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Fever throwing up chills: Fever, Headache, Nausea Or Vomiting And Shaking Chills (Rigors)

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Stomach pain and chills: 12 causes

Here, we list some of the common causes of stomach pain and chills:

1. The common cold

Most adults can expect to have two or three colds every year, according to the Centers for Disease Control and Prevention (CDC). Children usually have more.

The common cold causes symptoms including:

Symptoms typically improve after 7–10 days, though a cough can persist for 2 weeks or more.

Treatment involves home remedies such as resting, staying hydrated, and taking over-the-counter (OTC) medications.

2. Gastroenteritis

Gastroenteritis occurs when the stomach and intestines are inflamed due to a bacterial or viral infection.

Viral gastroenteritis, which some doctors call stomach flu, is the most common form. Other causes include reactions to food or medications.

In the United States, around 179 million cases of acute gastroenteritis each year, according to a study in the journal Emerging Infectious Diseases. This makes it one of the most common illnesses.

Signs and symptoms of gastroenteritis include:

  • diarrhea
  • headache
  • low-grade fever or chills
  • muscle aches
  • nausea
  • stomach cramps
  • vomiting

Symptoms can persist for up to a week. Some treatment options include resting, staying hydrated, eating soft foods, and taking OTC medications.

3.

Salmonella infection

Infection with Salmonella bacteria is a common occurrence in the U.S. It causes 1.2 million illnesses annually, according to the CDC. People typically get the infection as a result of consuming contaminated food or water.

Symptoms usually begin within 12–72 hours of infection and may include:

  • diarrhea
  • fever or chills
  • headache
  • nausea
  • stomach cramps
  • vomiting

Treatment is typically unnecessary, and most people recover within a few days. During this time, self-care measures can reduce discomfort. People with severe symptoms may require medication or even hospitalization.

4. Urinary tract infection

A urinary tract infection (UTI) occurs when bacteria or other microbes infect the urinary tract. Females have a higher risk of developing UTIs than males do, with 40–60 percent of females experiencing one in their lifetime.

Symptoms may include:

  • an increase in urinary frequency
  • an increase in urinary urgency
  • burning pain when urinating
  • cloudy, strong-smelling, or pink urine
  • fever or chills
  • pain in the pelvis or back, which may radiate to the abdomen
  • passing small amounts of urine regularly

Most UTIs will require antibiotic treatment, but some home remedies can reduce discomfort until the infection clears up. Home remedies include drinking plenty of water, avoiding caffeine, and using a heating pad on the abdomen.

5. Kidney stones

Share on PinterestDrinking fluids can help small kidney stones pass through the urinary tract.

When minerals and salts build up in the kidneys, they can form hard deposits called kidney stones.

A 2018 review in the journal Advances in Urology suggests that 1 in 11 people in the U.S. develop kidney stones.

These hard deposits may not cause any symptoms until they change positions in the kidney or urinary tract.

Kidney stones can then result in:

  • changes in urinary habits and amount
  • cloudy, strong-smelling, or pink urine
  • fever and chills, in the case of an infection
  • nausea
  • pain in the abdomen, groin, sides, and back
  • painful urination
  • vomiting

Small kidney stones can pass through the urinary tract on their own. It is helpful to drink fluids and take pain relivers until the stone passes.

At other times, it is necessary to undergo surgery or another type of medical procedure to remove the stone.

6. Prostatitis

Prostatitis is inflammation of the prostate gland, which is just below the bladder in males.

Prostatitis has a prevalence rate of 8.2 percent and is “the most common urological diagnosis” in males aged 50 and under.

Bacterial prostatitis, which results from bacterial infection, causes:

  • difficulty urinating
  • flu-like symptoms, such as chills
  • cloudy or bloody urine
  • frequent urination
  • pain in the abdomen, lower back, genitals, or groin
  • painful urination and ejaculation

Treatment may include taking antibiotics and other medications. Using heating pads, making dietary changes, and making lifestyle changes may provide some symptom relief.

7. Mononucleosis

Infectious mononucleosis, or the kissing disease or mono, passes between people through saliva. Along with stomach pain and chills, symptoms include:

  • fatigue
  • fever
  • headache
  • a sore throat
  • skin rash
  • swollen lymph nodes in the neck and armpits
  • swollen tonsils

Symptoms usually do not appear until 4–6 weeks after infection and last for up to 2 months.

Treatment includes resting, staying hydrated, and taking OTC pain relievers. Some people may require medications for secondary infections.

8. Pneumonia

Pneumonia is a lung infection that causes inflammation of the air sacs. In the U.S., it is “a leading cause of hospitalization” in both adults and children.

Pneumonia symptoms, which range in severity, include:

  • chest pain
  • chills
  • coughing up phlegm
  • diarrhea
  • difficulty breathing
  • fatigue
  • fever
  • nausea
  • stomach pain
  • vomiting

Pneumonia can be life-threatening for older adults, children, and those who have a compromised immune system. People who have symptoms should always speak with a doctor.

Treatment includes taking medication, resting, and other home remedies. Some people may require hospitalization.

9. Gallbladder inflammation

Gallbladder inflammation, or cholecystitis, is swelling of the gallbladder, which is a pear-shaped organ in the abdomen.

Gallstones are the most common cause of gallbladder inflammation. According to a 2012 study in the journal Gut and Liver, around 10–15 percent of adults will develop gallstones. Other causes include tumors and infections.

Cholecystitis symptoms, which often get worse after eating large or fatty meals, include:

  • abdominal pain and tenderness, usually in the upper right or center
  • fever or chills
  • nausea
  • pain in the back or right shoulder

If left untreated, gallbladder inflammation can cause severe complications. Some treatment options include hospitalization, fasting, intravenous fluids, and taking pain relievers. Surgery may be necessary to remove the gallstones or the entire gallbladder.

10. Pelvic inflammatory disease

Pelvic inflammatory disease (PID) occurs when sexually transmitted bacteria, including chlamydia or gonorrhea, spread to the fallopian tubes, uterus, or ovaries.

Research from 2017, which appeared in Morbidity and Mortality Weekly Report, suggests that 4.4 percent of sexually experienced females of reproductive age have PID.

PID does not always cause symptoms. Sometimes, people only realize that they have the condition when they experience difficulty getting pregnant.

If symptoms do occur, they include:

  • bleeding between periods
  • bleeding during or after sex
  • chills
  • difficult or painful urination
  • fever
  • heavy and foul-smelling vaginal discharge
  • pain in the lower abdomen and pelvis

Doctors usually prescribe antibiotics to people with PID. Sexual partners also require treatment.

Without treatment, the infection can cause chronic pelvic pain, ectopic pregnancy, and infertility.

11. Appendicitis

Appendicitis is inflammation of the appendix, which is a piece of tissue attached to the large intestine.

Appendicitis affects 1 in 1,000 people in the U.S., usually those aged 10–30 years old.

The condition causes pain on the lower right-hand side of the abdomen. This tends to get worse over time and may occur alongside:

Surgery is usually necessary to remove the appendix.

12. Diverticulitis

Diverticulitis occurs when diverticula, which are bulging pouches that form in the gut’s lining, develop an infection or inflammation.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, these pouches may form in 35 percent of U.S. adults aged 50 and below, and in 58 percent of all people over the age of 60. However, most cases do not progress to diverticulitis.

Symptoms include:

  • constipation or diarrhea
  • fever or chills
  • nausea
  • stomach pain, which may be severe and persistent
  • vomiting

Mild cases typically clear up by taking antibiotics, resting, and making dietary changes. Severe cases may require surgical intervention.

Other causes

Stomach pain and chills may have other less common symptoms, including:

  • cystic fibrosis, a genetic disorder that causes organ damage
  • epididymitis, or inflammation of the epididymis, which is a coiled tube at the back of the testicles
  • heart attack, but only in rare cases
  • leukemia, a cancer of the blood and bone marrow
  • malaria, an infectious disease that mosquitoes carry
  • meningitis, or inflammation of membranes that cover the brain and spinal cord
  • pancreatitis, or inflammation of the pancreas
  • peritonitis, or inflammation of the peritoneum tissue in the abdomen
  • scarlet fever, a bacterial illness
  • shingles, a viral infection similar to chickenpox
  • tuberculosis, a bacterial infection of the lungs
  • Weil’s disease, a bacterial infection often transmitted by rodents
  • yellow fever, an infection that mosquitoes carry

Stomach pain and chills: 12 causes

Here, we list some of the common causes of stomach pain and chills:

1. The common cold

Most adults can expect to have two or three colds every year, according to the Centers for Disease Control and Prevention (CDC). Children usually have more.

The common cold causes symptoms including:

Symptoms typically improve after 7–10 days, though a cough can persist for 2 weeks or more.

Treatment involves home remedies such as resting, staying hydrated, and taking over-the-counter (OTC) medications.

2. Gastroenteritis

Gastroenteritis occurs when the stomach and intestines are inflamed due to a bacterial or viral infection.

Viral gastroenteritis, which some doctors call stomach flu, is the most common form. Other causes include reactions to food or medications.

In the United States, around 179 million cases of acute gastroenteritis each year, according to a study in the journal Emerging Infectious Diseases. This makes it one of the most common illnesses.

Signs and symptoms of gastroenteritis include:

  • diarrhea
  • headache
  • low-grade fever or chills
  • muscle aches
  • nausea
  • stomach cramps
  • vomiting

Symptoms can persist for up to a week. Some treatment options include resting, staying hydrated, eating soft foods, and taking OTC medications.

3.

Salmonella infection

Infection with Salmonella bacteria is a common occurrence in the U.S. It causes 1.2 million illnesses annually, according to the CDC. People typically get the infection as a result of consuming contaminated food or water.

Symptoms usually begin within 12–72 hours of infection and may include:

  • diarrhea
  • fever or chills
  • headache
  • nausea
  • stomach cramps
  • vomiting

Treatment is typically unnecessary, and most people recover within a few days. During this time, self-care measures can reduce discomfort. People with severe symptoms may require medication or even hospitalization.

4. Urinary tract infection

A urinary tract infection (UTI) occurs when bacteria or other microbes infect the urinary tract. Females have a higher risk of developing UTIs than males do, with 40–60 percent of females experiencing one in their lifetime.

Symptoms may include:

  • an increase in urinary frequency
  • an increase in urinary urgency
  • burning pain when urinating
  • cloudy, strong-smelling, or pink urine
  • fever or chills
  • pain in the pelvis or back, which may radiate to the abdomen
  • passing small amounts of urine regularly

Most UTIs will require antibiotic treatment, but some home remedies can reduce discomfort until the infection clears up. Home remedies include drinking plenty of water, avoiding caffeine, and using a heating pad on the abdomen.

5. Kidney stones

Share on PinterestDrinking fluids can help small kidney stones pass through the urinary tract.

When minerals and salts build up in the kidneys, they can form hard deposits called kidney stones.

A 2018 review in the journal Advances in Urology suggests that 1 in 11 people in the U.S. develop kidney stones.

These hard deposits may not cause any symptoms until they change positions in the kidney or urinary tract.

Kidney stones can then result in:

  • changes in urinary habits and amount
  • cloudy, strong-smelling, or pink urine
  • fever and chills, in the case of an infection
  • nausea
  • pain in the abdomen, groin, sides, and back
  • painful urination
  • vomiting

Small kidney stones can pass through the urinary tract on their own. It is helpful to drink fluids and take pain relivers until the stone passes.

At other times, it is necessary to undergo surgery or another type of medical procedure to remove the stone.

6. Prostatitis

Prostatitis is inflammation of the prostate gland, which is just below the bladder in males.

Prostatitis has a prevalence rate of 8.2 percent and is “the most common urological diagnosis” in males aged 50 and under.

Bacterial prostatitis, which results from bacterial infection, causes:

  • difficulty urinating
  • flu-like symptoms, such as chills
  • cloudy or bloody urine
  • frequent urination
  • pain in the abdomen, lower back, genitals, or groin
  • painful urination and ejaculation

Treatment may include taking antibiotics and other medications. Using heating pads, making dietary changes, and making lifestyle changes may provide some symptom relief.

7. Mononucleosis

Infectious mononucleosis, or the kissing disease or mono, passes between people through saliva. Along with stomach pain and chills, symptoms include:

  • fatigue
  • fever
  • headache
  • a sore throat
  • skin rash
  • swollen lymph nodes in the neck and armpits
  • swollen tonsils

Symptoms usually do not appear until 4–6 weeks after infection and last for up to 2 months.

Treatment includes resting, staying hydrated, and taking OTC pain relievers. Some people may require medications for secondary infections.

8. Pneumonia

Pneumonia is a lung infection that causes inflammation of the air sacs. In the U.S., it is “a leading cause of hospitalization” in both adults and children.

Pneumonia symptoms, which range in severity, include:

  • chest pain
  • chills
  • coughing up phlegm
  • diarrhea
  • difficulty breathing
  • fatigue
  • fever
  • nausea
  • stomach pain
  • vomiting

Pneumonia can be life-threatening for older adults, children, and those who have a compromised immune system. People who have symptoms should always speak with a doctor.

Treatment includes taking medication, resting, and other home remedies. Some people may require hospitalization.

9. Gallbladder inflammation

Gallbladder inflammation, or cholecystitis, is swelling of the gallbladder, which is a pear-shaped organ in the abdomen.

Gallstones are the most common cause of gallbladder inflammation. According to a 2012 study in the journal Gut and Liver, around 10–15 percent of adults will develop gallstones. Other causes include tumors and infections.

Cholecystitis symptoms, which often get worse after eating large or fatty meals, include:

  • abdominal pain and tenderness, usually in the upper right or center
  • fever or chills
  • nausea
  • pain in the back or right shoulder

If left untreated, gallbladder inflammation can cause severe complications. Some treatment options include hospitalization, fasting, intravenous fluids, and taking pain relievers. Surgery may be necessary to remove the gallstones or the entire gallbladder.

10. Pelvic inflammatory disease

Pelvic inflammatory disease (PID) occurs when sexually transmitted bacteria, including chlamydia or gonorrhea, spread to the fallopian tubes, uterus, or ovaries.

Research from 2017, which appeared in Morbidity and Mortality Weekly Report, suggests that 4.4 percent of sexually experienced females of reproductive age have PID.

PID does not always cause symptoms. Sometimes, people only realize that they have the condition when they experience difficulty getting pregnant.

If symptoms do occur, they include:

  • bleeding between periods
  • bleeding during or after sex
  • chills
  • difficult or painful urination
  • fever
  • heavy and foul-smelling vaginal discharge
  • pain in the lower abdomen and pelvis

Doctors usually prescribe antibiotics to people with PID. Sexual partners also require treatment.

Without treatment, the infection can cause chronic pelvic pain, ectopic pregnancy, and infertility.

11. Appendicitis

Appendicitis is inflammation of the appendix, which is a piece of tissue attached to the large intestine.

Appendicitis affects 1 in 1,000 people in the U.S., usually those aged 10–30 years old.

The condition causes pain on the lower right-hand side of the abdomen. This tends to get worse over time and may occur alongside:

Surgery is usually necessary to remove the appendix.

12. Diverticulitis

Diverticulitis occurs when diverticula, which are bulging pouches that form in the gut’s lining, develop an infection or inflammation.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, these pouches may form in 35 percent of U.S. adults aged 50 and below, and in 58 percent of all people over the age of 60. However, most cases do not progress to diverticulitis.

Symptoms include:

  • constipation or diarrhea
  • fever or chills
  • nausea
  • stomach pain, which may be severe and persistent
  • vomiting

Mild cases typically clear up by taking antibiotics, resting, and making dietary changes. Severe cases may require surgical intervention.

Other causes

Stomach pain and chills may have other less common symptoms, including:

  • cystic fibrosis, a genetic disorder that causes organ damage
  • epididymitis, or inflammation of the epididymis, which is a coiled tube at the back of the testicles
  • heart attack, but only in rare cases
  • leukemia, a cancer of the blood and bone marrow
  • malaria, an infectious disease that mosquitoes carry
  • meningitis, or inflammation of membranes that cover the brain and spinal cord
  • pancreatitis, or inflammation of the pancreas
  • peritonitis, or inflammation of the peritoneum tissue in the abdomen
  • scarlet fever, a bacterial illness
  • shingles, a viral infection similar to chickenpox
  • tuberculosis, a bacterial infection of the lungs
  • Weil’s disease, a bacterial infection often transmitted by rodents
  • yellow fever, an infection that mosquitoes carry

Nausea and Vomiting, Age 11 and Younger

Is your child nauseated or vomiting?

Nauseated means you feel sick to your stomach, like you are going to vomit.

How old are you?

Less than 3 months

Less than 3 months

3 to 5 months

3 to 5 months

6 to 11 months

6 to 11 months

12 months to 3 years

12 months to 3 years

4 to 11 years

4 to 11 years

12 years or older

12 years or older

Are you male or female?

Why do we ask this question?

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Does your child have moderate to severe belly pain?

Has your child had a head injury in the past 24 hours?

Yes

Head injury in past 24 hours

No

Head injury in past 24 hours

Has your child swallowed or inhaled something that might be poisonous?

Yes

Ingested known or suspected poison

No

Ingested known or suspected poison

Does your baby seem sick?

A sick baby probably will not be acting normally. For example, the baby may be much fussier than usual or not want to eat.

How sick do you think your baby is?

Extremely sick

Baby is very sick (limp and not responsive)

Sick

Baby is sick (sleepier than usual, not eating or drinking like usual)

Is your child having trouble drinking enough to replace the fluids he or she has lost?

Little sips of fluid usually are not enough. The child needs to be able to take in and keep down plenty of fluids.

Yes

Unable to drink enough fluids

No

Able to drink enough fluids

Do you think your baby has a fever?

Did you take your child’s temperature?

This is the only way to be sure that a baby this age does not have a fever. If you don’t know the temperature, it’s safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious. Rectal temperatures are the most accurate. Taking an axillary (armpit) temperature is also an option.

Is it 38°C (100.4°F) or higher, taken rectally?

This would be an axillary temperature of 37.5°C (99.5°F) or higher.

Yes

Temperature at least 38°C (100.4°F) taken rectally

No

Temperature at least 38°C (100.4°F) taken rectally

Within the past week, has your child had an injury to the abdomen, like a blow to the belly or a hard fall?

Yes

Abdominal injury within past week

No

Abdominal injury within past week

Do you think the nausea or vomiting may be caused by an injury or by abuse?

Yes

Nausea or vomiting may be caused by injury or abuse

No

Nausea or vomiting may be caused by injury or abuse

Do you think your child has a fever?

Did you take your child’s temperature?

How high is the fever? The answer may depend on how you took the temperature.

High: 40°C (104°F) or higher, oral

High fever: 40°C (104°F) or higher, oral

Moderate: 38°C (100.4°F) to 39.9°C (103.9°F), oral

Moderate fever: 38°C (100.4°F) to 39.9°C (103.9°F), oral

Mild: 37.9°C (100.3°F) or lower, oral

Mild fever: 37.9°C (100.3°F) or lower, oral

How high do you think the fever is?

Moderate

Feels fever is moderate

Mild or low

Feels fever is mild

How long has your child had a fever?

Less than 2 days (48 hours)

Fever for less than 2 days

From 2 days to less than 1 week

Fever for more than 2 days and less than 1 week

1 week or longer

Fever for 1 week or more

Does your child have a health problem or take medicine that weakens his or her immune system?

Yes

Disease or medicine that causes immune system problems

No

Disease or medicine that causes immune system problems

Does your child have shaking chills or very heavy sweating?

Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off the child or soaking through his or her clothes.

Yes

Shaking chills or heavy sweating

No

Shaking chills or heavy sweating

Has there been any blood, yellow or green liquid (bile), or what looks like coffee grounds in the vomit?

Sometimes a food (like yellow squash or green peas) can be the reason for the vomit’s colour. But unless food is the obvious cause, vomit that is yellow, green, or bloody may be a sign of a serious medical problem.

Yes

Blood or yellow or green liquid (bile) in vomit

No

Blood or yellow or green liquid (bile) in vomit

Has your baby vomited after 2 feedings in a row?

.

Yes

Vomited after 2 feedings in a row

No

Vomited after 2 feedings in a row

Has there been any blood, yellow or green liquid (bile), or what looks like coffee grounds in the vomit?

Sometimes a food (like yellow squash or green peas) can be the reason for the vomit’s colour. But unless food is the obvious cause, vomit that is yellow, green, or bloody may be a sign of a serious medical problem.

Yes

Blood or yellow or green liquid (bile) in vomit

No

Blood or yellow or green liquid (bile) in vomit

How much blood or bile has your child vomited?

Vomit is mostly blood or bile, or contains what looks like coffee grounds

Vomit is mostly blood or bile, or contains material that looks like coffee grounds

Streaks of blood or a small amount of bile

Streaks of blood or small amount of bile in vomit

Is your child vomiting all the time, again and again, or is your child vomiting just now and then?

How often the child vomits is important. Repeated vomiting is more serious than vomiting that occurs now and then.

All the time

Repeated vomiting

Now and then

Occasional vomiting

Has your child been vomiting for more than 4 hours?

Yes

Vomiting for more than 4 hours

No

Vomiting for more than 4 hours

Has your child been vomiting for more than 8 hours?

Yes

Vomiting for more than 8 hours

No

Vomiting for more than 8 hours

Has the vomiting gone on for more than 3 days?

Yes

Vomiting for more than 3 days

No

Vomiting for more than 3 days

Has the vomiting gone on for more than 1 week?

Yes

Vomiting for more than 1 week

No

Vomiting for more than 1 week

Is your child starting to vomit more often, or is the vomiting getting more severe?

Yes

Occasional vomiting is becoming more frequent or severe

No

Occasional vomiting is becoming more frequent or severe

Does your child have diabetes?

Is your child’s diabetes getting out of control because your child is sick?

Yes

Diabetes is affected by illness

No

Diabetes is affected by illness

Is the plan helping get your child’s blood sugar under control?

Yes

Diabetes illness plan working

No

Diabetes illness plan not working

How fast is it getting out of control?

Quickly (over several hours)

Blood sugar quickly worsening

Slowly (over days)

Blood sugar slowly worsening

Has your baby been vomiting for more than 2 days?

Yes

Vomiting for more than 2 days

No

Vomiting for more than 2 days

Has your child vomited after 2 or more feedings or meals in a row?

Yes

Vomited after 2 or more feedings/meals in a row

No

Vomited after 2 or more feedings/meals in a row

Does your child spit up often?

Spitting up is not the same as vomiting. It usually occurs right after eating, happens easily without any effort by the child, and is not forceful or painful like vomiting can be.

Has your child been spitting up more than usual?

This can mean more often than usual or larger amounts than usual.

Yes

Spitting up is increased in amount or more frequent

No

Spitting up is increased in amount or more frequent

Does spitting up occur with other symptoms, such as diarrhea, constipation, or fussiness?

Yes

Spitting up occurs with other symptoms

No

Spitting up occurs with other symptoms

Has your child been spitting up for more than 1 month?

Yes

Spitting up for more than 1 month

No

Spitting up for more than 1 month

Do you think that a medicine could be causing the nausea or vomiting?

Think about whether the nausea or vomiting started after you began using a new medicine or a higher dose of a medicine.

Yes

Medicine may be causing nausea or vomiting

No

Medicine may be causing nausea or vomiting

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines and natural health products can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Repeated vomiting: The child vomits nearly every time he or she tries to drink something. This type of vomiting makes it impossible to keep down any fluids or solid food, which greatly increases the chance of becoming dehydrated. The child has an even greater chance of dehydration if he or she also has diarrhea.

Occasional vomiting: Some young children vomit every once in a while for no clear reason. This usually does not increase the risk of dehydration or other problems as long as the child can keep down fluids between vomiting. The more time that passes between episodes of vomiting, the less serious it probably is. But if the vomiting continues, it may be important to find the cause.

Colic is an extreme type of crying in a baby between 3 weeks and 3 months of age. All babies cry, but a colicky baby will cry for hours at a time, no matter what you do.

During a crying episode, a colicky baby may cry loudly and continuously and be hard to comfort. The baby may get red in the face, clench the fists, and arch his or her back or pull the legs up to the belly.

Certain health conditions and medicines weaken the immune system’s ability to fight off infection and illness. Some examples in children are:

  • Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
  • Steroid medicines, which are used to treat a variety of conditions.
  • Medicines taken after organ transplant.
  • Chemotherapy and radiation therapy for cancer.
  • Not having a spleen.

If you’re not sure if a child’s fever is high, moderate, or mild, think about these issues:

With a high fever:

  • The child feels very hot.
  • It is likely one of the highest fevers the child has ever had.

With a moderate fever:

  • The child feels warm or hot.
  • You are sure the child has a fever.

With a mild fever:

  • The child may feel a little warm.
  • You think the child might have a fever, but you’re not sure.

Babies can quickly get dehydrated when they lose fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For example:

  • The baby may be fussy or cranky (mild dehydration), or the baby may be very sleepy and hard to wake up (severe dehydration).
  • The baby may have a little less urine than usual (mild dehydration), or the baby may not be urinating at all (severe dehydration).

You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For example:

  • You may feel tired and edgy (mild dehydration), or you may feel weak, not alert, and not able to think clearly (severe dehydration).
  • You may pass less urine than usual (mild dehydration), or you may not be passing urine at all (severe dehydration).

Severe dehydration means:

  • The baby may be very sleepy and hard to wake up.
  • The baby may have a very dry mouth and very dry eyes (no tears).
  • The baby may have no wet diapers in 12 or more hours.

Moderate dehydration means:

  • The baby may have no wet diapers in 6 hours.
  • The baby may have a dry mouth and dry eyes (fewer tears than usual).

Mild dehydration means:

  • The baby may pass a little less urine than usual.

Severe dehydration means:

  • The child’s mouth and eyes may be extremely dry.
  • The child may pass little or no urine for 12 or more hours.
  • The child may not seem alert or able to think clearly.
  • The child may be too weak or dizzy to stand.
  • The child may pass out.

Moderate dehydration means:

  • The child may be a lot more thirsty than usual.
  • The child’s mouth and eyes may be drier than usual.
  • The child may pass little or no urine for 8 or more hours.
  • The child may feel dizzy when he or she stands or sits up.

Mild dehydration means:

  • The child may be more thirsty than usual.
  • The child may pass less urine than usual.

It is easy for your diabetes to become out of control when you are sick. Because of an illness:

  • Your blood sugar may be too high or too low.
  • You may not be able take your diabetes medicine (if you are vomiting or having trouble keeping food or fluids down).
  • You may not know how to adjust the timing or dose of your diabetes medicine.
  • You may not be eating enough or drinking enough fluids.

An illness plan for people with diabetes usually covers things like:

  • How often to test blood sugar and what the target range is.
  • Whether and how to adjust the dose and timing of insulin or other diabetes medicines.
  • What to do if you have trouble keeping food or fluids down.
  • When to call your doctor.

The plan is designed to help keep your diabetes in control even though you are sick. When you have diabetes, even a minor illness can cause problems.

Symptoms of serious illness in a baby may include the following:

  • The baby is limp and floppy like a rag doll.
  • The baby doesn’t respond at all to being held, touched, or talked to.
  • The baby is hard to wake up.

Symptoms of serious illness may include:

  • A severe headache.
  • A stiff neck.
  • Mental changes, such as feeling confused or much less alert.
  • Extreme fatigue (to the point where it’s hard for you to function).
  • Shaking chills.

Temperature varies a little depending on how you measure it. For children up to 11 years old, here are the ranges for high, moderate, and mild according to how you took the temperature.

Oral (by mouth) temperature

  • High: 40° C (104° F) and higher
  • Moderate: 38° C (100.4° F) to 39.9° C (103.9° F)
  • Mild: 37.9° C (100.3° F) and lower

A forehead (temporal) scanner is usually 0.3° C (0.5° F) to 0.6° C (1° F) lower than an oral temperature.

Ear or rectal temperature

  • High: 40.5° C (104.9° F) and higher
  • Moderate: 38.5° C (101.3° F) to 40.4° C (104.7° F)
  • Mild: 38.4° C (101.1° F) and lower

Armpit (axillary) temperature

  • High: 39.8° C (103.6° F) and higher
  • Moderate: 37.8° C (100° F) to 39.7° C (103.5° F)
  • Mild: 37.7° C (99.9° F) and lower

Note: For children under 5 years old, rectal temperatures are the most accurate.

A baby that is extremely sick:

  • May be limp and floppy like a rag doll.
  • May not respond at all to being held, touched, or talked to.
  • May be hard to wake up.

A baby that is sick (but not extremely sick):

  • May be sleepier than usual.
  • May not eat or drink as much as usual.

Many non-prescription and prescription medicines can cause nausea or vomiting. A few examples are:

  • Antibiotics.
  • Antidepressants.
  • Aspirin, ibuprofen (such as Advil or Motrin), and naproxen (such as Aleve).
  • Medicines used to treat cancer (chemotherapy).
  • Opioid pain medicines.
  • Vitamins and mineral supplements, such as iron.

Starting a new medicine or increasing the dose can cause nausea and vomiting. Nausea and vomiting also may mean that there is too much medicine in your body, even if you took it properly.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Nausea and Vomiting, Age 12 and Older

Head Injury, Age 4 and Older

Abdominal Pain, Age 11 and Younger

Poisoning

Head Injury, Age 3 and Younger

Stomach Bug, COVID-19, or Flu: How to Tell

Stomach Bug, COVID-19, Flu, or Serious GI Issue?  How to Tell

 
COVID-19 cases around the country are increasing as we head into the winter months, a time when illnesses are on the rise – including stomach bugs (gastroenteritis) and seasonal flu. Symptoms of common winter bugs may include fever, cough, and gastrointestinal issues like nausea, vomiting, and diarrhea. These can also be symptoms of COVID-19, which can lead people to wonder whether they have COVID-19 or another common infection.

 
Dr. Michael DeSimone, a Gastroenterologist with Concord Gastroenterology Associates, talks about common gastrointestinal (GI) symptoms found in winter bugs. As with any medical issue you experience, it is always best to contact your doctor or visit an Urgent Care Center if you need medical care or have questions about your health.  If you have any symptoms of a stomach bug, COVID-19, or flu, you should self-isolate until your symptoms resolve or you have a firm diagnosis from a medical professional.

 

How to Tell if You Might Have Gastroenteritis/Stomach Bug

Millions of people get gastroenteritis every winter. Here are some facts:  

  • Though it is sometimes referred to as “stomach flu,” viral gastroenteritis is not related to the influenza virus that causes the flu, it is caused by other viruses like Norovirus or Rotavirus.
  • Viral gastroenteritis is highly contagious and symptoms usually develop within 1-2 days after exposure to someone with the illness.
  • Typical symptoms include abdominal pain, nausea, vomiting, and diarrhea. Fever occurs in about half of patients. People are usually sick for approximately 2-3 days.
  • Milder infections in healthy people can often be managed at home, but people with more severe symptoms should seek medical attention.

How to Tell if Your GI issues Might Be COVID-19

If you experience new GI symptoms, follow these guidelines:

  • Research consistently shows that approximately 5-10% of adults with COVID-19 report GI symptoms such as nausea, vomiting, or diarrhea. Typically, patients who have GI symptoms of COVID-19 will also have the more common upper respiratory symptoms that accompany COVID-19, such as a dry cough or difficulty breathing. However, sometimes the GI symptoms will come first and the respiratory symptoms will follow a day or so later.
  • If you have new GI symptoms like nausea, vomiting, or diarrhea – watch for fever, cough, or shortness of breath over the next few days. If you develop these respiratory symptoms, call your doctor and ask if you should be tested for COVID-19
  • Do not worry alone – call your doctor with any questions you have about your symptoms.

 

Symptoms Common in COVID-19 and Flu

Here are some symptoms that are common in both COVID-19 and seasonal flu:

 
If you have these symptoms, you should call your doctor to ask about COVID-19 and Flu testing. Remember to isolate yourself if you have any symptoms. Avoid public places and contact with others while waiting for testing and results.
 

How to Tell if You Might Have a Serious GI Issue

Some symptoms  are not expected with a stomach bug or COVID-19 and may indicate a more serious gastrointestinal condition like colon cancer, stomach ulcers, or Crohn’s Disease. Call your doctor or seek medical help if you experience any of these symptoms:

  • Blood in your vomit or your stool
  • GI symptoms that lead to weight loss
  • GI symptoms lasting longer than one week

Stomach Bug, COVID-19, Flu, or Serious GI Condition

Refer to this chart to compare symptoms associated with gastroenteritis, COVID-19, flu, and serious GI conditions. It is always best to contact your doctor to discuss any symptoms you are experiencing. Your primary care physician, gastroenterologist, or a local Urgent Care center can assess your condition and give you an order for a COVID-19 test if needed.
 












  Gastroenteritis/

Stomach Bug
COVID-19 Flu Serious GI Condition
Nausea Yes Sometimes Sometimes Sometimes
Vomiting Yes Sometimes Sometimes Sometimes
Abdominal Pain Yes Sometimes Sometimes Sometimes
Diarrhea Yes Sometimes Sometimes Sometimes
Blood in Stool No No No Often
Fever Sometimes Yes Yes Sometimes
Fatigue Yes Yes Yes Yes
Body Aches Yes Yes Yes Sometimes
Weight Loss No No No Yes
Loss of Taste/Smell No Yes Rarely No

 

Support Emerson Hospital

Thank you for reading our article on COVID-19 symptoms. As a community hospital we rely on the support of our community to continue to provide our local health care needs. We welcome your help in fostering a healthy community. If this content has helped you in an way, please consider making an online gift to Emerson Hospital so that we can continue to support our community’s health needs.

 

Related Content

CDC adds 6 new conditions to include chills, muscle pain and more

Public health experts have consistently said that shortness of breath, fever and cough are the most common symptoms of the novel coronavirus. But now that the virus has been circulating in the U.S. for several weeks, the Centers for Disease Control and Prevention is expanding its guidance for identifying COVID-19.

On the CDC website, the list of symptoms now includes six new warning signs to look out for:

  • Fever
  • Cough
  • Shortness of breath or difficulty breathing
  • Chills
  • Repeated shaking with chills
  • Muscle pain
  • Headache
  • Sore throat
  • New loss of taste or smell

“People with COVID-19 have had a wide range of symptoms reported — ranging from mild symptoms to severe illness,” the CDC said on its site. “These symptoms may appear 2-14 days after exposure to the virus.”

Download the TODAY app for the latest coverage on the coronavirus outbreak.

The agency also calls out symptoms that could indicate more severe illness requiring immediate medical attention. These include: trouble breathing, persistent pain or chest pressure, new confusion or inability to arouse and bluish lips or face. It cautions, though, that this list is not all inclusive and advises individuals to contact their medical providers to learn what symptoms they should be concerned about for their own health.

The coronavirus has been especially difficult to track at least in part because of its complex symptoms. While cough and fever are still the quintessential signs, others have appeared with some regularity.

Related

TODAY first reported in late March that a loss of taste or smell could be a sign of COVID-19 after the American Academy of Otolaryngology announced it had “rapidly accumulating” anecdotal evidence. Nausea and diarrhea also seem common in people with mild illness, and an upset stomach is often the first or only symptom for these individuals.

Conjunctivitis, aka pink eye, may occur in 1-3% of infected people, the American Academy of Ophthalmology has said, and coughing blood has come up as an unusual but logical extension of the lung problems that the virus causes.

COVID-19 likely affects the skin, too, according to the American Academy of Dermatology, even though these possible symptoms aren’t on the CDC’s list. Some patients have reported a tingling feeling on skin, also described as “fizzing” and “buzzing,” and rashes are a common side effect of viral infections.

Dermatologists and podiatrists are also investigating another possible symptom known as COVID toes. It looks like red or purple discoloration, inflammation and ulcerations on the hands and feet, and it can show up before or instead of respiratory signs.

As more and more people experience COVID-19, doctors are gaining further knowledge of the disease. While it might seem like a new symptom pops up every other day, raising awareness of what to look out for can help to slow the spread of this disease.

Maura Hohman

Maura Hohman is a Brooklyn-based weekend editor and reporter for TODAY Digital who joined the team early in the coronavirus pandemic. While she happily writes about a range of topics, from pop culture to politics, she has a special interest in in-depth health coverage, especially COVID-19 research, women’s health and racial health disparities.

What are the symptoms of acute gastritis?

Author

Sarah El-Nakeep, MD Associate Professor, Gastroentrology and Hepatology Unit, Internal Medicine Department, Faculty of Medicine, Ain Shams University, Egypt

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

BS Anand, MD Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

BS Anand, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Additional Contributors

Vincent W Yang, MD, PhD R Bruce Logue Professor, Director, Division of Digestive Diseases, Department of Medicine, Professor of Hematology and Oncology, Winship Cancer Institute, Emory University School of Medicine

Vincent W Yang, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, Association of American Physicians, American Gastroenterological Association, American Society for Clinical Investigation

Disclosure: Nothing to disclose.

Waqar A Qureshi, MD, FRCP(UK), FACP, FACG, FASGE Professor of Medicine, Chief of Endoscopy, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

Waqar A Qureshi, MD, FRCP(UK), FACP, FACG, FASGE is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Gwendolyn Sarver 

Disclosure: Nothing to disclose.

Mohammad Wehbi, MD Associate Professor of Medicine, Associate Program Director, Department of Gastroenterology, Emory University School of Medicine; Section Chief of Gastroenterology, Atlanta Veterans Affairs Medical Center

Mohammad Wehbi, MD is a member of the following medical societies: American College of Physicians, American Gastroenterological Association, American Medical Association

Disclosure: Nothing to disclose.

Kamil Obideen, MD Assistant Professor of Medicine, Division of Digestive Diseases, Emory University School of Medicine; Consulting Staff, Division of Gastrointestinal Endoscopy, Atlanta Veterans Affairs Medical Center

Kamil Obideen, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Sunil Dacha, MBBS, MD House Staff, Division of Digestive Disease, Emory University School of Medicine

Sunil Dacha, MBBS, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Acknowledgements

Nicole M Griglione, MD Fellow in Gastroenterology, Department of Medicine, Emory University School of Medicine

Nicole M Griglione, MD is a member of the following medical societies: American Medical Association and Illinois State Medical Society

Disclosure: Nothing to disclose.

Richard H Snyder, MD Vice-Chair, Program Director, Department of Medicine, Norfolk General Hospital; Clinical Associate Professor, Department of Internal Medicine, East Virginia Medical School

Richard H Snyder, MD is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Your baby will get a cold, fever and upset stomach. Know the symptoms and learn how to deal with them

 

 

The first time your baby gets a cold, fever or upset stomach, it’s normal to worry. But knowing the symptoms of common baby illnesses, and learning how to deal with them, can help you breathe easier. Here’s some advice, organized by symptom.

 


Coughing and Sneezing 

Newborn babies often cough or sneeze to clear stuffy nasal passages. This doesn’t mean they have a cold. In fact, it’s uncommon for a newborn to develop a cold within the first six weeks.

If you’re concerned about coughing or sneezing, check with your healthcare provider or call HealthLink BC at 8-1-1. Don’t give your baby any cough or cold medications unless they’re recommended by a health professional. Many over the counter medicines are not safe for children under six years old.

Diarrhea

Diarrhea is often caused by an infection, illness or irritation. Your baby’s stools will be watery and foul smelling. Diarrhea is serious because it can cause dehydration, which can make babies very sick, very quickly.

Most cases of mild diarrhea can be treated at home. Your baby should be taking in enough fluids and nutrients, peeing normal amounts and seeming to improve. 

If your baby has signs of dehydration, see your healthcare provider or call HealthLink BC at 8-1-1 right away. Signs of dehydration include:

  • decreased urination (fewer than four wet diapers in 24 hours for a baby older than four or five days)
  • increased thirst
  • no tears
  • dry skin, mouth and tongue
  • accelerated heart beat
  • sunken eyes
  • greyish skin
  • sunken soft spot (fontanelle) on baby’s head
  • irritable or extremely sleepy and difficult to wake up

Vomiting

Vomiting involves the forceful throwing up of large amounts of liquid. Vomiting is usually caused by a virus or bacteria and, like diarrhea, it can lead to dehydration. See your healthcare practitioner if your baby can’t keep any fluids down or appears dehydrated (see signs of dehydration above).

Fever

A high temperature, or fever, is usually caused by an infection. The source of the infection can be a bacteria or a virus. Babies less than 3 months old who have a fever need see a healthcare provider. If your baby is 3-6 months old and has a fever, call your healthcare provider or Healthlink BC at 8 1 1 to get advice on what to do.

Keep in mind that your baby’s temperature changes throughout the day. It’s lowest in the early morning and highest in the early evening.

A “normal” temperature depends on what kind of thermometer you are using.

Method Normal temperature range
Armpit 36.5°C – 37.5°C (97.8°F – 99.5°F)
Mouth (not recommended for children younger than 2 years) 35.5°C – 37.5°C (95.9°F – 99.5°F)
Ear (not recommended for children younger than 2 years) 35.8°C – 38°C (96.4°F – 100.4°F)
Rectal (Bum) 36.6°C – 38°C (97.9°F – 100.4°F)

If your baby has a fever, do not offer Aspirin or other drugs with acetylsalicylic acid (ASA).  ASA may cause Reye’s syndrome – a serious condition that damages the brain and liver.

Signs of fever in your baby are:

  • the back of the neck feels hot, even when extra clothing is removed
  • having no interest in usual things
  • looking ill or overly sleepy
  • looking flushed or pale
  • may be sweaty
  • may be extra thirsty

The most common way to take a baby’s temperature is under the armpit. The most accurate way to take a temperature is in the bum (rectal method), but only use a rectal thermometer if you are comfortable doing so and a health care provider has shown you how to do it safely. When taking your baby’s temperature, use an easy to read thermometer, such as a digital unit.

Here’s how to take your baby’s temperature in their armpit:

  • Put the tip of the thermometer in the centre of the armpit.
  • Tuck the arm snugly against the body, then comfort and distract your baby.
  • After about one minute the thermometer will beep if it’s digital. If it’s not digital, wait about five minutes. Gently remove the thermometer and read the temperature.
  • If you find your baby has a fever by checking under the arm, re-check it to be sure.

Thrush

Thrush is a common infection in infants. It appears as a whitish gray coating on the tongue and the insides of the cheeks and gums that doesn’t wipe off easily. Babies may also develop thrush on their diaper area. Most babies don’t experience pain or complications with thrush, however thrush can be passed to mothers through breastfeeding. If you think your baby has thrush, see your healthcare provider as soon as possible.


Resources & Links:

HealthLink BC: Cough Symptoms in Children 
HealthLink BC: Diarrhea, Age 11 and Younger 
HealthLink BC: Nausea and Vomiting, Age 11 and Younger 
HealthLink BC: Fever or Chills, Age 11 and Younger 
HealthLink BC: Thrush

90,000 Chapter 2. Fever and chills

Fever is an increase in body temperature as a result of changes in the center of thermoregulation of the hypothalamus. Although a temperature of up to 37 ° C is considered normal, its maximum values ​​are from 37.2 “C at 6 a.m. to 37.7” C at 4 p.m. serve as cytokines. There are few symptoms in clinical medicine that have the same diagnostic value as fever.Hyperthermia without fever occurs when the body cannot adequately release the heat it produces (for example, when the ambient temperature rises) or under the influence of medications (neuroleptic malignant syndrome, malignant hyperthermia).

True fever occurs as a result of infection, immune disorders, vasculitis or thrombosis, heart attack, trauma, granulomatous disease (sarcoidosis), colitis, tumor (especially Hodgkin’s disease, lymphoma, leukemia, renal carcinoma, hepatoma) or acute disorders metabolism (thyroid crisis, adrenal crisis).

Clinical picture

Fever patients note myalgia, arthralgia, anorexia and drowsiness. Most of them have chills and chills. With tremendous chills, severe fever, piloerection and trembling occur, the patient’s teeth chatter. Activation of heat loss mechanisms leads to perspiration. Abnormalities in mental status, including delirium and seizures, are more common in very young, very old, or debilitated patients.

Diagnosis

The clinical picture should be carefully evaluated.Anamnesis, life history of the patient, his travels, heredity are studied in detail. Further, a detailed functional examination of the patient is carried out, repeating it. Laboratory tests are performed, including a clinical blood test with the necessary detail (plasma cells, toxic granularity, etc.), as well as a study of pathological fluid (pleural, articular). Other tests: ESR, general urine analysis, determination of the functional activity of the liver, blood cultures for sterility, urine, sputum and feces (for microflora).Special research methods include X-ray, MRI, CT (to detect abscesses), radionuclide studies. If non-invasive research methods do not make it possible to make a diagnosis, a biopsy of organ tissue is performed, bone marrow puncture is advisable in patients with anemia.

Fever of unspecified origin (LDL)

The diagnosis is made when the body temperature rises above 38.3 ° C several times for more than 2 weeks, and the cause cannot be determined a week after hospitalization or after three visits to the patient.Most often, such a fever is associated with an infection, tumor, DBST, or vasculitis. Other causes: medication, granulomatosis, NUC, PE A, simulation, Mediterranean fever, erythema multiforme, Behcet’s syndrome, Fabry’s disease, Whipple’s disease. It is unlikely that LDL over 6 months is associated with infection. If no cause can be found, the prognosis is usually good.

Treatment

High fever (above 41 ° C) should be treated with antipyretics and refrigeration by rubbing the body with a damp sponge.Low or low fever can be left untreated, except in situations such as febrile seizures in children, pregnancy, and impaired cardiopulmonary and brain activity. Paracetamol (650 mg) every 3 hours during the day is effective in treating most cases of fever. The advantage of the drug is that it does not mask the symptoms of inflammation (which may suggest the cause of the fever), does not disrupt platelet function, and does not cause Reye’s syndrome in children. Non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin have anti-inflammatory and antipyretic effects.NSAIDs are especially appropriate for tumor-associated fever. Specific therapy is determined by the reliability of the diagnosis. If bacterial sepsis is suspected, trial therapy with antimicrobial agents is possible. In adult patients with normal immune status and gram-positive infection, treatment with various antibiotics can be performed, including imipenem, ticarcillin or clavulanate, third generation cephalosporins (ceftazidime, etc.). Patients with neutropenia and fever should be treated empirically with an aminoglycoside + Pseudomonas aeruginosa drug, imipenem (thienam), or ceftazidime (the latter two as monotherapy).In other pathological conditions, with suspicion of rickettsiosis, bacterial infection in a patient with a removed spleen, typhoid syndrome, a trial empiric therapy is indicated before a specific diagnosis is established.

HYPERTHERMIA IN PATIENTS WITH INJURY OF THE CENTRAL NERVOUS SYSTEM | Tokmakov

HYPERTHERMIA IN PATIENTS WITH CENTRAL NERVOUS SYSTEM DAMAGE

HYPERTHERMIA IN PATIENTS WITH CENTRAL NERVOUS SYSTEM DAMAGE

Tokmakov K.A., Gorbacheva S.M., Unzhakov V.V., Gorbachev V.I.

Irkutsk State Medical Academy of Postgraduate Education
– branch of the FSBEI DPO “Russian Medical Academy of Continuous
vocational education “, Irkutsk, Russia,
Regional State Budgetary Healthcare Institution” Regional
clinical hospital No. 2 “of the Ministry of Health of the Khabarovsk Territory, Khabarovsk, Russia

CLASSIFICATION
HYPERTHERMAL STATES

Promotion
body temperature above normal is a cardinal sign of hyperthermic conditions.From the standpoint of the course of pathophysiology, hyperthermia is a typical form of the disorder
heat exchange resulting from the action of high temperature
environment and / or disruption of the body’s heat transfer processes;
characterized by a disruption of the mechanisms of heat regulation, manifested by an increase
body temperature above normal [38]. There is no generally accepted classification of hyperthermia. IN
in the domestic literature, hyperthermic states include: 1) overheating
organism (actually hyperthermia), 2) heatstroke, 3) solar
stroke, 4) fever, 5) various hyperthermic reactions [38].IN
in the English-language literature, hyperthermic states are classified into
hyperthermia and fever (pyrexia). Hyperthermia includes heatstroke,
drug-induced hyperthermia (malignant hyperthermia [16],
neuroleptic malignant syndrome [40], serotonin syndrome [9]),
endocrine hyperthermia (thyrotoxicosis, pheochromocytoma, sympathoadrenal
crisis) [66]. In these cases, the body temperature rises to 41 ° C and above, and
traditional antipyretic pharmacotherapy is usually ineffective.Fevers are classified according to two principles: infectious and non-infectious;
out-of-hospital and in-hospital (48 hours and later after
admission to the hospital) [23].
For such
patients experience less significant rises in body temperature, and
traditional pharmacotherapy is very effective in this case. In this way,
with stimulation of neurons of the thermoregulation center, as well as associated with it
zones of the cortex and trunk of the GM, which occurs when the corresponding parts of the brain are damaged,
according to the Russian-language literature, a centrogenic hyperthermic
reaction (one of the forms of hyperthermic reactions) [38], from the standpoint of foreign literature
– neurogenic fever, neurogenic fever
(non-infectious fever) [46].

EFFECT OF INCREASED BODY TEMPERATURE ON
NEURO-REANIMATION PATIENTS

Proved that hyperthermic conditions are more common
in intensive care patients with acute brain injury, compared with
patients in general intensive care units [3, 56]. There was also
it has been suggested that fever in patients in intensive care units
profile may be a useful response of the body to infection [8, 43], and
aggressive temperature drop in this case can be not only not
shown, but may also be accompanied by an increase in the risk of developing a fatal
the outcome [59].One such study demonstrated that the use of
antipyretic drugs increased mortality in patients with
sepsis, but not in non-infectious patients [37]. In a controlled
a randomized study of 82 patients with various injuries (for
excluding TBI) and body temperature ≥ 38.5 ° C were divided into two
groups: one was carried out “aggressive” antipyretic therapy (650 mg
acetaminophen (paracetamol) every 6 hours at body temperature ≥ 38.5 ° C and
physical cooling at body temperature ≥ 39.5 ° C), others – “permissive”
(therapy was started only at body temperature ≥ 40 ° C, acetaminophen was administered, and
physical cooling was carried out until the temperature reached below 40 ° C).Study
was stopped when mortality in the “aggressive” therapy group was 7 cases
to one in the permissive therapy group [62].
However, there is compelling evidence that
in patients with brain damage, the hyperthermic response increases
the probability of death [17, 20, 25, 43, 54, 60]. It has been shown that
mortality increases in patients with TBI, stroke, if they have
increased body temperature in the first 24 hours from the moment of admission to the department
critical conditions; but in patients with a central nervous system infection
(CNS) no such pattern was found [60].In another job
390 patients with acute cerebrovascular accident were studied,
analyzed the relationship between high body temperature and mortality,
the degree of neurological deficit in survivors and the size of the lesion in
GM. It turned out that for every 1 ° C increase in body temperature,
the relative risk of an unfavorable outcome (including death) by 2.2 times,
also the hyperthermic state is associated with the large size of the focus
damage to GM [54].Out of 580 patients with subarachnoid hemorrhage
(SAH) 54% had fever and worse results
the outcome of the disease [70]. Meta-analysis of data from 14 431 case histories
patients with acute GM injury (primarily stroke) associated
increased body temperature with the worst outcome for each assessed indicator
[25]. Finally, an analysis of 7,145 case histories of TBI patients (of which 1,626 were
with severe TBI) showed that the likelihood of an unfavorable outcome (including
lethality) on the Glasgow Outcome Scale is higher in patients with
increased body temperature in the first three days of being in the intensive unit
therapy, moreover – the duration of the fever and its degree directly affect
outcome [30].
There are several possible explanations for why
hyperthermic conditions increase mortality in patients with
damage to GM. It is known that the temperature of the GM is not only slightly higher
internal body temperature, but the difference between them increases as
increasing the latter [57]. Hyperthermia Increases Metabolic Requirements
(an increase in temperature by 1 ° C leads to an increase in the metabolic rate by
13%), which is detrimental to ischemic neurons [28].Temperature increase
GM is accompanied by an increase in intracranial pressure [57]. Hyperthermia
increases edema, inflammation in the damaged tissue of the GM [4]. Other possible
mechanisms of GM damage: violation of the integrity of the blood-brain barrier,
violation of the stability of protein structures and their functional activity [25]. Evaluating
metabolism in 18 patients with SAH with hyperthermia and induced
normothermia, found a decrease in the lactate / pyruvate ratio and a lower number
cases where lactate / pyruvate> 40 (“metabolic crisis”) in
patients with normal body temperature [49].
Considering the impact
elevated temperature to the damaged GM, it is very important to quickly and accurately
determine the etiology of the hyperthermic state and begin the correct treatment.
Of course, if indicated, the appropriate antibacterial drugs –
life-saving means. However, early and accurate diagnosis of centrogenic
hyperthermia can prevent patients from prescribing unnecessary antibiotics
and associated complications.

HYPERTHERMAL
CONDITIONS IN THE INTENSIVE THERAPY DEPARTMENTS OF NEUROSURGICAL PROFILE

According to Badjatia N.(2009), 70% of patients with GM damage have an increased body temperature in
during the period of their stay in intensive care, and, for example, among patients of general intensive care – only 30–45%. Moreover, only half of
cases of fever (infectious cause) were noted [3]. Among patients
neurosurgical intensive care units (ICU), patients with SAH had
the greatest risk of developing a hyperthermic state, moreover, as a fever
(infectious genesis) and centrogenic hyperthermic reaction
(non-infectious genesis) [12].
Other factors
risk for centrogenic hyperthermia is ventricular catheterization of the GM and
duration of ICU stay [13]. Out of 428 patients of the neurosurgical
ICU 93% with hospital stay> 14 days
had a fever, 59% of patients with SAH also experienced
rises in body temperature above febrile numbers [33]. In turn, among
of patients with SAH, the highest risk of developing a hyperthermic reaction was in patients
with a high degree on the Hunt & Hess scale, with intraventricular hemorrhage and
large size of the aneurysm [20].

FEVER
NON-INFECTIOUS GENESIS

Not all
patients with high body temperature, an infectious etiology is detected as
the cause of the fever. Among ICU patients with a neurosurgical profile, only 50%
cases of fever, an infectious cause is identified [3]. In intensive care units
general profile, the most common cause of noncommunicable fever is the so-called
postoperative fever [7]. Other possible non-infectious causes
fevers: drugs, venous thromboembolism, non-calculous
cholecystitis.Almost any drug can cause fever.
but among the most commonly used in ICU settings: antibiotics (especially
β-lactams), anticonvulsants (phenytoin), barbiturates [31].
Medicinal
fever remains a diagnosis of exclusion. There are no characteristic signs. In a number of
cases, this fever is accompanied by relative bradycardia, rash,
eosinophilia [39]. There is a temporary connection between the prescription of the drug and
the appearance of fever or withdrawal of the drug and the disappearance of increased
temperature.Possible mechanisms of development: hypersensitivity reactions,
idiosyncratic reactions [31]. In 14% of patients diagnosed with
pulmonary embolism was observed body temperature ≥ 37.8 ° C without
association with some other alternative cause, according to the PIOPED (Prospective Investigation of Pulmonary Embolism Diagnosis) study [64]. Fever associated with venous thromboembolism
usually short-term, with low temperature rises, stops after
initiation of anticoagulant therapy [48].Hyperthermia associated with venous
thromboembolism, accompanied by an increased risk of 30-day mortality [6].
Spontaneous ischemic or inflammatory damage to the gallbladder also
can occur in a critically ill patient. Vesicular occlusion
duct, bile stasis, secondary infection can lead to gangrene and
perforation of the gallbladder [29]. The diagnosis should be suspected in patients with
fever, leukocytosis, pain in the right hypochondrium.Ultrasonic
examination (ultrasound) of the gallbladder has a sensitivity and specificity> 80%,
while the diagnostic value of spiral computed tomography (SCT)
the gallbladder area is higher [32].

CENTROGENIC
HYPERTHERMAL REACTION

Even
after a thorough examination in some patients it will not be established
etiology of fever. The genesis of fever in 29% of neurological ICU patients remains
riddle [50, 53].So, by
Oliveira – Filho J., Ezzeddine M.A. et
al. (2001), among 92 examined patients
with SAK 38 had a febrile temperature, and 10 (26%) of them had an infectious
the source of the fever has not been identified [50].
Among patients with TBI, 4–37% have
centrogenic hyperthermia (after excluding other
reasons) [67]. Pathogenesis of centrogenic
hyperthermia is not fully understood [34]. Damage to the hypothalamus with
corresponding rises in PgE levels underlie the origin of centrogenic hyperthermia [58].A study in rabbits revealed hyperthermia and increased levels of PgE in the cerebrospinal fluid (CSF) after
introduction of hemoglobin into the ventricles of the GM [22]. it
correlates with many clinical observations in which
intraventricular blood is a risk factor for the development of non-infectious fever [20,
12].
Centrogenic hyperthermic reactions also have
a tendency to occur at the beginning of the course of treatment, thereby confirming the fact that
the initial damage is centrogenic [53].Among patients with TBI, patients with diffuse axonal injury (DAP) and
damage to the frontal lobes are at risk for the development of centrogenic
hyperthermia [67]. Probably, these types of TBIs are accompanied by damage
hypothalamus. A study on cadavers showed that damage to the hypothalamus
occur in 42.5% of TBI cases, combined with hyperthermia [68]. Also
it is believed that one of the causes of centrogenic hyperthermia may be
called an imbalance of neurotransmitters and neurohormones involved in the processes
thermoregulation (norepinephrine, serotonin, dopamine) [34].With a deficit
dopamine, persistent centrogenic hyperthermia develops [34]. A number of
research was aimed at identifying patient-specific
neurosurgical ICU predictors of centrogenic hyperthermia. One of these
predictors – time of fever onset. For non-infectious fevers, it is typical
emergence in the early stages of hospitalization of the patient in the ICU. So, one
the study showed that the occurrence of hyperthermia in the first 72 hours
hospitalizations along with SAH are the main predictors of non-infectious etiology
fever [53].A study of 526 patients found that SAH,
intraventricular hemorrhage (IVH) causes hyperthermia in the first 72 hours
from the moment of admission to intensive care, a long period of fever are predictors of centrogenic
hyperthermia [27]. Another study linked long-term ICU stays,
Ventricular catheterization of GM and SAH with non-infectious etiology of fever [12].
The authors of the study concluded that, after all, blood in the ventricles is
a risk factor, since catheterization of the ventricles of the GM occurs often with
intraventricular hemorrhage.

DIFFERENTIAL
DIAGNOSTICS

Skill
to differentiate infectious and non-infectious causes of fever has a decisive
importance in the treatment of patients with neurological ICU. Should be held
a thorough examination aimed at identifying an infectious source.
If the risk of infection is high or the patient is unstable, antibiotic therapy should be
be started immediately [41]. One of the possible detection tools
infectious nature of fever – serum biomarkers of infection.Procalcitonin
– one such marker – has been widely studied as an indicator of sepsis.
A 2007 meta-analysis (based on 18 studies) showed
sensitivity and specificity of the procalcitonin test> 71%
[65].
Duration
antibiotic therapy started after a positive result of procalcitonin
test, should theoretically decrease. Thus, a recent meta-analysis of 1,075 stories
disease (7 studies) showed that antibiotic therapy started after
positive result of procalcitonin test, does not affect mortality,
however, the duration of antibiotic therapy is significantly reduced [52].Also for
differential difference of centrogenic hyperthermia from
infectious-inflammatory fever, a symptom such as
insignificant (<0.5 ° C) difference between basal and peripheral temperatures - isothermia [34]. To detect it, thermometry is performed in three different points (axillary and rectally).
Interesting
clinical observation that an extremely high
body temperature (> 41.1 ° C), occurring in patients of departments
intensive care neurosurgical profile, as a rule, has
non-infectious etiology and may be a manifestation of centrogenic hyperthermic
reactions, malignant hyperthermia, neuroleptic malignant
syndrome, drug fever [14].In addition to testing for
identification of infectious genesis of fever should also exclude drug
genesis of hyperthermia [31]. The ratio of temperature to heart rate
can be an important criterion for the differential diagnosis of hyperthermic
states. Typically, the heart rate increases with
an increase in body temperature (with an increase in body temperature by 1 ° C, the frequency
heart rate increases by about 10 beats / min).If a
heart rate is lower than predicted at a given temperature (> 38.9 ° C),
then there is relative bradycardia, unless the patient
is receiving β-blockers, verapamil, diltiazem, or has been diagnosed with
pacemaker.
Considering data
exclusion criteria, relative bradycardia in department patients
intensive neurosurgical therapy with hyperthermia (with a high proportion of
probability) indicates its non-infectious genesis, in particular, centrogenic
hyperthermic reaction or drug fever.Moreover, only in
in rare cases, relative bradycardia is observed in “feverish”
patients of general intensive care units against the background of the developed
nosocomial pneumonia, ventilator-associated pneumonia due to
outbreaks of nosocomial legionellosis [15].
Medicinal
fever occurs in about 10% of ICU patients. Moreover
its occurrence does not exclude the possibility of developing an infectious disease
or other condition accompanied by hyperthermia.Classically such
patients look “relatively good” for their temperature numbers. Patients with
drug fever invariably show relative bradycardia, but
if the body temperature is <38.9 ° C, then the pulse deficit may not be so obvious. In laboratory, such patients will have an unexplained leukocytosis with a shift to the left (imitation of an infectious process), eosinophilia, increased ESR, but blood cultures for sterility will not show signs infectious genesis of hyperthermia; levels may also rise slightly aminotransferases, immunoglobulin E.As a rule, such patients are burdened with allergic history, in particular, medicinal. Very common misconception is that the patient cannot develop a drug a fever for a drug he has been taking for a long time, and if previously, such reactions to it did not arise. In most cases it turns out that the cause of such a fever is precisely the drug that the patient took for a long time [14].
In case
the patient continues to “fever” despite taking antibiotics, or
microbial source not found, screening for venous thrombosis should be performed – how
clinical and instrumental (ultrasound of the veins of the upper and lower extremities) [71].
Atelectasis has often been cited as a cause of noncommunicable fevers, but several
the studies carried out did not find any regularity [19].
Non-calculous cholecystitis can be a life-threatening condition given
very vague symptoms in patients in coma [51].An abdominal ultrasound should
help diagnose. Only after careful exclusion of infection and
of the aforementioned non-infectious causes of fever in the ICU of the neurological
profile can be diagnosed with centrogenic hyperthermia. What already
mentioned, some nosologies are more predisposed to the development of centrogenic
hyperthermia [12, 27, 67]. Aneurysmal SAH is the most significant factor
risk, followed by IVH [28]. Among patients with TBI, patients with DAP and
damage to the frontal lobes – in the risk group for the development of hyperthermia [67].Continuing fever despite treatment [27] and onset within the first 72 hours
from the moment of admission to the ICU [27, 53] also indicates a centrogenic
hyperthermia. Centrogenic hyperthermia may not be accompanied by tachycardia and
sweating, as is common with infectious fever, and may be resistant to
the action of antipyretics [68]. Thus, the diagnosis “centrogenic
hyperthermic reaction ”- a diagnosis of exclusion [41]. Although it is advisable to avoid
prescribing antibiotics without indications due to the development of undesirable side effects
effects, refusal of antibiotic therapy in patients with sepsis may be
fatal.

THERAPEUTIC CAPABILITIES

Since the fever is caused by prostaglandin-induced
displacement of the “setting temperature” of the hypothalamus, appropriate therapy
should block this process. Conventional antipyretic drugs, including paracetamol
and nonsteroidal anti-inflammatory drugs (NSAIDs) that interfere with the synthesis
prostaglandins [4]. Several studies have shown their effectiveness in arresting
fever [44, 26], but they do not affect the mortality rate.Also
studies have shown that centrogenic hyperthermic reactions in one way or another
degrees are resistant to traditional pharmacological therapy [68, 61]. Only 7%
of patients with TBI and 11% of patients with SAH, there was a decrease in temperature
body while taking antipyretics [2]. Generally accepted cupping technique
there are no centrogenic hyperthermic reactions. Some
drugs: continuous intravenous infusion of clonidine as part of
so-called neurovegetative stabilization [35], the use of
dopamine receptor agonists –
bromocriptine in combination with amantadine [34], propranolol [42], continuous infusion of low doses of diclofenac [13].Physiotherapeutic methods of therapy have been proposed, in particular, the effect
electromagnetic radiation is in contact with the area located between the spinous processes of the C7 – Th2 vertebrae. One study even showed that decompression hemicraniectomy for severe TBI reduces
brain temperature, probably due to an increase in conductive heat transfer
[45]. In a clinical study involving 18 children aged 1 week and older
up to 17 years of age, among whom most of them had severe TBI, for a quick
for relief of hyperthermia, a 10-15-minute intravenous infusion of cold saline (4 ° C) was used in an average volume of 18 ml / kg.The authors concluded that this technique is safe and effective [21].
Similar studies were carried out in adult patients with severe TBI and also
have shown their effectiveness [5]. Physical cooling is used when
drug therapy is insufficient. Basically all medical methods
hypothermia can be divided into two categories: invasive and non-invasive. General
external cooling can cause muscle tremors, which in turn will reduce
the effectiveness of the technique and will increase the metabolic needs of the body [4].To avoid this, deep sedation of the patient with
using including muscle relaxants. Alternatively in a number
research is proposed to use selective craniocerebral
hypothermia [10], as well as non-invasive intranasal hypothermia [1, 63], although
data from clinical studies conducted in patients with severe TBI are very
contradictory primarily regarding the effectiveness of this method.
For the rapid induction of hypothermia,
endovascular (invasive) cooling devices.Comparing efficiency and
safety of endovascular coolants and external devices
hypothermia, it can be noted that today both methods are the same
effective for the induction of hypothermia, there is no significant difference in the incidence
side effects, mortality, poor outcome in patients. but
external cooling gives less precision in the maintenance phase of hypothermia [24].

CONCLUSION

Increased
body temperature among patients in critical care units –
a common symptom.Damaged GM is especially sensitive to hyperthermia,
numerous experimental and clinical studies show
poor outcome in patients with TBI with elevated body temperature,
regardless of its genesis. In addition to fever, the cause of the rise in temperature
the body in patients with acute GM injury may have a so-called
centrogenic hyperthermia, in other words, the neurological disease itself.
Subarachnoid
hemorrhage, intraventricular hemorrhage, certain types of TBI –
risk factors for the development of the latter.Centrogenic hyperthermia – diagnosis of exclusion,
which should only be installed after careful examination of the patient
to identify an infectious or non-infectious cause of fever. And fever and
centrogenic hyperthermia should be stopped in patients with acute injury
GM. For this, pharmacological antipyretics can be used (effective for
fever, to a lesser extent with centrogenic hyperthermia) and physical methods
cooling (effective both for fever and for centrogenic hyperthermia).
Considering that today the generally accepted
there is no method for stopping centrogenic hyperthermia, in the future it is necessary
conducting more and better quality clinical trials,
aimed at determining an effective and safe method of cupping
centrogenic hyperthermia.

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Malaria

Malaria is an infectious disease that causes repeated attacks of chills and fever. The causative agent of malaria is Plasmodium, a parasite transmitted by the bites of mosquitoes that carry the infection. Malaria kills approximately one million people worldwide every year, but it is most common in countries with tropical and subtropical climates.

There is no vaccine to prevent malaria, but with prophylaxis, the risk of getting sick is reduced.

The success of treatment depends on the type of plasmodium, the patient’s condition and other factors.

Synonyms Russian

Swamp fever, intermittent fever, paroxysmal malaria.

English synonyms

Malaria, Jungle fever, Marsh fever.

Symptoms

Malaria is characterized by periodic recurrence of attacks (every 48-72 hours, depending on the type of pathogen).The attack lasts approximately 1-2 hours and is accompanied by the following symptoms:

  • chills – moderate to severe,
  • high body temperature (up to 39-41 ° C),
  • cough,
  • profuse sweating (appears at the end of an attack and is accompanied by a decrease in temperature to normal or below normal).

In addition, other symptoms may appear:

  • headache,
  • nausea, vomiting, diarrhea,
  • fatigue, fast fatigue,
  • loss of appetite,
  • muscle pain,
  • jaundice.

Malaria usually appears within a few weeks of being bitten by an infected mosquito. However, some parasites can remain in the body for months or years without causing any symptoms.

General information about the disease

Malaria is an infectious disease that causes repeated attacks of chills and fever. The causative agent is four types of parasites transmitted by the bites of mosquitoes – carriers of the infection.Less commonly, malaria spreads through blood transfusions or from mother to fetus. It is most often found in countries with tropical and subtropical climates.

The life cycle of a malaria parasite begins when a female Anopheles mosquito feeds on the blood of a malaria patient and swallows the parasites. In the process of sexual development in the body of a mosquito, sporozoites (one of the life forms of the parasite) develop from them, which are located in the salivary glands of the insect.

When bitten, a mosquito injects saliva with sporozoites into the human body, where they reproduce asexually in liver cells.After a period of maturation, lasting from several days to several months, the parasites are released from the liver cells and enter the red blood cells (red blood cells), which is the beginning of the active phase of the disease. In erythrocytes, further asexual reproduction of parasites occurs; when the erythrocyte membrane ruptures (every 48-72 hours), the plasmodia are in the blood plasma, which causes fever and chills. Then they penetrate into unaffected erythrocytes and the cycle repeats. Intermediate forms of plasmodia can persist in the body (in the liver) for up to several years, causing the disease to re-develop even after a course of treatment.

Malaria can be fatal, most often in children under 5 years of age. Usually death is associated with complications of the disease:

  • cerebral malaria – infected red blood cells can block small blood vessels in the brain, causing swelling or damage;
  • respiratory failure due to accumulation of fluid in the lungs;
  • organ damage – hepatic or renal failure, damage to the spleen;
  • severe anemia as a result of a decrease in the number of normally functioning red blood cells;
  • low blood sugar (can be triggered by both malaria and its treatment).

Who is at risk?

People living in countries with tropical and subtropical climates (African states south of the Sahara desert, the Indian subcontinent, the Solomon Islands, Papua New Guinea and Haiti) or visitors to these countries most often suffer from malaria.

More severe course of malaria susceptible to:

  • children under 5 years old,
  • tourists from regions where the disease is not common who have visited subtropical or tropical countries,
  • pregnant women and their unborn children,
  • poor people who do not have access to qualified medical care.

Diagnostics

Periodic attacks of fever, especially if the patient has been in foci of malaria over the past two years, allows suspicion of the disease. To confirm the diagnosis, it is necessary to detect the parasite in blood smears.

Laboratory research methods

  • Blood smear microscopy. This analysis is still the leading method for diagnosing malaria. It is quite simple and inexpensive, but relatively laborious.Blood for the preparation of a smear must be taken from the patient during an attack of fever – this increases the likelihood of detecting malaria plasmodia. After making a smear and staining it using a special technology, it is possible to detect the causative agents of the disease themselves or characteristic changes in erythrocytes. In particular, in malaria, spots caused by inclusions of plasmodia are determined in erythrocytes. Based on the results of a blood smear test, the presence of infection is judged, as well as the type of parasite and the stage of the disease.
  • Determination of antibodies to the causative agent of malaria – molecules produced by the immune system in response to the ingestion of malaria plasmodium. A negative test result excludes the diagnosis of malaria.
  • Determination of pathogen proteins. A modern analysis with which it is possible to identify in the blood the molecules that make up the malaria plasmodium. It is a fast, inexpensive diagnostic method with high reliability for malaria infection.
  • Determination of the genetic material of Plasmodium malaria by polymerase chain reaction (PCR). Allows you to determine even a small number of pathogens in the blood. Due to its high cost, the study is not widely disseminated.
  • Complete blood count (without leukocyte count and ESR).
    • Hemoglobin and erythrocytes. Since the destruction of red blood cells (hemolysis) occurs during attacks of malaria, their level in the blood, as well as the level of hemoglobin contained in them, can be reduced, indicating the development of anemia.
    • Platelets. A decrease in platelet count is a characteristic feature of malaria and occurs in about 70% of patients.
    • Lymphocytes. In malaria, altered (atypical) lymphocytes (white blood cells) can be detected in the blood.
    • Reticulocytes are maturing red blood cells. Since mature red blood cells are destroyed during attacks of malaria, the production of reticulocytes increases.
  • Lactate dehydrogenase (LDH) is an enzyme found in many human organs and tissues, including erythrocytes.An elevated LDH is a hallmark of malaria.
  • Alanine aminotransferase (ALT), aspartate aminotransferase (AST). An increase in the liver enzymes ALT and AST will indicate liver damage caused by malaria.
  • Total bilirubin. Bilirubin is the end product of the breakdown of hemoglobin. With increased destruction of red blood cells, its level rises.

Other research methods

  • Computed tomography of the brain.If there are signs of central nervous system damage, a computed tomography scan of the brain may be required to detect cerebral edema and bleeding in the lining of the brain.

Treatment

Treatment of malaria involves taking special antimalarial drugs, as well as eliminating complications of the disease.

Drug resistance of some types of malaria has been noted. There is no vaccine that will completely rid the patient of this disease, although there is an active search for it.

Prevention

  • The use of antimalarial drugs when traveling to regions with a high incidence of malaria.
  • Prevention of infection by bite. You can avoid mosquito bites with:
    • treatment of the walls of the house with special sprays,
    • for using mosquito nets impregnated with mosquito repellent,
    • Wearing clothing that covers the body, spraying clothing with mosquito sprays.

Recommended analyzes

  • Complete blood count
  • Lactate dehydrogenase
  • Alanine aminotransferase (ALT)
  • Aspartate aminotransferase (AST)
  • Total bilirubin

High fever – causes of occurrence, under what diseases it occurs, diagnosis and treatment methods

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication.In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For a diagnosis and correct prescription of treatment, you should contact your doctor.

High temperature – the reasons for the appearance, for what diseases it occurs, diagnosis and treatment methods.

An increase in temperature serves as a protective reaction of the body and can occur under the influence of various factors. It is imperative to separate conditions such as hyperthermia (overheating) and fever, which is also accompanied by an increase in body temperature, but its mechanism differs from overheating and requires other measures of influence on the body.

Possible causes

Fever is triggered by external (or exogenous) pyrogens – substances foreign to the body that have entered the bloodstream. These include infectious pyrogens: viral toxins and metabolic products of microorganisms. Also, the primary group includes non-infectious pyrogens: certain lipids, proteins and protein-containing substances that enter the body from the external environment or arise in the body during inflammatory processes, allergic reactions or the decay of tumor tissues.Primary pyrogens, interacting with cells of the immune system, initiate the production of internal, or endogenous (secondary) pyrogens – cytokines. It is they who, acting on the center of thermoregulation in the brain, cause an increase in body temperature.

The feverish state has its own dynamics and includes several stages.

If body temperature is taken as the criterion for the course of fever, then three stages can be distinguished:

Stage 1 – a period of temperature rise;

Stage 2 – the period of preservation, or standing of the temperature;

Stage 3 – the period when the temperature drops to normal values….

Temperature rise stage

The rate of temperature rise depends on the concentration of pyrogens in the blood and can serve as a diagnostic sign.

A rapid rise in temperature to high values ​​is observed with influenza, lobar pneumonia,

and it is also possible if a foreign protein enters the bloodstream (for example, during transfusion of blood components).In this case, there is a strong chill, there is a cooling of the skin, which is caused by a spasm of the superficial blood vessels.

A slow rise in temperature is characteristic of adenovirus infection, typhoid fever, and brucellosis. In these cases, pronounced chills may be absent, and the first sensations of the disease will be fever, dry eyes, headache, and malaise. Pale skin, cold feet and palms are possible.

What should you do?

First of all, it is necessary to warm the patient by wrapping him in a blanket.A heating pad applied to the legs and arms gives a good effect.

Stage of standing temperature

After reaching the upper value, the temperature is kept at this level for some time. This period is called the stage of standing temperature, when a balance is established between heat production and heat transfer. At this stage of the disease, the patient feels fever, drowsiness. Possibly lack of appetite, thirst. Depending on the level of temperature rise, a weak or subfebrile temperature is distinguished – 37-38 ° C; moderate, or febrile – 38-39 ° C; high – 39-41 ° C and excessive – above 41 ° C.

Knocking down the temperature is not always appropriate.

Fever is a protective and adaptive reaction of the body that occurs in response to the action of pyrogens.

At a temperature of 37.5-38 ° C, the body actively fights infection. However, each person reacts differently to fever. Therefore, when deciding on a drug decrease in temperature, one should focus on well-being and related symptoms.This is especially true for children. Conventionally, the threshold temperature at which it is necessary to strengthen monitoring of the state of health and external manifestations is considered to be a temperature of 38 ° C and above.

The period of maintaining the temperature at a high level depends on the infectious agent, the state of immunity and the treatment being carried out.

In normal cases, this time can vary from one to five days, but with a severe course of the disease, it can stretch for several weeks.

Temperature fluctuations in a febrile patient have a certain rhythm: the maximum values ​​are noted at 5-6 pm, the minimum – at about 4-5 am and variability. With pneumonia, for example, the temperature can remain high for a long time. For bronchitis, pulmonary tuberculosis, significant daily temperature fluctuations (1-2 ° C) are characteristic. The so-called debilitating fever is very dangerous, which is characterized by sharp jumps in temperature (with a rapid rise and fall), sometimes repeated two or three times during the day.There is such a fever in sepsis, the presence of cavities in pulmonary tuberculosis and the decay of lung tissue.

What should you do?

At high temperatures, it is necessary, if possible, to free the patient from excess clothing and provide access to fresh air, excluding drafts. You can put a cold compress on the forehead and areas of large vessels (elbow and knee bends). You can wipe your body with a towel dampened in cool water.

The question of medication lowering the temperature is decided in each case individually.

It is more difficult for a person to endure not high temperature, but intoxication of the body. Therefore, the main measures should be aimed at removing toxic metabolic products from the body. This is achieved by drinking plenty of fluids, and, if necessary, by cleansing enemas.

When prescribing antipyretic drugs for children, the following nuances are taken into account:

– the child is less than three months old, and the temperature has risen above 38 ° C;

– in a previously healthy child aged three months to six years, the temperature rose above 39 ° C;

– a child with heart or lung disease has a temperature higher than 38 ° C;

– a child of any age (up to 18 years old) with convulsive syndrome, diseases of the central nervous system, in the presence of such external signs as pallor, cyanosis of the skin and cold extremities, general lethargy and lethargy, it is necessary to lower the temperature if it reaches 38 ° C …Otherwise, a convulsive syndrome may occur, which is extremely dangerous and can lead to suffocation.

At high temperatures, the functioning of all organ systems changes.

The heart rate increases by 8-10 beats per minute for each degree the temperature rises. Often there are arrhythmias, more often extrasystole (extraordinary contractions), spasm of blood vessels and increased blood pressure.

The secretory and motor functions of the gastrointestinal tract are reduced, which leads to retention of food in the intestines, and a lack of fluid causes constipation.Considering these factors, it is necessary to adjust the diet of a febrile patient. Preference should be given to liquid, easily digestible foods, reducing the serving size but increasing the number of meals.

There is a feature that should be taken into account by patients with diabetes mellitus. It must be remembered that fever is accompanied by an increase in blood glucose levels, which requires appropriate action.

Treatment

The main antipyretic drugs include non-steroidal anti-inflammatory drugs – paracetamol, ibuprofen, diclofenac.These drugs work quickly and are quickly eliminated from the body.

Although it is common practice to take antipyretic tablets in the form of pills, experience shows that the side effects are more pronounced in this case.

It is preferable to use rectal suppositories.

With this method of administering drugs, the active substance through the blood vessels of the rectum directly enters the bloodstream. There is no irritating effect of medications on the gastric mucosa.It becomes possible to administer the drug regardless of food intake.

Temperature reduction stage

A decrease in temperature in infectious diseases occurs either quickly and is accompanied by profuse sweating, and sometimes a drop in blood pressure, or slowly, over one or two days.

What should you do?

You can help a patient with a sharp drop in temperature by quickly changing wet clothes to dry ones and giving them hot tea.

It is important to remember that a decrease in temperature is not an indicator of recovery.

The body still contains microorganisms or viruses that can cause a second wave of the disease. Streptococcal infections are especially dangerous in this regard, which often give complications to the heart, kidneys and joints. Therefore, one should observe bed rest not only at high temperatures, but also immediately after its decrease. Upon recovery, it is recommended to perform clinical blood and urine tests.

90,000 symptoms, causes of appearance, diagnosis, treatment

When the body is struggling with various types of infection, an increase in body temperature is characteristic during this period. This can be due to the ingress of infection into the body, as well as to non-infectious problems (heatstroke, dehydration, the consequences of trauma). Frequent breathing, hyperemia often accompany fever. Fever plays the role of a protective reaction of the human body to various shocks from the external environment.

There are forms of fevers:

  • Subfebrile.
  • Febrile.
  • Hyperpyretic.

3 stages of fever

  • Increased fever. In some cases, this stage lasts several hours and is accompanied by chills. In other cases, it is several hours.
  • The height of the disease. The temperature is in a high position. Duration in severe cases up to several weeks.
  • Decrease in temperature. The drop in body temperature can be intense, and in some cases it can last for several days.

Fever types:

  • Constant.
  • Laxative.
  • Intermittent.
  • Hectic.
  • Reverse fever.
  • Irregular fever.
  • Returnable.
  • Wavy.

Most diseases are characterized by some type of fever. This greatly helps in determining the correct diagnosis. In the process of diagnostics, observation of dynamic changes in body temperature is used.A sudden rise in temperature, within a few hours, is characteristic of an acute onset of the disease. The maximum body temperature, reached only on the third day, indicates a subacute onset. With a gradual start, the maximum mark on the thermometer can be seen only on the seventh day.

Fever stimulates the sympathetic nervous system. The list of diseases associated with prolonged fever is unusually wide. Diseases in which fever can occur: tuberculosis, diffuse tissue diseases, thyrotoxicosis.Inflammation in the biliary tract is often identified as the cause of fever.
The most unexpected cause of fever is prostatitis. It can cause high fever, which is sometimes misleading, even for the most experienced professionals. Fever is an important symptom of the disease after pain. It helps to identify the presence of infection in the early stages. When diagnosing a disease, it is worth paying attention to temperature fluctuations, which must be measured every 3 hours.

When the temperature does not reach 38.5 degrees, antipyretic drugs should not be prescribed.At this moment, the body itself fights the disease. However, people who do not tolerate such a body temperature can not do without these funds.

Get advice
general practitioner

90,000 Head of the Clinic of Infectious Diseases on accurate thermometers, the dangers of panic attacks and reliable disinfectants

The pandemic affects not only physical health but also mental health. Many give in to panic and start looking for symptoms of coronavirus infection.

Often they complain of increased body temperature – from 37 to 38 degrees. It is called subfebrile. More than once we have devoted publications to this topic. By the way, the January article about “subfebrile” has become the most popular on our site old.sgrpess.ru, it has already been read almost 600 thousand times.

What does high temperature have to do with coronavirus? How dangerous is it in principle? This time our interlocutor was Dmitry Konstantinov, Head of the Department and Clinic of Infectious Diseases with Epidemiology, Samara State Medical University, .We held the meeting online, asked questions ourselves and provided such an opportunity to readers.

– Dmitry Yuryevich, our readers never stop complaining about low-grade fever. What are the main reasons for it?

– Indeed, subfebrile temperature is an urgent problem. We see such patients every day in the clinic for infectious diseases. Most often, we are contacted with a minimum temperature rise – 37.2-37.4 degrees, but lasting for a long time.

To begin with, let me explain the main thing: a fever or a rise in temperature is a protective reaction of the body. Symptoms of fever include chills, fever, and increased sweating. Its causes can be infectious or non-infectious.

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For example, an infectious agent entering the body causes disease. These can be parasitic diseases, viruses, bacteria, fungi.

Non-infectious causes include abscesses in the liver or lungs, which can also be accompanied by fever.Subfebrile temperature is typical for less pronounced pathological processes in the body, for example, for diseases of the endocrine system.

To clarify the diagnosis, it is necessary to take tests and undergo examinations.

Temperature, by the way, can also rise during normal physiological processes.

– The temperature of 37 degrees is very insidious: it appears and disappears. If it lasts for several months, then we can assume that this is the norm for a particular person?

– Each person is different.For one, 37.3 is the norm, and for another it is a disease. Different processes can be hidden under this. Therefore, the patient must be examined.

– What should people who have passed all kinds of examinations, but the reason remains unclear?

– If a person has passed all the tests, and signs of fever persist, then you should not panic. We need to understand what its biological rhythm is. For example, the temperature may rise one to two degrees after eating – this is a normal physiological process.It is important for infectious disease specialists to understand how long subfebrile condition lasts – a month, three, six months. It is also necessary to clarify exactly when the temperature rises – in the morning, in the evening, during the day. We ask patients to create a sheet in which they will record their temperature readings every two hours. This helps to understand what the promotion is related to.

– People who suffer from allergic reactions can feel low-grade fever during exacerbations?

– Allergy is the body’s reaction to something foreign or its own – in the case of autoimmune diseases.If a person is prone to allergies, then his body is in a tense state. The reaction can be sneezing, nasal congestion, lacrimation and the same subfebrile condition. Temperature depends on the cycles and the amount of allergen ingested. For example, today you are in a clean apartment, and tomorrow dust will accumulate, hence the corresponding reaction.

Of the frequent diseases associated with temperature, there are lesions of the gastrointestinal tract, cholecystitis and other chronic ailments. In addition, the body has its own flora everywhere.As you know, from 1.5 to 4 kilograms of human body weight falls on microorganisms. An imbalance in the microflora can also be accompanied by a change in temperature. This is not a disease, it can be regarded as a condition that requires regulation. To find out the reason, you need to understand what the patient is doing during the day: whether he is sitting at a table or unloading wagons.

– What is the best way to measure temperature? Which thermometers are more accurate?

– In my opinion, mercury thermometers give less false readings than electronic ones.Incidentally, the wrong measurement can add complexity. If a person measured his temperature and noticed a strong deviation from the usual, then he will have anxiety. And even it alone can trigger a whole cascade of mechanisms: under stress, blood vessels expand, a thermal reaction occurs. No need to worry. Better to measure the temperature again with a reliable instrument. A mercury thermometer should be kept for up to 10 minutes.

– Question from readers: “All family members had a temperature of 39 degrees for three days.What could it be connected with? ”

– A temperature of 39 degrees without any symptoms – nasal congestion, sore throat, sore throat is rare. You need to understand what it was accompanied by – headache, chills, intoxication syndrome. It is necessary to remember what hurt the day before, what medications you took. Perhaps these are atypical forms of acute respiratory diseases that have erased symptoms. This means that this family could have suffered a mild form of ARVI. If the temperature has passed, it means that the body has coped and won a victory over the agent.

– Fever is one of the symptoms of COVID-19. Do I need to sound the alarm if the thermometer shows more than 37 degrees?

– I will repeat again: you do not need to wind yourself up. If a person has a feeling of discomfort in the nose or a sore throat, then this is not necessarily a coronavirus. People still get sick with “classic” acute respiratory infections, they are now at their peak. In medical institutions, there are patients who have confirmed influenza, parainfluenza, adenovirus.These are all standard seasonal illnesses.

The specialists of the clinic of Samara State Medical University studied the statistics of morbidity. They found out that in the past year, in the same period, a greater number of patients with acute respiratory infections and acute respiratory viral infections were recorded.

Don’t panic. It is imperative to be at home, to measure the temperature, to listen to your well-being, but not to fall into hypochondria. Coronavirus cannot be without clinically pronounced manifestations that lead to shortness of breath and a severe course of the disease.It happens that patients diagnose themselves with pneumonia after news broadcasts – they complain of heavy breathing and chest discomfort. It’s often psychological.

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Samara specialists have developed tactics of action, prepared medical institutions, and are using reliable diagnostic methods. Now everything depends on the conscious choice of the population. Help doctors stay home.

– There is still a shortage of antiseptic agents in Samara.Is vodka suitable for disinfecting hands and clothes?

– The alcohol concentration that instantly destroys and kills bacteria is 70 percent. But in the absence of an antiseptic and 40-degree vodka can be used. However, any soap, detergent, and running water will also remove bacteria. If you did not keep your distance, came into contact with someone suspicious and think that there is a virus on your clothes, then it is better to take them off and take them, for example, to the balcony, let them lie down there.A virus cannot live long on its own.

90,000 Colorado Tick Fever – Southern Nevada Medical District

What is Colorado Tick Fever?

Colorado tick fever is a disease caused by a virus carried by small mammals such as ground squirrels, porcupines and chipmunks and transmitted by tick bites.

Who Gets Colorado Tick Fever?

Anyone who lives or travels in areas of the western United States and Canada above 5,000 feet and has contact with infected ticks, especially the Anderson Derm Center, can contract tick-borne fever in Colorado.

How does Colorado tick fever spread?

In humans, Colorado tick fever after a tick bite. There is no evidence of human-to-human transmission of the virus. However, rare cases of transmission through blood transfusion have been reported. The virus that causes Colorado tick-borne fever can remain in the blood for up to four months after the onset of the disease.

What are the symptoms of Colorado tick fever?

Illness causes:

  • Fever
  • Chills
  • Nausea
  • Severe headache

These symptoms usually last for several days, go away, and then return for a few days.A rash sometimes appears.

How soon do symptoms appear?

Symptoms usually appear four to five days after an infectious tick bite.

How to uncheck the box?

  • Ticks should be removed quickly and carefully with tweezers and a gentle, even motion.
  • Do not crush the tick body when removing it, and apply the tweezers as close to the skin as possible to avoid leaving parts of the tick’s mouth on the skin.
  • Do not remove ticks with bare hands.
  • Protect your hands with gloves, a cloth or tissue and be sure to wash your hands after removing the tick.

How can tick inflammation be prevented in Colorado?

  • Avoid mite infested areas, especially during warmer months.
  • Wear light-colored clothing so that the mites are easily visible. Wear a long-sleeved shirt, hat, long pants, and tuck your pant legs into your socks.
  • Walk down the center of the trail to avoid overhanging grass and brush.