L24: Boy with a fever

Question 1

What is a fever?

Answer 1

State of increased core body temp
Often part of defensive response to invasion by pathogens
Normal 35.6-38.2 (women slightly higher than men)

Question 2

Body heat control

Answer 2

• Metabolism
• Distributed by circulation
• Controlled by cutaneous blood flow
• Under influence of thermo-regulators in hypothalamus
• Core and cutaneous thermo-sensors

Question 3

Fever pathophysiology

Answer 3

• Pyrogen activated leukocytes
• Cytokines (IL-6) released -> interact with nuclei in hypothalamus
• Cause febrile response (fever, malaise, lethargy, loss of appetite)

Question 4

Function of fever

Answer 4

(not related to pathogens not being able to replicate)

• Neutrophil granules more likely to release ROS at higher temp
• Enhanced phagocytosis, antibody function

Question 5

Why treat a fever?

Answer 5

Febrile convulsions (often infants, benign convulsions)
Not recommended to use paracetamol to treat fever

Question 6

Significance of fever

Answer 6

Height of fever irrelevant, just presence

In some young children height of fever may have some implications

Question 7

Investigate a fever rigorously if:

Answer 7

Age < 3months
Unwell
Immunocompromised
Duration >10 days