Febrile Conditions

Author: Laiba B. (IG: @yourhealthguide_)

SCG ID: 0401202010

Definition:

Febrile illness is the medical term used to describe a sudden fever or elevation in body temperature. This happens when the body is invaded by a pathogen and the immune system is activated to fight it off.

What is Acute Febrile Illness?

When the body is invaded by a foreign pathogen like a virus or bacteria, the immune system kicks into gear and tries to fight the infection before it has a chance to spread. When this happens, the body's temperature is elevated to try to kill off the pathogen, and this results in what we call a fever. Acute febrile illness is when fever develops suddenly; specifically, the body temperature rises above 37.5 degrees Celsius (99.5 degrees Fahrenheit).

Explanation:

The body’s mechanism to respond to infection causes fever. The infection could be viral or bacterial, and as a response, the body increases the temperature of the blood that we know as fever. Nevertheless, it is difficult to diagnose the disease without knowing the presence of signs and symptoms other than fever.

Acute fever can happen to adults and kids, but it is more common in infants. In addition, an acute fever could be mild, moderate or severe. In a healthy adult, a mild acute fever could be transient and may subside without any harm. Nevertheless, high-grade fever (referred to as hyperpyrexia) or a persistent fever may require medical attention and intensive treatment as it indicates some serious underlying cause.

In most of the cases, one of the body systems (mentioned below) is involved in acute fever.

1. Respiratory system (mainly upper respiratory tract)

2. Digestive system (involving the gastrointestinal tract)

3. Urogenital system (mainly urinary tract)

4. Skin diseases

The symptoms of acute fever solely depend on which body system is involved. For instance, acute fever due to respiratory tract infection may have malaise, cough or wheezing sound in the lungs in auscultation. While most of the acute fever is controllable, high-grade fever due to sepsis (septicemia) is a life-threatening condition that requires immediate treatment with hospitalization. The acute fever might be associated with pain and body ache, especially in viral infections.

Medical Causes:

Acute febrile illness can occur whenever the body is invaded by some type of infectious disease, but it is especially worrisome in tropical and sub-tropical regions where serious diseases loom. These can include malaria, dengue, typhoid, chikungunya, leptospirosis, scrub typhus, influenza, encephalitis, histoplasmosis, enteric fever, rickettsiosis, Hantavirus, and many, many others. Specifically, the hypothalamus is the part of the brain responsible for regulating body temperature, and it may decide to elevate body temperature in response to an infection. Let us list common infection or condition sorted by body systems that help in understanding the differential diagnosis of acute fever.

Upper respiratory tract infection

The common conditions include acute sinusitis, tonsillitis etc. The symptoms include -

1. Running nose, nasal congestion, coughing (dry or with phlegm)

2. Presence of pus (indicates that it is most probably due to bacterial infection)

3. Sneezing and malaise

4. Change in voice (referred to as xenophonia) and, as a result, hoarseness

5. Sore or burning throat

6. Burning eyes, tired eyes

7. Burning sensation in nose

8. Difficulty in breathing (mainly due to congestion)

9. Heaviness in the head

10. Headache

Lower respiratory tract infection

The common conditions include bronchitis, pneumonia, lung disease (such as an abscess), empyema etc. The common symptoms along with acute fever in this include

1. Dry or cough with mucus

2. Sputum with blood (requires immediate medical attention)

3. Breathlessness (dyspnea)

4. Abnormal breathing sounds (severe wheezing)

5. Pain in chest

6. Heaviness in thorax

Gastrointestinal tract infection

The common conditions in this section include gastroenteritis that could be due to viral or bacterial infection. The common symptoms other than acute fever include

1. Nausea or vomiting

2. Severe abdominal cramps

3. Indigestion (diarrhoea)

4. Foul smell in flatulence

5. Bloating

6. Lethargy

7. Weakness

Urinary tract infection (UTI)

The symptoms other than acute fever in the urinary tract infection include

1. Painful micturition

2. Dark urine (if it is blood, contact a healthcare provider immediately)

3. Burning sensation in urine

4. Change in frequency of urination (either very frequent or very less)

5. Urinary incontinence

6. Pus discharge (if this is present, contact a healthcare provider immediately)

7. Severe tenderness in the pelvic region

8. Retention of urine (may require surgical attention)

Skin diseases

Some skin diseases may produce acute fever along with other signs and symptoms mentioned below.

1. Itching at a particular site

2. Burning sensation at the affected area or the whole body

3. Redness or change in normal skin tone (colour)

4. Inflammation or swelling of the skin

5. Tenderness or pain at a particular site (may or may not be)

6. Warmth (change in local temperature at the affected site)

7. The appearance of blister

8. Formation of pus (especially in abscess)

9. Frothing from the mouth, giddiness or even shock (in case of poison injection as in case of insect sting, animal bite or poisonous chemical/substance contact)

Drug-induced acute fever

Some drugs can also produce mild to moderate fever as their side effects. Drug-induced fever does not require specific treatment. When the causative drug is stopped, the fever subsides. Here is the list of the group of drugs that might produce pyrexia in individuals.

Diagnosis:

The diagnosis depends upon the cause. In most of the cases, hemogram (complete blood test) is advised. A thorough physical examination, auscultation, palpation along with patient’s history helps in diagnosing the condition of acute fever. ESR, smear for parasites (mainly for malaria), blood culture, typhoid test (WIDAL), urine routine and micro etc. help in finding the exact cause of acute fever. In some cases, X-Ray chest and ultrasound are carried out to check the health of the internal organs. In conditions like meningitis, the fluid (spinal) is preferred for microscopic study.

Treatment and Remedy:

While in most of the cases of acute fever, treatment remains symptomatic, but in treatment of acute rheumatic fever requires special attention. Firstly, the patient is asked to take absolute rest until the symptoms of inflammation pass. At earliest, sedative drugs and cardiac tonics have resorted, and daily heart check-up is preferred. The salts of salicylic acid are preferred to alleviate pain and fever. Nevertheless, to overcome these drugs’ side effects (such as gastrointestinal irritation), certain anti-emetic and anti-acidity drugs can be combined in treatment.