Facts and figures

Question 1

Normal average values (morning):

Answer 1

Normal body temp. (measured orally) is 36–37.3°C (av. 36.8°C);

• there is considerable diurnal variation in temperature
• so that it is higher in the evening by ~ 0.6°C

–oral 36.8°C

–axilla 36.4°C

–rectum 37.3°C

Question 2

Fever (pyrexia):

Answer 2

–morning oral >37.2°C

–evening oral >37.8°C

Fevers due to infections have an upper limit

• of 40.5–41.1°C (105–106°F)

Hyperthermia (temp. >41.1°C) and hyperpyrexia

• appear to have no upper limit

Question 3

Fever plays an important physiological role in

Answer 3

the defence against infection

Infection remains the most important cause of acute fever

Question 4

Symptoms associated with fever include

Answer 4

• sweats
• chills
• rigors
• headache

Features of a true chill are teeth chattering and bed shaking

• lasting 10–20 minutes,

with absence of sweating; a feature of:

• bacterial infection
• and malaria

Question 5

Drugs can cause fever

Answer 5

• allopurinol
• antihistamines
• barbiturates
• cephalosporins
• cimetidine
• methyldopa
• penicillins
• isoniazid
• quinidine
• phenolphthalein
• inc. laxatives
• phenytoin
• procainamide
• salicylates
• sulphonamides

Question 6

Complications include

Answer 6

dehydration (usually mild)

and febrile convulsions.

Question 7

Fever of less than 3 days duration

Answer 7

Usually due to self-limiting viral URTI

Watch out for:

• an infectious disease
• UTI
• pneumonia
• or other infection

Consider routine urine examination

Most can be managed conservatively

Question 8

If fever persists beyond 4–5 days:

Answer 8

a less common infection should be suspected

• since most common viral infections will have resolved by about 4 days
  e. g.
• Epstein–Barr mononucleosis
• PID
• drug fever
• zoonosis
• travel acquired infection
• abscess inc. dental abscess