab.
Ibuprofen 400-600 mg 8 hourly.
Or Tab.
Nimesulide 100 mg 12 hourly.
Specific Antibiotics/antimalarials depending upon the cause suggested by clinical and laboratory evaluation.
Outcome In most cases of fever, patient may either recover spontaneously or a diagnosis is reached after repeated clinical evaluation and investigations.
If no diagnosis is reached in upto 3 weeks, patient is said to be having fever of unknown origin (FUO) and is managed accordingly.
Patient education Self medication should be avoided.
Antibiotics should be taken only on advise of a physician.
Avoid covering the patient having high fever with blanket etc.
Plenty of fluids should be taken.
Stay in cool environment.
Cold sponging of face and limbs should be done repeatedly.
8 + 0.
4ºC, with a nadir at 6 AM and a peak at 4-6 PM.
An AM temperature of greater than 37.
2ºC and a PM temperature of greater than 37.
7ºC is defined as fever.
Fever may be continuous, intermittent or remittent.
However, with frequent self-medication with antipyretics, classic patterns are not generally seen.
Diagnosis It is important to work towards finding the cause of fever.
A meticulous history of chronology of symptoms, any associated focal symptom(s), exposure to infectious agents and occupational history may be useful.
A thorough physical examination repeated on a regular basis may provide potentially diagnostic clues.
Diagnostic tests A large range of diagnoses may possibly be the cause of fever.
If the history and physical examination suggest that it is likely to be more than a simple URI or viral fever, investigations are indicated.
The extent and focus of diagnostic work-up will depend upon the extent & pace of illness, diagnostic possibilities and the immune status of the host.
If there are no clinical clues, the work-up should include a complete haemogram with ESR, smear for malarial parasite, blood culture, Widal test, urine analysis including urine culture.
If the febrile illness is prolonged to more than 2 weeks, an x-ray chest is indicated even in the absence of respiratory symptoms.
Any abnormal fluid collection should be sampled.
Treatment Routine use of antipyretics in low-grade fever is not justified.
This may mask important clinical indications.
However, in acute febrile illnesses suggestive of viral or bacterial cause, fever should be treated.
Nonpharmacological Hydrotherapy and rest.
Pharmacological Non-Specific Tab.
Paracetamol 500-1000 mg 6-8 hourly.
Or Tab.
Ibuprofen 400-600 mg 8 hourly.
Or Tab.
Nimesulide 100 mg 12 hourly.
Specific Antibiotics/antimalarials depending upon the cause suggested by clinical and laboratory evaluation.
Outcome In most cases of fever, patient may either recover spontaneously or a diagnosis is reached after repeated clinical evaluation and investigations.
If no diagnosis is reached in upto 3 weeks, patient is said to be having fever of unknown origin (FUO) and is managed accordingly.
Patient education Self medication should be avoided.
Antibiotics should be taken only on advise of a physician.
Avoid covering the patient having high fever with blanket etc.
Plenty of fluids should be taken.
Stay in cool environment.
Cold sponging of face and limbs should be done repeatedly.
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