Fever –what to do?

Fever is one of the most common complaints for which people visit hospitals and seek treatment. It is also one of the most common causes for worry and also abstinence from work. Technically, fever is the elevation of the body temperature above normal. Irrespective of the temperature in the environment, one’s body temperature is maintained in a normal range by the regulatory mechanisms in the sympathetic system and hypothalamus in the brain. This entire system keeps the temperature within normal limits, though the environment may be hot or cold. There is a range of normal body temperature, but generally 37.4 degree Celsius is accepted as the upper limit of normal. One can make out that fever is present in an individual when he or she feels listless and on touching the forehead it feels unusually hot. Rise in temperature is confirmed by recording body temperature with a thermometer. It can be recorded from the mouth, rectum or axilla (armpit). Temperatures taken in the mouth or rectum are said to be more accurate than the ones taken from the armpits. Along with high temperature one has headache, body ache, feeling of being weak, nausea, e.t.c. a wide variety of symptoms. There may be associated mild dehydration as profuse sweating occurs at times in attempt to bring down the elevated temperature by the body’s regulatory mechanisms. A wide range of infections produce fever in the body. It can also occur due to collagen diseases like rheumatoid arthritis or systemic lupus erythematosus. Malignancies like lymphomas and leukemias also present fever as one of their manifestations. Different kinds of diseases produce distinct types of fever. For example T.B. mostly causes low grade fever in evening, malaria produces intermittent fever, i.e. there are episodes of fever interspersed with periods of normal temperature. Typhoid has a characteristic pattern where the fever fluctuates but usually does not come to normal unless treated. Mostly once fever develops, patients do self medication with some antipyretic drug (drug to reduce fever) and antibiotics . These drugs taken immediately tend to mask the pattern of fever hence making clinical diagnosis of the disease difficult and leading to prolonged unnecessary treatments. Unnecessary use of antibiotics increases possibility of antibiotic resistant microbes and also exposes one to their adverse effects. Fever is in fact one of the defense mechanisms of the body. It is due to presence of fever that one is alerted to the fact that something is wrong in the body. Elevation of the temperature destroys the infective germs. It also removes the toxins from the body and stimulates the immune system. Therefore one should not intervene to reduce the fever immediately. Mild infections may subside by themselves if the body has a strong immune system. Very high fever (hyperpyrexia) is harmful as it can damage the brain if it persists. In adults it is considered as temperature of 39.4 degree c. or more, but in children temperature above 38 degrees is also harmful as they can have convulsions easily due to high fever. Here it is necessary to bring down the elevated temperature to normal or near normal soon. Aspirin should be avoided if alternate drugs are available as it can cause bleeding and or gastritis and precipitate allergic asthma. Paracetamol can be used frequently even after 4 to 6 hours, till the high temperature is reduced. Cold sponging of the body is a simple economical and harmless measure to bring down the high temperature. In moderate or hot room temperature, the entire body can be covered with a wet sheet. If the weather is cold, a wet towel or napkin soaked in tepid tap water can be applied over the forehead. Drinking plenty of liquids is also beneficial for a person having high fever. Some people restrict the diet of an individual if he develops fever but there is no scientific basis for diet restriction. When somebody eats well, the weakness associated with fever does not occur Very high or persistent fever, seizures, neck stiffness or continuous vomiting are situations where one should seek medical intervention in the hospital. –rachna212002@yahoo.co.uk