Infectious Disease Book

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FeverAka: Remittent Fever, Recurrent Fever, Intermittent Fever, Hectic Fever, Sustained Fever, Continuous Fever, Pulse-Temperature Dissociation

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  1. See Also
    1. Fever Evaluation in Children
    2. Fever Symptomatic Treatment
    3. Fever in the Returning Traveler
  2. Definitions
    1. Fever
      1. Celsius temperature >38 degrees
      2. Fahrenheit temperature >100.4 Fahrenheit
    2. Remittent Fever
      1. Daily elevated temperature (>38 C or 100.4 F)
      2. Returns to baseline but not to normal
    3. Intermittent Fever (Periodic Fever)
      1. Intermittently elevated temperature (>38 C, 100.4 F)
      2. Return to baseline and to normal
      3. Examples
        1. PFAPA Syndrome: Fever every 3-4 weeks
          1. Most common cause in children age <5 years
        2. Relapsing Fever (Borrelia species): Every 2-3 weeks
        3. Malaria: Fever every other or every third day
        4. Rat Bite Fever: Fever every 3 to 5 days
        5. Hodgkin's Disease: Pel-Ebstein Fever
        6. Cyclic Neutropenia: Fever every 3 weeks
          1. Associated with Mucosal Ulcer
    4. Hectic Fever
      1. Daily elevated temperature (>38 C or 100.4 F)
      2. Either remittent or intermittent pattern
      3. Temperature excursion >1.4 C (2.5 F)
      4. Examples
        1. Intermittent bacteremia (dental abscess, UTI)
        2. Epstein-Barr Virus
        3. Familial Mediterranean Fever
        4. Crohn's Disease
        5. Still's Disease (Juvenile Rheumatoid Arthritis)
    5. Sustained or Continuous Fever
      1. Daily elevated temperature (>38 C or 100.4 F)
      2. Fluctuation of elevated temperature < 0.3 C (0.5 F)
      3. Associated conditions
        1. Drug Fever
        2. Salmonella
    6. Pulse-Temperature Dissociation
      1. Pulse slower than normal for fever degree
      2. Associated conditions
        1. Typhoid Fever
        2. Rickettsial infection
  3. Classifications
    1. Fever Without Focus
      1. Age <24 months
      2. Higher risk in younger infants
      3. Fever without localizing signs
      4. Acute onset of fever persisting <1 week
      5. Assess for Occult Bacteremia
    2. Fever of Unknown Origin (FUO)
      1. Fever exceeding 1 week duration
      2. Fever documented in the hospital
      3. All possible investigations performed during the week
  4. Special Circumstances: Fever in adults over age 65 years
    1. Fever: temperature rise of 1.1 C (2 F) over baseline
    2. High fever suggesting severe infection: 38.3 C (101 F)
  5. Technique: Axillary temperature
    1. Age <5 weeks old
      1. Rectal = Axillary Temperature + 0.2/week of age (C)
    2. Age >1 month old
      1. Rectal = Axillary Temperature + 1 (Celsius)
    3. Axillary temperature accurate by recent study (n=120)
    4. References
      1. Shann (1996) Arch Pediatr Adolesc Med 150:74
  6. Common Non-Infectious Causes of Low Grade Fever
    1. Over-dressing
    2. Recent Exercise
    3. Hot weather
    4. Warm foods
    5. Recent Immunization
      1. DTP Vaccine within 24 hours
      2. MMR Vaccine within 7 to 10 days
  7. Management
    1. See Fever Symptomatic Treatment
    2. See Fever Without Focus
  8. References
    1. Schmitt (1980) Am J Dis Child 134:176
    2. Kimmel (1996) Fam Pract Recert 18(7):69

Fever (C0015967)

Definition (AIR)Fever: a documented body temperature higher than 38 degrees C., or 100.4 degrees F.
Definition (MSH)An abnormal elevation of body temperature, usually as a result of a pathologic process.
Definition (CSP)abnormal elevation of body temperature, usually as a result of a pathologic process.
Definition (GO)A rise in body temperature above the normal, often as a response to infection. [GOC:jl]
Definition (NCI)The elevation of the body's temperature above the upper limit of normal, usually taken as 37.7 degrees C.
ConceptsFinding (T033)
ICD9780.6
BasqueSUKARRA
DanishFeber
DutchKoorts
EnglishBody temperature above normal, BODY TEMPERATURE INCREASED, Febrile, febris, Feels feverish, Fever, Fevers, Has a temperature, High body temperature, Hyperthermia, Hyperthermias, Increased body temperature, Pyrexia, Pyrexial, Pyrexias, Temperature elevated, TEMPERATURE ELEVATION, TEMPERATURE INCREASE, Temperature raised
FinnishKUUME
FrenchFievre
GermanFieber
Hebrewxom
Hungarianlaz
ItalianFebbre
NorwegianFEBER
PortugueseFebre
Spanishafiebrado, aumento de la temperatura corporal, febril, fiebre, hipertermia, pirexia, temperatura corporal aumentada, temperatura corporal elevada
SwedishFEBER
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Continuous fever (C0424767)

ConceptsFinding (T033)
EnglishContinuous fever, Sustained fever
Spanishfiebre continua
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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