What temperature is considered a fever in adults. How high of a fever is dangerous. When should you seek medical attention for a fever. What are the common causes and symptoms of high fevers. How can you treat a fever at home.

Understanding Fever: What Constitutes an Elevated Body Temperature?

Fever is a crucial defense mechanism employed by the body to combat infections. It’s essential to understand what constitutes a fever and when it becomes a cause for concern. The average body temperature is typically 98.6°F (37°C), but this can vary from person to person and fluctuate throughout the day.

A fever is generally defined as a body temperature of 100.4°F (38°C) or higher. However, it’s important to note that fever severity can be categorized into different levels:

• Low-grade fever: 99.1°F to 100.4°F (37.3°C to 38.0°C)
• Moderate-grade fever: 100.6°F to 102.2°F (38.1°C to 39.0°C)
• High-grade fever: 102.4°F to 105.8°F (39.1°C to 41°C)

Understanding these ranges can help you determine when a fever might require medical attention.

Recognizing Dangerous Fever Levels in Adults

While fevers are often beneficial in fighting infections, there are instances when they can become dangerous. A fever over 104°F (40°C) is considered high enough to warrant immediate medical attention. This level of fever can lead to serious complications if left untreated.

Besides the temperature itself, certain accompanying symptoms can indicate a potentially dangerous situation. Seek immediate medical help if you experience a fever along with:

• Seizures
• Loss of consciousness
• Confusion or delirium
• Stiff neck
• Difficulty breathing
• Severe pain in any part of the body
• Swelling or inflammation
• Unusual vaginal discharge
• Pain or burning sensation when urinating

These symptoms, when combined with a high fever, may indicate a severe underlying condition that requires prompt medical intervention.

Common Causes of High Fevers in Adults

Understanding the potential causes of high fevers can help you better assess your situation and determine when to seek medical help. While infections are the most common cause, several other conditions can lead to elevated body temperatures:

Infectious Causes

• Viral infections (e.g., influenza, COVID-19)
• Bacterial infections
• Fungal infections

Non-Infectious Causes

• Inflammatory conditions (e.g., rheumatoid arthritis)
• Reactions to medications or vaccines
• Certain types of cancers
• Thyroid storm
• Serotonin syndrome
• Intracranial hemorrhage
• Kawasaki syndrome
• Drug overdose

It’s important to note that the underlying cause of a fever can significantly impact its severity and duration. Identifying the root cause is crucial for effective treatment.

Recognizing Symptoms Associated with High Fevers

High fevers often come with a range of accompanying symptoms that can help you gauge the severity of your condition. Being aware of these symptoms can guide your decision on whether to seek medical attention:

• Profuse sweating
• Chills and shivering
• Severe headache
• Muscle aches and joint pain
• Loss of appetite
• Skin rashes
• Restlessness or irritability
• Weakness and fatigue
• Confusion or delirium (in cases of very high fever)

If you experience a combination of these symptoms along with a high fever, it’s advisable to consult a healthcare professional promptly.

Diagnosing the Underlying Cause of a Fever

When you visit a doctor with a high fever, they will likely conduct a thorough examination to determine the underlying cause. This diagnostic process may include:

1. Detailed medical history: Your doctor will ask about recent illnesses, surgeries, injuries, vaccinations, new medications, and travel history.
2. Physical examination: This may include checking for signs of infection or inflammation in various parts of your body.
3. Laboratory tests: Blood tests, urine analysis, or cultures may be ordered to identify potential infections or other abnormalities.
4. Imaging studies: In some cases, X-rays, CT scans, or MRIs might be necessary to identify internal issues.

By gathering this information, your healthcare provider can make an accurate diagnosis and recommend appropriate treatment.

Effective Home Remedies for Managing Fevers

While high fevers often require medical attention, there are several steps you can take at home to manage lower-grade fevers and alleviate discomfort:

• Stay hydrated: Drink plenty of fluids to prevent dehydration and help cool your body.
• Rest: Give your body the time it needs to fight the infection and recover.
• Eat light, easily digestible foods: This can help maintain your energy levels without overtaxing your digestive system.
• Use over-the-counter medications: Acetaminophen, ibuprofen, or naproxen can help reduce fever and relieve associated aches and pains.
• Apply cool compresses: Place damp washcloths on your forehead and wrists to help lower your body temperature.
• Take a lukewarm bath: This can help cool your body, but avoid cold water as it can cause shivering, which may raise your body temperature.

Remember, these measures are suitable for managing mild to moderate fevers. For high-grade fevers or those accompanied by severe symptoms, always seek professional medical advice.

When to Seek Immediate Medical Attention for a Fever

While many fevers can be managed at home, certain situations require immediate medical intervention. It’s crucial to recognize these scenarios to ensure timely and appropriate care. Seek emergency medical attention if you experience:

• A fever of 103°F (39.4°C) or higher that doesn’t respond to medication
• A fever lasting more than three days
• Signs of dehydration, such as decreased urination, dark urine, or dizziness
• Severe headache or neck stiffness
• Difficulty breathing or chest pain
• Abdominal pain or vomiting
• Unusual skin rashes, especially if they’re spreading quickly
• Confusion, hallucinations, or seizures

These symptoms, particularly when combined with a high fever, may indicate a serious underlying condition that requires immediate medical evaluation and treatment.

Special Considerations for Certain Groups

Some individuals may need to seek medical attention for fevers at lower temperatures or with less severe symptoms. These groups include:

• Older adults (65 years and above)
• Individuals with compromised immune systems
• People with chronic medical conditions (e.g., heart disease, diabetes, lung disease)
• Pregnant women

If you fall into any of these categories, it’s advisable to consult your healthcare provider even for mild fevers, as your risk of complications may be higher.

Understanding the Body’s Fever Response Mechanism

To fully grasp the significance of fever and its potential dangers, it’s helpful to understand how the body’s fever response works. This natural defense mechanism is triggered by pyrogens, which are fever-producing substances that can be either external (like bacteria or viruses) or internal (produced by the body itself).

The Fever Process

1. Pyrogen detection: When the immune system detects pyrogens, it signals the hypothalamus, the body’s thermostat.
2. Temperature elevation: The hypothalamus raises the body’s set point temperature.
3. Heat generation: The body responds by generating and retaining more heat, often causing chills as it works to reach the new, higher temperature.
4. Immune system activation: The elevated temperature helps activate the immune system, making it more efficient at fighting off infections.
5. Resolution: Once the threat is neutralized, the body’s temperature gradually returns to normal.

While this process is generally beneficial, extremely high temperatures can lead to complications, which is why monitoring and managing high fevers is crucial.

Benefits and Risks of Fever

Fever serves several important functions in fighting infections:

• Enhances immune system function
• Creates an unfavorable environment for some pathogens
• Slows down bacterial growth
• Increases production of disease-fighting white blood cells

However, very high fevers can also pose risks:

• Dehydration
• Increased metabolic demands on the body
• Potential for seizures or organ damage in extreme cases

Understanding this balance is key to managing fevers effectively and knowing when to seek medical help.

Preventing Fevers and Boosting Immune Health

While not all fevers are preventable, there are steps you can take to reduce your risk of infections that often lead to fevers. Strengthening your immune system can also help your body fight off potential threats more effectively.

Preventive Measures

• Practice good hygiene: Wash your hands frequently and thoroughly.
• Stay up to date with vaccinations: This includes annual flu shots and other recommended vaccines.
• Avoid close contact with sick individuals when possible.
• Maintain a clean environment: Regularly disinfect frequently-touched surfaces.
• Practice food safety: Cook foods thoroughly and avoid consuming raw or undercooked meats.

Boosting Immune Health

• Maintain a balanced diet rich in fruits, vegetables, and lean proteins.
• Stay hydrated by drinking plenty of water throughout the day.
• Get regular exercise to improve overall health and immune function.
• Ensure you’re getting adequate sleep each night.
• Manage stress through relaxation techniques or mindfulness practices.
• Consider supplements like vitamin C, vitamin D, and zinc, after consulting with your healthcare provider.

By implementing these preventive measures and focusing on overall health, you can potentially reduce the frequency and severity of fevers.

Understanding Fever in Special Populations

While we’ve focused primarily on fever in adults, it’s important to recognize that fever can manifest differently and pose unique risks in certain populations. Understanding these differences can help in providing appropriate care and knowing when to seek medical attention.

Fever in Older Adults

Older adults may not exhibit typical fever symptoms due to age-related changes in their immune system. Key points to consider:

• Lower baseline temperatures: Normal body temperature in older adults may be lower than the standard 98.6°F (37°C).
• Blunted fever response: Older adults might not develop high fevers even with serious infections.
• Increased risk of complications: Even mild fevers can indicate serious illness in older adults.

For these reasons, any change in body temperature or overall health in older adults should be taken seriously and evaluated by a healthcare professional.

Fever in Immunocompromised Individuals

People with weakened immune systems, such as those undergoing chemotherapy or living with HIV/AIDS, may experience fevers differently:

• Higher risk of infections: These individuals are more susceptible to various pathogens.
• Atypical presentations: Fevers might be the only sign of a serious infection.
• Rapid progression: Infections can worsen quickly, making prompt medical attention crucial.

Immunocompromised individuals should have a low threshold for seeking medical care when experiencing any signs of fever or infection.

Fever During Pregnancy

Pregnant women need to be particularly cautious about fevers due to potential risks to the developing fetus:

• Increased body temperature: Pregnancy can slightly elevate normal body temperature.
• Risks to the fetus: High fevers, especially in early pregnancy, may increase the risk of certain birth defects.
• Dehydration concerns: Fever can lead to dehydration, which is particularly dangerous during pregnancy.

Pregnant women should consult their healthcare provider promptly if they develop a fever, especially if it’s 101°F (38.3°C) or higher.

The Role of Technology in Fever Monitoring and Management

As technology continues to advance, new tools and methods for monitoring and managing fevers are becoming available. These innovations can provide more accurate and continuous temperature monitoring, potentially improving fever management and early detection of concerning trends.

Advanced Thermometers

Modern thermometers offer features that go beyond simple temperature readings:

• Infrared thermometers: Allow for non-contact temperature measurement.
• Smart thermometers: Can track temperature over time and sync with smartphone apps.
• Continuous monitoring patches: Adhere to the skin for ongoing temperature tracking.

These devices can provide more comprehensive data, helping both individuals and healthcare providers make informed decisions about fever management.

Telemedicine and Remote Monitoring

The rise of telemedicine has changed how fevers can be assessed and managed:

• Virtual consultations: Allow for quick medical advice without leaving home.
• Remote patient monitoring: Enables healthcare providers to track patient temperatures and symptoms from afar.
• AI-assisted triage: Some platforms use artificial intelligence to help assess the severity of symptoms and provide guidance.

These technological advancements can facilitate earlier interventions and more personalized care, particularly beneficial for those at higher risk of complications from fevers.

Mobile Health Apps

Numerous mobile applications now exist to help individuals track and manage their health, including fever symptoms:

• Symptom trackers: Allow users to log temperatures and associated symptoms over time.
• Medication reminders: Help ensure proper timing and dosing of fever-reducing medications.
• Educational resources: Provide information on fever management and when to seek medical care.

While these apps can be valuable tools, it’s important to remember that they should complement, not replace, professional medical advice.

The Future of Fever Management and Research

As our understanding of the human body and immune system continues to evolve, so too does our approach to managing fevers. Ongoing research and emerging technologies promise to reshape how we view and treat fevers in the future.

Personalized Medicine

The field of personalized medicine is likely to impact fever management:

Fever in adults – Harvard Health

Fever is one of the body’s most effective ways of fighting infection. It is part of your body’s defense against infection-causing germs.

You get a fever most often when your body is trying to kill infectious invaders such as viruses or bacteria. A higher body temperature helps the immune system respond more vigorously to the attack, and makes it harder for these microbes to survive.

What is considered a fever in adults?

The average body temperature is 98.6° F (37°C). But “normal” body temperature varies from person to person. It also changes during the day, rising a bit after you eat or exercise. Body temperature is often higher in the afternoon than it is when you wake up in the morning.

Fever means a body temperature of 100.4° F (38°C) or higher.

High fever in adults

While any temperature above your normal temperature range is considered a fever, there are different levels of fever severity:

• Low-grade: 99. 1 to 100.4 F (37.3 to 38.0 C)
• Moderate-grade: 100.6 to 102.2 F (38.1 to 39.0 C)
• High-grade: 102.4 to 105.8 F (39.1 to 41 C)

When to worry about fever

If you have a fever over 104°F (40°C), you should call your doctor.

Seek medical help right away if you have a fever along with any of these symptoms:

• seizure
• loss of consciousness
• confusion
• stiff neck
• trouble breathing
• severe pain anywhere in the body
• swelling or inflammation of any part of the body
• vaginal discharge that is discolored or smells bad
• pain when urinating or urine that smells bad.

Causes of fever

An infection, such as the flu, is the most common cause of fever.

Other conditions can also cause a fever. These include diseases that produce inflammation, such as rheumatoid arthritis; reactions to drugs or vaccines; and even certain types of cancers.

Accompanying symptoms

The following symptoms may also accompany fever:

• sweats
• chills
• headache
• achy muscles
• lack of desire to eat
• rash
• restlessness
• weakness.

A very high fever can cause confusion, extreme sleepiness, irritability, and seizures.

Diagnosing the cause of a fever

To help determine why you have a fever, your doctor will ask you about:

• other symptoms such as coughing, abdominal pain, vomiting, diarrhea, or pain when urinating
• recent surgeries or injuries
• recent vaccinations
• new drugs you may be taking
• recent travel, particularly travel abroad.

How to treat a fever at home

By itself, fever is usually harmless, though a high fever can be miserable. These steps may help you feel better:

• Drink plenty of fluids to help cool your body and prevent dehydration.
• Eat light foods that are easy to digest.
• Get plenty of rest.
• Take ibuprofen (Advil, Motrin, or others), naproxen (Aleve, Naprosyn, or others), or acetaminophen (Tylenol, others) to help relieve head and body aches and lower your temperature.
• Take a slightly warm (not cool) bath, or apply damp washcloths to the forehead and wrists.

Image: yacobchuck/Getty Images

How High of a Fever Is Dangerous for Adults?

5% to 20% of the US population gets the flu every year, resulting in 31.4 million outpatient visits annually. Whether you have the flu, the coronavirus, or another illness, one of the early symptoms is often a high-grade fever.

How high of a fever is dangerous for adults? Keep reading to find out.

By knowing how to recognize the symptoms, you can visit a doctor for treatment as soon as possible. Otherwise, the cause of your fever might lead to bigger complications in the future.

Don’t wait to get the help you need. Instead, learn how to recognize dangerous fever levels with this guide. 

A Little About Fevers

A fever is an elevation in body temperature. Usually, a body temperature above 98.6 F is considered elevated. However, a fever isn’t considered significant until it reaches about 100.4 F.

How high of a fever is dangerous for adults? Another below 100.4 F is considered a low-grade fever. If you have a fever above 100.4 F, you need to see a doctor.

Otherwise, your fever could result in delirium or convulsions. 

Possible Causes

Dangerous fever levels occur when your immune system is attacking a foreign invader, including a:

• Virus
• Bacteria
• Fungi
• Drug
• Toxin

These invaders are fever-producing substances called pyrogens that trigger your body’s immune response. Pyrogens tell your brain to increase your body temperature to fight off the infections. Common medical conditions associated with high-grade fevers include:

• Intracranial hemorrhage
• Thyroid storm
• Serotonin syndrome
• Sepsis
• Kawasaki syndrome
• Drug overdose

A fever is also a natural response to colds, flu, infections, and autoimmune disorders. 

Symptoms

You’ll likely notice different symptoms between a low-grade and high-grade fever.

For example, low-grade (pyrexia) fever symptoms include:

• Chills
• Sweats
• Headaches
• Thirst
• Low appetite
• Feeling hot
• Achy or tired eyes

An early high-grade (hyperpyrexia) fever can cause:

• Extreme sweating
• Dizziness
• Muscle cramps
• Fatigue
• Weakness
• Nausea

As the fever progresses, you might experience:

• Cool, moist, pale skin
• Mold confusion
• Vomiting
• Decreased urine
• Contracted pupils

When your fever hits above 106. 1 F, it can lead to:

• Extreme confusion
• Weak, fast heartbeat
• Dilated pupils
• Seizures
• Shallow, rapid breathing
• Loss of consciousness
• Hallucinations

If you’re wondering how high of a fever is dangerous for adults, a fever about 106.1 F is extremely dangerous. Seek medical attention immediately to prevent long-term consequences.

Treatment

You don’t always need to treat a low-grade fever. Remember, fevers indicate your body is fighting off an infection.

If you start to develop fever-related symptoms, however, you might want to use over-the-counter medications. These can include acetaminophen or ibuprofen. Make sure to rest and drink plenty of water.

If you develop a high-grade fever, however, the fever won’t go away until the infection is gone. Depending on the specific pathogen, you’ll likely need medical treatment.

Visit your local urgent care center right away if you develop a high-grade fever.

How High of a Fever Is Dangerous for Adults?: Know When It’s Time to See a Medical Professional

To recap, how high of a fever is dangerous for adults? If it’s above 106.1 F, it’s time to visit a medical professional.

Don’t wait to receive treatment. Contact us or just walk in to discuss your options.

Fever | Didkovsky N.A., Tanasova A.N.

L fever – an increase in body temperature as a result of a non-specific protective and adaptive reaction of the body, characterized by a restructuring of thermoregulation processes and occurring in response to exposure to pathogenic stimuli. There are fever infectious and inflammatory nature (viruses, bacteria, intracellular parasites) and non-infectious genesis (autoimmune processes, allergic diseases, tumors, metabolic disorders, the use of certain drugs, etc.) [2]. The regulation of body temperature is carried out with a complex interaction of the nervous, endocrine and immune systems. The most common trigger in the development of hyperthermia are exogenous pyrogens (bacteria, viruses, toxins, etc.), which, when ingested, stimulate the production of endogenous pyrogens by blood cells [4].

Fig.1. The mechanism of development of fever under the influence of exogenous and endogenous pyrogens. ACTH – ACTH, CRF – corticotropin-releasing factor, PGE2 – prostaglandin E2 (CECIL Textbook of Medicine, 19 h edition).

Currently, 11 cytokines are known to have pyrogenic activity, the most important of which are interleukins – IL-1 and IL-6, as well as tumor necrosis factor – TNF-a [4]. Endogenous pyrogens are produced by stimulated monocytes and macrophages. The properties of pyrogens are also possessed by a-, b- and g-interferons. IL-1 and TNF-a are transported with the blood stream to target cells that carry specific receptors for these cytokines, and act on thermosensitive neurons in the preoptic region of the hypothalamus through increased prostaglandin (PG) synthesis E ₂ and PGF _2a from arachidonic acid.

Fig. 2. Metabolism of arachidonic acid (according to A.A. Yarilin) ​​[3]. International abbreviations for prostaglandins (PG), leukotrienes (LT) and thromboxanes (Tx) are used.

The exact mechanism of “switching” of the thermoregulation center under the action of PG has not yet been established. The direct effect of cytokines on the nervous tissue is not excluded. An increase in body temperature activates metabolic processes, the functions of the nervous, endocrine, and immune systems (an increase in the production of antibodies, interferon, an increase in chemotaxis, phagocytic and bactericidal activity of neutrophils), an increase in the antitoxic function of the liver, and an increase in renal blood flow. IL-1 and TNF-a are able to enhance the immune response by activating T-cells and stimulating the production of IL-2. Under the action of IL-1, B-cell proliferation is enhanced, which is accompanied by an increase in antibody formation. It is important to note that these processes proceed most intensively at a temperature of 39°C. Under the action of endogenous pyrogens, the synthesis of “acute phase” proteins (fibrinogen, C-reactive protein, complement fractions B, C 3-4, alpha-glycoprotein, serum amyloid A, proteinase inhibitors) is stimulated by the liver, which play an important role in specific and non-specific protection. Hyperthermia is accompanied by a decrease in serum levels of iron, zinc and copper, which inhibits the growth and reproduction of microorganisms.

In a typical course, fever goes through the following phases or periods – a prodromal period, a period of temperature rise, a period of relative stability, a period of decrease in body temperature, each of which is accompanied by certain vegetative reactions. What changes accompany the development of fever?

1) Tachycardia. With an increase in body temperature by 1 ° C, an increase in heart rate by 10–15 beats per minute occurs.

2) It is possible to develop extrasystole, which is due to both the direct toxic effect of bacteria and viruses, and the activation of the sympathetic-adrenal system under the influence of cytokines.

3) In the phase of temperature rise, an increase in blood pressure is possible, and in the phase of temperature decrease, blood pressure drops to a collaptoid state against the background of a decrease in TPS.

4) Upon reaching the maximum body temperature, the process of sweating increases significantly (up to 1 liter of sweat per day is possible), which can contribute to a decrease in BCC and lead to a deterioration in the condition of patients with pathologies of the cardiovascular system. Fluid losses are also aggravated by a compensatory increase in respiratory rate at the height of fever.

5) At the height of fever and even after normalization of temperature, transient appearance in the urine of protein, casts and an increase in creatinine levels is possible. These changes are associated with the direct damaging effect of fever.

6) Fever affects the activity of various parts of the gastrointestinal tract, which is manifested by impaired secretion of digestive juices, impaired motility and absorption processes. As a result, there may be a decrease in appetite, the development of a syndrome of impaired absorption and constipation (the latter has a particularly adverse effect on elderly patients). Loss of appetite during fever is associated both with functional disorders of the gastrointestinal tract and with the direct influence of cytokines. So, with prolonged exposure to high concentrations of TNF-a (which has a second name in Western literature – “cachectin”) and partially IL-1, depletion may develop due to the suppression of hunger / appetite (which is most typical for chronic infections and oncological processes).

7) Against the background of fever, metabolic processes in cells increase sharply (with an increase in body temperature by 0. 6 ° C, the level of basal metabolism increases by approximately 10%), redox processes accelerate, and oxygen consumption increases. Hyperthermia can increase blood glucose levels, increasing protein catabolism (negative nitrogen balance). Loss of protein up to 300-400 grams per day is possible. A decrease in diuresis against the background of a reduced BCC can lead to the development of metabolic acidosis.

8) Changes in consciousness (from minor to the development of a delirious state) are associated with the release of b-endorphins under the influence of TNF-a and IL-1. The risk group includes young children, the elderly, patients with pathology of the cardiovascular system, as well as people who abuse alcohol.

9) Due to the immaturity of the central nervous system and the imperfection of the thermoregulation system in children under the age of 5 years, the development of febrile convulsions is possible.

10) An increase in body temperature can lead to the activation of latent herpesvirus infection (HSV-1). For reasons that are not completely clear, most often herpetic eruptions accompany diseases caused by a pyogenic bacterial infection (pneumococci, streptococci, meningococci), malaria, and rickettsiosis. Nasolabial herpes is a marker of reduced cellular immunity. It is important to note that subjective sensations during fever are of a different nature. Some patients are sensitive to even small fluctuations in body temperature, while others do not experience discomfort with a significant increase in temperature (for example, with pulmonary tuberculosis). However, in most cases, patients complain of weakness and malaise, headache, pain in the muscles and joints, chilling or excessive sweating, which “pushes” the doctor to prescribe antipyretics. When deciding on the need to prescribe non-steroidal anti-inflammatory drugs (NSAIDs), it is necessary to take into account both positive and potentially dangerous manifestations of fever. It must be remembered that fever, like any protective-adaptive reaction, with the depletion of compensatory mechanisms or with a hyperergic variant, can cause the development of pathological conditions. So, an excessive increase in temperature leads to inhibition of immune responses, dysfunction of parenchymal organs, the development of febrile convulsions, functional and degenerative disorders in the cardiovascular and central nervous system. A critical decrease in body temperature can contribute to the development of collapse due to a sharp drop in total peripheral resistance and aggravate the condition of patients with pathology of the cardiovascular system.

So in what case is it necessary to use antipyretics?

An increase in body temperature within 3°C does not have a damaging effect on the human body, however, its increase by more than 6°C (i.e. more than 42.2°C) leads to irreversible changes in the structures of the brain, which is a state incompatible with life. When deciding on the need to prescribe NSAIDs, it is necessary to take into account the age of the patient, the severity of the underlying and concomitant diseases, as well as the subjective tolerance of fever.

Currently NSAIDs are widely used in the symptomatic treatment of fever in ARVI. However, little attention is paid to non-drug (physical) methods of lowering body temperature, which is especially important in pediatric practice. I would like to remind you that physical methods to lower the temperature (such as wiping the body with a weak solution of vinegar, applying cold to the area of ​​​​large arteries, wet wrapping, a warm (not cold!) bath, an enema with water at room temperature) are recommended not only in the domestic , but also in modern foreign literature, can be quite effective and have no side effects. It is necessary to remember such rules for caring for patients with fever, such as an adequate drinking regimen, a sparing diet, mandatory ventilation of the room, and the prohibition to “wrap up” the patient, since the latter prevents heat transfer.

In febrile conditions on the background of infectious and inflammatory diseases, rectal suppositories Cefecon N are used as an antipyretic, anti-inflammatory and analgesic. Cefecon N suppositories are a unique combination of naproxen, caffeine and salicylamide, which ensures high antipyretic, analgesic activity. Cefecon H has a number of advantages over oral NSAIDs.

Before entering the systemic circulation, medicinal substances must pass through the stomach, small intestine, liver, where they are destroyed and adsorbed to a certain (sometimes significant) degree, which can lead to damage to this organ. Even if taken on an empty stomach, drugs enter the systemic circulation on average no earlier than 30 minutes later. When taking drugs orally in the form of powders and especially tablets, there is the greatest likelihood of their local irritating effect on the gastric mucosa.

With the rectal route of administration, the intake of substances adsorbed in the rectum is carried out simultaneously through the circulatory and lymphatic systems, which are especially developed in this area. In this case, an insignificant part of the adsorbed drugs enters the portal vein, which carries blood from the internal organs to the liver. Moreover, bioavailability from the rectal mucosa for a number of drugs is equivalent to that after intravenous administration. Thus, the introduction of NSAIDs in suppositories can reduce the risk of side effects from the gastrointestinal tract and ensure that the full dose of the drug is delivered, regardless of food intake and concomitant therapy (for example, antacids). In this regard, the use of NSAIDs in the form of rectal suppositories (Cefecon N) seems to be a very promising direction.

Despite the fact that, in the understanding of the patient, fever is often an undesirable manifestation of the disease, the doctor, when determining the strategy for treating the patient, must take into account the positive factors of the hyperthermic reaction. Moreover, the elimination of fever should not be the main goal of the therapy (which often occurs in the presence of SARS). It is well known that the course of an infectious disease without a temperature reaction may indicate that the patient has an immunodeficiency state and is an unfavorable prognostic factor.

1. Luchsheva Yu., Cold. How to deal with it. The effectiveness of symptomatic therapy for acute respiratory viral infections // Pharmaceutical Bulletin No. 37 (236), 2001.

2. NSAIDs: the role of rectal suppositories.//Russian Medical Journal, Vol. 10, No. 21(165), 2002, pp. 982–986.

3. Yarilin A.A., Fundamentals of immunology, M. “Medicine”, 1999, pp. 163–168.

4. Bruce Beutler, Steven M. Beutler, The Pathogenesis of Fever// CECIL Textbook of Medicine,19th edition, 1994, p.1568–1571.

5. Cranswick N, Coghlan D., Paracetamol efficacy and safety in children : the first 40 years// Am J Ther, 2000, 7(2): 135–41.

6. Glasow.J.F.T., Middleton B., Reye syndrome – insights on causation and prognosis// Arch Dis Child, 2001, 85, 351–353.

Hemorrhagic fevers

Hemorrhagic fevers are a group of acute infectious diseases caused by representatives of four types of viruses: arenaviruses, bunyaviruses, flaviviruses and filoviruses. Common to these diseases is severe intoxication and a characteristic thrombohemorrhagic syndrome.

Viruses that cause hemorrhagic fevers are widespread in many parts of the world. Some are also found in developed countries, but Africa, Asia and South America are endemic for most types of pathogens.

The course of hemorrhagic fever, depending on the pathogen, can vary from moderate to extremely severe. Mortality from individual variants of infection ranges from 10 to 90%. Certain variants of hemorrhagic fever lead to severe damage to internal organs and often to death.

The prognosis of the disease depends on the type of virus, the age and general condition of the patient, in particular on the activity of his immune system.

Synonyms English

Viral hemorrhagic fevers, hemorrhagicfevers, VHF, VHFs.

Symptoms

Symptoms of hemorrhagic fevers vary depending on the type of virus that caused the disease. Common manifestations for all infections are severe fever itself and increased bleeding. Symptoms in the initial stage of the disease are most often nonspecific, however, in the process of further development of the pathological process, signs of damage to certain organs and body systems may appear.

Main symptoms of hemorrhagic fevers:

• fever;
• weakness, dizziness;
• muscle pain;
• skin hyperemia;
• petechial rash on skin and mucous membranes;
• disturbance of consciousness;
• redness of the eyes;
• blood in stool, bloody vomiting;
• drop in blood pressure.

General information about the disease

Hemorrhagic fevers can be caused by four families of RNA viruses: arenaviruses (Arenaviridae), bunyaviruses (Bunyaviridae), filoviruses (Filoviridae) and flaviviruses (Flaviviridae). Arenaviruses cause Lassa fever, Argentinean, Brazilian, Venezuelan and Bolivian fevers, bunyaviruses cause Crimean-Congo fever, Rift Valley fever, hemorrhagic fever with renal syndrome, filoviruses cause Ebola fever, flaviviruses cause yellow fever, Dengue fever, etc.

“Reservoirs” of viruses are some animals and insects, most often small rodents, bats, mosquitoes, ticks. As a rule, certain types of hemorrhagic fevers are found mainly in the habitat of those animals that are the source of a particular pathogen. For example, the source of the Rift Valley fever virus, which is common in Africa, is mosquitoes. Crimean-Congo hemorrhagic fever occurs in Europe, Asia, Africa, it is spread by ticks. The source of some diseases, such as Ebola, remains unknown, suggesting that it may be bats. Some types of viruses are transmitted through the blood or semen of an infected animal or person, through unsterile needles. Certain causative agents of hemorrhagic fevers can be infected by inhalation of microparticles of faeces and urine of animal carriers.

All representatives of the viruses that cause hemorrhagic fevers are united by a common pathogenesis. They tend to affect the vascular endothelium, which explains the development of the hemorrhagic syndrome in most hemorrhagic fevers. After the virus enters the bloodstream through insect bites, scratches, abrasions, injections, the respiratory mucosa, a local reaction to infection is first formed, followed by viremia and a generalized lesion of the microcirculation system (the virus also infects the cells of the vascular wall). When the pathogen enters the bloodstream, it adheres to the cell membrane, penetrates into it, actively multiplies and spreads to other tissues of the body. This is accompanied by the release of biologically active substances that violate the permeability of blood vessels, the rheological properties of blood. A manifestation of this process is a rash, hyperemia of the skin, redness of the vessels of the sclera, internal bleeding may occur, accompanied by a sharp drop in blood pressure, shock. A number of viruses cause damage to the bone marrow, in particular megakaryocytes. Weakening of the body’s immune system, a weak or delayed response of protective mechanisms can lead to the rapid development of the pathological process, accompanied by massive bleeding, multiple organ damage.

Who is at risk?

• Those who work with infected people or animals, such as medical workers, biologists, pest control workers, livestock farm workers.
• Living in endemic areas.
• Intravenous drug users.
• Those who neglect barrier methods of contraception.

Diagnosis

Diagnosis is based on anamnesis, physical examination, results of laboratory and instrumental studies. When questioning the patient, attention is drawn to possible contact with the pathogen – travel to regions endemic for the disease, contact with animal carriers or infected people. The incubation period of most hemorrhagic fevers is 10-21 days, so the disease can develop after returning from a trip to a dangerous area. If hemorrhagic fever is suspected, it is necessary to conduct a series of studies in the hospital as soon as possible to differentiate the disease from other diseases and establish the type of pathogen:

• Complete blood count (without leukocyte formula and ESR). In a general blood test for hemorrhagic fevers, leukopenia and thrombocytopenia can be detected. In some cases, such as Lassa fever, these changes are absent. Hemoglobin levels may drop.
• Erythrocyte sedimentation rate (ESR). May be upgraded.
• Prothrombin index (PI) , activated partial thromboplastin time (APTT) are increased.
• Fibrinogen. Fibrinogen and platelet monitoring is used to detect possible disseminated intravascular coagulation.
• The test is used when a urinary tract infection is suspected.
• Culture of biological fluids: blood, urine, throat and nose swabs. Used to identify possible infectious agents.
• Detection of the causative agent of infection in the blood by polymerase chain reaction (PCR).
• Detection of antibodies to the infectious agent in the blood.

All diagnostic manipulations should be performed with extreme caution due to the high pathogenicity of pathogens.