Fever

Several factors can trigger the fever response, including:

Infections

Infections are the primary cause of fever. Below are some common infections that can lead to fever:

• Respiratory infections like Cold, Croup, Pneumonia
• Ear infections such as Otitis media
• Gastroenteritis
• Urinary tract infections
• Measles
• Mumps
• Malaria
• Dengue
• Chikungunya
• Typhoid
• Leptospirosis
• Tuberculosis
• Brain infections like Meningitis, Encephalitis, and brain abscesses
• Herpes infection
• Hepatitis A
• HIV infection

Hypersensitivity

Hypersensitivity refers to an exaggerated immune response to allergens. It can increase the likelihood of fever. Common allergens include:

• Pets
• Dust mites
• German cockroaches
• Grass
• Fungi
• Plants
• Bee and wasp venom
• Eggs
• Milk
• Latex
• Antibiotics
• Shellfish

Blood Transfusion

Blood transfusions can provoke an immune response, especially if there is a mismatch or incompatibility with the transfused blood. This immune reaction may cause fever, which can occur immediately or a few days following the transfusion.

Medications

Some drugs can cause fever, typically after 7 to 10 days of use. The fever subsides once the medication is discontinued. Drugs commonly linked to fever include:

• Penicillins
• Cephalosporins
• Antituberculars
• Quinidine
• Procainamide
• Methyldopa
• Phenytoin

Nutritional Deficiencies

Individuals who are malnourished tend to have weakened immune systems, making them more susceptible to infections that can cause fever.

Cancer

Certain cancers can lead to fever due to the release of pyrogenic chemicals from tumor cells. Common cancers associated with fever include:

• Lymphoma
• Kidney cancer
• Liver cancer
• Blood cancers
• Ovarian cancer

Autoimmune Disorders

In autoimmune diseases, the immune system mistakenly attacks the body’s own cells, often resulting in fever. Common autoimmune conditions linked to fever include:

• Systemic lupus erythematosus (SLE)
• Rheumatoid arthritis

Ischemic Conditions

Ischemia occurs when blood flow to a specific area of the body is restricted. Some ischemic conditions that can cause fever include:

• Stroke
• Heart attack
• Pulmonary embolism

Diagnosing fever involves a thorough medical history and laboratory tests to determine its underlying cause.

Medical History

A detailed medical history helps pinpoint the cause of fever. Information typically gathered includes:

• Onset and duration of the fever
• Temperature degree
• Method of temperature measurement
• Medications taken
• Exposure to toxins
• Recent travel history
• Recent vaccinations

Physical Examination

A physical exam may reveal signs such as:

• Shock
• Weak peripheral pulses
• Increased heart rate
• Respiratory distress
• Skin discoloration or spots
• Reduced mental status

Temperature Measurement

• Oral Temperature: Used for patients over 4-5 years old. A temperature of 100°F (37.8°C) or higher is considered a fever.
• Axillary Temperature: Measures peripheral temperature, with readings above 37.2°C (99°F) being considered high.
• Rectal Temperature: Typically used for children under 3 years. A temperature of 38°C (100.4°F) or higher is regarded as a fever.
• Ear (Tympanic) Temperature: A temperature above 37.9°C (100.2°F) indicates fever when measured with a tympanic thermometer.
• Forehead Temperature: Measured with electronic thermometers that detect heat from the temporal artery. This reading is typically 0.3°C (0.5°F) to 0.6°C (1°F) lower than an oral reading.

Blood Tests

Depending on the patient’s symptoms and medical history, several blood tests may be conducted to identify the cause of the fever, including:

• Complete blood count
• Erythrocyte sedimentation rate (ESR)
• C-reactive protein (CRP)
• Procalcitonin
• Serum lactate dehydrogenase (LDH)
• Rheumatoid factor (RF) test
• Antinuclear antibody (ANA) test
• Creatine phosphokinase (CPK) test
• Serum protein electrophoresis

Urine Routine and Microscopy

Urine tests are used to rule out urinary infections as the cause of fever.

Stool Culture and Sensitivity

A stool culture is performed if there is suspicion of bacterial enteritis, especially if there is blood in the stool or certain risk exposures.

Lumbar Puncture

A lumbar puncture involves inserting a needle into the space around the spinal column to collect cerebrospinal fluid (CSF). This is necessary when sepsis, meningitis, or encephalitis is suspected.

Imaging Tests

Based on initial findings, imaging tests like chest X-rays or MRI scans may be performed to further assess the situation.

Note: Additional specific tests may be prescribed based on the patient's individual history and symptoms.

There are several preventive steps that can help minimize the chances of developing a fever. Some of these general practices include:

Get Vaccinated on Time

While vaccines may cause a mild fever temporarily, they significantly reduce the likelihood of recurring fevers caused by infections throughout life. Both children and adults should follow the recommended vaccination schedule for their age group.

Practice Good Hand Hygiene

Many viral infections that cause fever can be prevented by thoroughly washing hands with soap and water for at least 10 seconds, especially:

• After using the toilet
• Before preparing or eating food
• After handling vomit from an infected person
• After changing diapers

Additionally, alcohol-based hand sanitizers can also help reduce the risk of viral infections, especially in environments like offices and daycares, leading to fewer school absences.

Maintain Proper Sanitation

Infectious diseases often spread through contaminated surfaces. Practicing proper hygiene is key to preventing infections. Measures to ensure cleanliness include:

• Keep nails trimmed and avoid wearing artificial nails, nail polish, or jewelry, as they can hinder proper hand cleaning
• Disinfect surfaces exposed to vomit or feces
• Wear disposable gloves and masks when cleaning up vomit or feces from infected individuals
• Use disposable paper towels to dry hands instead of cloth towels, as bacteria can survive on them
• Regularly clean kitchen counters, toys, toilet seats, and diaper change tables to prevent bacterial and viral growth

Review Cooking Methods

Food and beverages that are contaminated are a significant source of infection. Certain dietary precautions can help reduce the risk:

• Cook food thoroughly
• Avoid consuming raw or unpasteurized milk
• Drink bottled water when traveling
• Steer clear of food buffets, raw foods, unpeeled fruits and vegetables, and ice in drinks
• Research suggests that daily probiotics, particularly for children, can reduce the frequency of infections

Enhance Your Immunity

A strong immune system helps prevent infections. To maintain a robust immune response, adopt a healthy lifestyle that includes a balanced diet, regular physical activity, adequate rest, and stress management.

Specialist Consultation

You should seek medical attention if your fever:

• Persists for 2-3 days without improvement
• Recurs after several days
• Exceeds 104°F

Specialists to consult include:

• General Physician: They diagnose the cause of the fever and, if necessary, refer you to a specialist based on the condition.
• Infectious Disease Specialist: These specialists diagnose and treat illnesses caused by pathogens like bacteria or viruses, which are common fever triggers.
• Internal Medicine Specialist: They offer comprehensive care for adults, especially for complex cases, and address underlying health issues.

The goal of fever treatment is to:

• Normalize the body temperature
• Address the underlying cause of the fever
• Prevent any complications

Common medications prescribed to manage fever include:

Paracetamol (Acetaminophen)

This pain reliever and fever reducer is used to manage mild-to-moderate fever and discomfort. It is available over the counter in various forms such as tablets, capsules, and syrups (for children). Always follow the recommended dosage.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs reduce pain, inflammation, and fever by inhibiting the production of prostaglandins, chemicals that increase body temperature. Common examples include:

• Ibuprofen
• Aspirin
• Naproxen
• Diclofenac

These are often used in combination with Paracetamol.

Antibiotics

If an infection is suspected, antibiotics may be prescribed, depending on the symptoms and diagnosis. Some examples include:

• Cefadroxil
• Amoxicillin
• Cefixime
• Doxycycline
• Tetracycline
• Azithromycin
• Cefazolin
• Cephalexin
• Ciprofloxacin
• Clarithromycin

If a fever persists at dangerously high levels, it can lead to serious complications, such as:

• Neurological damage
• Low blood pressure
• Inflammation in the gastrointestinal system
• Swelling (Edema)
• Acute kidney injury
• Liver damage
• Spontaneous bleeding
• Prolonged clotting times
• Thrombocytopenia (low platelet count)

Important:

Pregnant women who experience fever along with a rash and joint pain should seek immediate medical attention, as this may indicate an infection that could harm the baby.

Here are some important dos and don’ts to follow when dealing with a fever:

DO’S

1. Measure the Temperature with a Thermometer
2. It's best to use a thermometer to accurately monitor the temperature rather than relying on touch to estimate it.
3. Cold or Tepid Water Sponging
4. Dip a cloth or sponge in cold or lukewarm water, squeeze out excess moisture, and gently apply it to the forehead.
5. Stay Hydrated
6. Ensure you drink plenty of fluids, especially if a loss of appetite occurs due to the infection.
7. Wear Light Clothing
8. Opt for loose, lightweight cotton clothing as wearing too many layers can raise the body temperature.

DON’TS

1. Avoid Layering with Multiple Blankets
2. Covering yourself with excessive blankets can increase body heat instead of reducing fever, unless you're experiencing chills or cold sensations.
3. Don’t Starve
4. Though appetite may decrease during fever, avoid starvation as it can weaken the body’s ability to fight the infection and lead to fatigue.
5. Don’t Self-Medicate
6. Consult a healthcare professional before taking medication, especially if the fever is high (over 102°F) or if you feel excessively weak.
7. Avoid Strenuous Activities
8. Refrain from engaging in physically demanding activities, as overexertion can worsen the condition and lead to muscle soreness.

First Aid for High-Grade Fever

• Monitor the temperature using a thermometer.
• Keep the person in a comfortable, cool environment, preferably with a fan or air conditioner.
• If chills are present, cover them with light clothing.
• Administer 500 mg of paracetamol every 6 hours consistently.
• Provide a sponge bath using lukewarm water.
• Encourage them to drink plenty of fluids.
• Seek medical attention if the fever persists after 24 hours.
• If the temperature exceeds 106°F, immediately call for an ambulance or rush to the hospital.

What to Do if Your Child Has a Fever?

• Ensure the child stays hydrated to prevent dehydration.
• Administer paracetamol based on the child’s weight, as per the doctor’s recommendation.
• Avoid Aspirin.
• Dress the child in light clothing to help their body cool down.
• Do not force-feed; a moderate amount of fluids (2-3 liters) is sufficient to maintain hydration and urine output.
• Use a cool, wet cloth for fomentation on the child’s forehead.
• Give the child a lukewarm bath to reduce their body temperature.
• Keep the child at home and avoid sending them to school or daycare until their temperature returns to normal for at least 24 hours.
• Ensure the child gets adequate rest and sleep.

Note: Immediate medical attention is crucial if the child is 3 months or younger and has a temperature above 100.4°F (38°C), as it could indicate a serious condition.

Home Remedies

Traditional remedies may support recovery from fever. Here are a few examples:

1. Giloy (Guduchi or ‘Amrita’) Giloy is an herb known for boosting immunity and helping reduce fever. You can consume Giloy as a juice by blending chopped branches with water, straining the mixture, and drinking it. Supplements are also available.
2. Holy Basil (Tulsi) Considered the "Queen of herbs," Tulsi has potent antibacterial and fever-reducing properties. Boil 10-12 Tulsi leaves in a glass of water for 10 minutes, strain, and drink this extract every 2-3 hours for best results.
3. Turmeric (Haldi) Turmeric is known for its immune-boosting, antibacterial, and antioxidant qualities. Mix one teaspoon of turmeric into a glass of warm milk and consume it before bedtime for optimal effect.
4. Ginger (Adrak) Ginger has antibacterial properties that can help with fever and other symptoms like cough. Add a pinch of grated ginger to a cup of boiling water and drink 1-2 times daily.
5. Garlic (Lehsun) Garlic possesses antibacterial properties beneficial for fever management. Crush 2-3 garlic cloves, add them to a quarter cup of warm water, strain, and consume.