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    Group 7 - Subgroup 2 Chief Complaint

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    KAYLLIEN DURAN
    The document discusses fever, including its definition, pathophysiology, classifications, and types or patterns. Fever is an elevation of body temperature above the normal daily variation, usually considered a temperature over 37.7°C. It is often caused by infections but can also be due to inflammatory, malignant or central causes. Fever occurs when pyrogens such as cytokines act on the hypothalamus, increasing its temperature set point and causing the body to raise its temperature through mechanisms such as vasodilation and shivering. Fever can be classified based on duration as acute, subacute or chronic, and based on temperature as low grade, moderate or high grade. Patterns include sustained, intermittent or remittent fever

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    Group 7 - Subgroup 2 Chief Complaint

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    KAYLLIEN DURAN
    25 views5 pages
    The document discusses fever, including its definition, pathophysiology, classifications, and types or patterns. Fever is an elevation of body temperature above the normal daily variation, usually considered a temperature over 37.7°C. It is often caused by infections but can also be due to inflammatory, malignant or central causes. Fever occurs when pyrogens such as cytokines act on the hypothalamus, increasing its temperature set point and causing the body to raise its temperature through mechanisms such as vasodilation and shivering. Fever can be classified based on duration as acute, subacute or chronic, and based on temperature as low grade, moderate or high grade. Patterns include sustained, intermittent or remittent fever

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    The document discusses fever, including its definition, pathophysiology, classifications, and types or patterns. Fever is an elevation of body temperature above the normal daily variation, usually considered a temperature over 37.7°C. It is often caused by infections but can also be due to inflammatory, malignant or central causes. Fever occurs when pyrogens such as cytokines act on the hypothalamus, increasing its temperature set point and causing the body to raise its temperature through mechanisms such as vasodilation and shivering. Fever can be classified based on duration as acute, subacute or chronic, and based on temperature as low grade, moderate or high grade. Patterns include sustained, intermittent or remittent fever

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    © All Rights Reserved
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    Download as pdf or txt
    25 views5 pages

    Group 7 - Subgroup 2 Chief Complaint

    Uploaded by

    KAYLLIEN DURAN
    The document discusses fever, including its definition, pathophysiology, classifications, and types or patterns. Fever is an elevation of body temperature above the normal daily variation, usually considered a temperature over 37.7°C. It is often caused by infections but can also be due to inflammatory, malignant or central causes. Fever occurs when pyrogens such as cytokines act on the hypothalamus, increasing its temperature set point and causing the body to raise its temperature through mechanisms such as vasodilation and shivering. Fever can be classified based on duration as acute, subacute or chronic, and based on temperature as low grade, moderate or high grade. Patterns include sustained, intermittent or remittent fever

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    GROUP 7 SUBGROUP 2 - SECTION A

    Ward Precept: Dr. Celerio

    Duran, Kayllien
    Duran, Marie Nicole
    Ecita, Sharissa May
    Enriquez, Cheska
    Enriquez, Jeena Patricia

    CHIEF COMPLAINT: Fever

    I. Intro

    Fever
    - An elevation of body temperature that exceeds the normal daily variation and
    occurs in conjunction with an increase in the hypothalamic set point (e.g., from
    37℃ to 39℃).
    - Often associated with chills, rigors, malaise and tachycardia.
    - Its etiologies include infective, inflammatory, malignant and central entities.
    - According to a study of >35,000 individuals of ≥18 years of age seen in routine
    medical visits, the mean oral temperature is 36.6℃. In light of this study, a
    temperature of >37.7℃, which represents the 99th percentile for healthy
    individuals, defines a fever.
    II. Pathophysiology
    In response to exogenous pyrogens such as bacterial LPS, leukocytes
    produce endogenous pyrogens such as IL-1, TNF, and IL-6. These cytokines act
    on vascular and perivascular cells of the hypothalamus to induce
    cyclooxygenase, converting AA into prostaglandins. Of these, PGE2 is very
    important. It induces neurotransmitters such as cAMP to reset the body's
    temperature set-point. This causes fever, somnolence, and lethargy. It also
    explains how NSAIDs and acetaminophen are antipyrogenic.
    If the pyrogens are not removed, a new set point will be set and the body
    temperature will continue to rise. When the fever “breaks” the person is
    considered afebrile.
    If the pyrogens are removed (e.g. antibiotics or antipyretics are initiated)
    the last phase, or fever break phase, begins with a drop in the hypothalamus
    setpoint. As the body temperature drops the person becomes warm and flushed
    due to vasodilation and diaphoresis sets in to assist with heat loss.
    III. CLASSIFICATIONS
    BASED ON DURATION:
    1. Acute fever - fever less than 7 days and is a characteristic of infectious diseases such as
    malaria and viral-related upper respiratory tract infection. However, any cause of acute
    fever can become persistent or chronic if untreated.
    2. Sub-acute fever - usually not more than 2 weeks in duration which may be seen in cases
    of typhoid fever and intra-abdominal abscess.
    3. Chronic or persistent fever - more than 2 weeks in duration which are typical of chronic
    bacterial infections such as tuberculosis, viral infections like HIV, cancers and connective
    tissue diseases.
    BASED ON THE HEIGHT OF BODY TEMPERATURE

    It can also be classified into low grade, moderate grade, high grade and hyperpyrexia. The
    height of body temperature may have some diagnostic and prognostic implications. Some
    studies have attributed high grade fevers in infants to serious bacterial infections, although
    others have also shown that children with high fevers are at equally high risk for serious
    bacterial infections and for viral illness. Hyperpyrexia in severe malaria is defined as rectal
    temperature above 40°C

    IV. TYPES/PATTERN
    1. Sustained/ continuous fever
    ● Defined as fever that does not fluctuate more than about 1°C during 24 hours but
    no time touches normal
    ● These fevers are Characteristics if lobar and gram-negative penumonia, typhoid,
    acute bacterial meningitis, UTI, among others
    2. Intermittent fever
    ● Defined as fever present only for several hours during the day
    ● Seen in malaria pyogenic infections, tuberculosis, schistosomiasis, lymphomas,
    leptospira, borrelia or septicemia
    3. Remittent fever
    ● Defined as a fever pattern in which temperature varies during each 24-hour
    period but never reaches normal
    ● Often associated with infectious diseases such as infective endocarditis,
    ricketsiae infections, brucllosis
    ● Relapsing fevers - refers to those that are recurring and separated by periods
    with low-grade fever or no fever
    REFERENCES
    - Fong, N. J. M. (2018). Algorithms In Differential Diagnosis: How To Approach

    Common Presenting Complaints In Adult Patients, For Medical Students

    And J Junior Doctors. Singapore: World Scientific Publishing Company.

    - Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J, eds.
    Harrison's Principles of Internal Medicine. 20th ed. McGraw Hill; 2018.
    Accessed April
    19,2020.http://accessmedicine.mhmedical.com/content.aspx?bookid=219
    - Ogoina, 2011 Fever, Fever Patterns and diseases called ‘fever’ - A review

    https://doi.org/10.1016/j.jiph.2011.05.002

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