Fever Flashcards
what is diurnal temp variation
up in mid-day - indep of time of day
what is normal T range
under 38
what is practical def. of fever
monitor closely for 37.8-37.9, over 38 abnormal
def. of febrie neutropenia
T > 38 x1 orall or >38 for >hour
def. of fever of unknown origin (FUO)
fever > 38 on multiple reading over 3 weeks
- no cause after invest
- not applicable to FN, HIV, HSCT, nosocomial aquired
what is body thermostat
hypothalamus
mech of fever in infection
- exogenous pyogens
- activated leukocytes
- IL-1, TFN, IFN, IL-6
- vascular epithelium near hypothlamus
- PGE2 on other side of BBB
- increase hypothalmic set point
what is fever good for
Tmax and survaval correlated in Gr- bacteremia, bact peritonitis
disadv of fever
symptomatic - chills, sweats, tachycardia and tachypnea
- no adverse effects in adults
possible problem in children
risk of febrile seizures
2 situations in which high temp is not a fever
- hyperthermia - can’t lose heat, set-point not changed
2. hyperpyrexia - T > 41 , usually hypothal. damage
DDx of fever
- infection
- non-infection inflammatory disorders
- malignancy
- vascular thrombosis
- endocrine
- drugs/meds
how has cause of FUO changed with time
more likely to be no diagnosis in recent times
what is standard investigation of FUO
TSH, bloods, TB test, CT chest/abdo, doppler US
what is common treatment of fever
Cox blockers
