What is considered a high grade fever in adults. When should you worry about a fever. How to accurately measure body temperature. What are the common causes of fever in adults. Is a fever always a sign of infection.

Understanding Fever: Definition and Purpose

A fever is defined as an elevated body temperature of 100.4°F (38°C) or higher. It’s a natural defensive mechanism employed by the body to combat infections. But what exactly happens when we develop a fever?

During a fever, the body intentionally raises its temperature to create an inhospitable environment for pathogens. This increase in temperature can help:

• Accelerate the production of white blood cells
• Enhance the effectiveness of immune system responses
• Slow down the reproduction of bacteria and viruses

Interestingly, adults can develop a fever without exhibiting any other symptoms. This phenomenon often puzzles both patients and healthcare providers alike.

Common Causes of Fever in Adults

Fevers can arise from various sources, including:

1. Viral infections (e.g., COVID-19, influenza, common cold)
2. Bacterial infections
3. Fungal infections
4. Parasitic infections
5. Autoimmune disorders
6. Certain medications
7. Heat exhaustion or heat stroke

In many cases, particularly with viral infections, fevers often resolve on their own within a few days without requiring specific treatment.

High Grade Fever: Definition and Implications

In the medical community, a high grade fever in adults is typically defined as a temperature of 103°F (39.4°C) or higher. But why is this threshold significant?

High grade fevers can be indicative of more severe infections or underlying health conditions. They demand closer monitoring and may require medical intervention. However, it’s crucial to remember that the severity of an illness isn’t always directly correlated with the height of the fever.

Potential Causes of High Grade Fever

High grade fevers can be triggered by various factors, including:

• Severe bacterial infections (e.g., pneumonia, meningitis)
• Viral infections (e.g., dengue fever, yellow fever)
• Malaria
• Endocarditis
• Certain cancers
• Drug reactions

While these causes can be serious, it’s important not to jump to conclusions. A thorough medical evaluation is necessary to determine the underlying cause of a high grade fever.

Accurately Measuring Body Temperature

To ensure you’re getting an accurate reading of your body temperature, it’s crucial to use the right method. What’s the most reliable way to measure body temperature in adults?

Oral temperature measurement is generally considered the most accurate method for adults. However, to obtain a reliable reading, follow these guidelines:

• Wait at least 30 minutes after eating or drinking hot or cold substances
• Keep the thermometer under your tongue for the recommended time (usually about 1 minute for digital thermometers)
• Ensure your mouth is closed around the thermometer

Other methods, such as ear (tympanic) or forehead (temporal artery) thermometers, can be convenient but may be slightly less accurate than oral measurements.

When to Seek Medical Attention for a Fever

While most fevers aren’t cause for immediate concern, certain situations warrant medical attention. When should you consider contacting a healthcare provider or visiting an emergency room?

Seek medical help if you experience a fever along with any of the following conditions:

• Temperature remains high despite taking fever-reducing medication
• Fever persists for several days or keeps recurring
• You have underlying health conditions such as diabetes, heart disease, cancer, or autoimmune disorders
• You’re pregnant
• You’ve recently returned from overseas travel
• You have a compromised immune system or are undergoing chemotherapy
• You’ve recently been bitten by a tick

Additionally, if you’re not fully vaccinated against COVID-19 and develop a high-grade fever, it’s advisable to contact your healthcare provider promptly.

Fever in the Context of COVID-19

Given the ongoing global pandemic, it’s natural to wonder about the relationship between fever and COVID-19. Can a fever be a sign of a “breakthrough” COVID-19 case in fully vaccinated individuals?

While breakthrough cases of COVID-19 in fully vaccinated people have been reported, they are relatively rare. When they do occur, symptoms tend to be milder than in non-vaccinated individuals. This includes fever, which may be less severe or absent altogether in breakthrough cases.

However, it’s important to note that a fever alone isn’t sufficient to diagnose COVID-19. Other symptoms, such as cough, loss of taste or smell, and fatigue, are also common indicators. If you’re concerned about potential COVID-19 exposure or symptoms, it’s best to consult with a healthcare provider and consider getting tested.

Debunking the Myth of “Normal” Body Temperature

For centuries, 98.6°F (37°C) has been considered the standard “normal” body temperature. However, recent research suggests this might not be entirely accurate. Is there really such a thing as a “normal” body temperature?

Studies indicate that the average body temperature can range from about 97°F to 99°F (36.1°C to 37.2°C). This variation can be due to several factors:

• Time of day (body temperature tends to be lower in the morning and higher in the evening)
• Age (older adults often have lower body temperatures)
• Physical activity
• Hormonal changes
• Menstrual cycle in women

Interestingly, research suggests that average body temperatures have been declining over time. Some theories attribute this to lower rates of chronic inflammation due to improved hygiene and healthcare, as well as changes in metabolic rates.

Managing Fever at Home

While high-grade fevers often require medical attention, milder fevers can usually be managed at home. What are some effective strategies for managing fever symptoms?

Here are some tips for managing fever at home:

1. Stay hydrated by drinking plenty of fluids
2. Rest and avoid overexertion
3. Use over-the-counter fever reducers like acetaminophen or ibuprofen as directed
4. Keep the room temperature comfortable, not too hot or cold
5. Dress in light, breathable clothing
6. Use a cool, damp cloth on your forehead or wrists

Remember, fever is often a sign that your body is fighting an infection. While these measures can help alleviate discomfort, they won’t treat the underlying cause of the fever.

The Role of Fever-Reducing Medications

Fever-reducing medications, also known as antipyretics, can help lower body temperature and alleviate discomfort associated with fever. Common over-the-counter options include:

• Acetaminophen (Tylenol)
• Ibuprofen (Advil, Motrin)
• Aspirin (not recommended for children due to the risk of Reye’s syndrome)

While these medications can provide relief, it’s crucial to follow dosage instructions carefully and be aware of potential side effects or interactions with other medications you may be taking.

Fever in Special Populations

While this article primarily focuses on fever in general adult populations, it’s worth noting that certain groups may require special consideration when it comes to fever management. Who are these special populations?

Special populations that may require different approaches to fever management include:

• Elderly individuals: They may not develop fever as readily as younger adults and might have atypical presentations of infections.
• Immunocompromised individuals: Those with weakened immune systems may be at higher risk of serious infections and complications from fever.
• Pregnant women: Fever during pregnancy can potentially affect fetal development, so prompt medical attention is often recommended.
• Individuals with chronic health conditions: Certain conditions like heart disease or diabetes may complicate fever management.

If you fall into one of these categories, it’s important to discuss fever management strategies with your healthcare provider and have a clear plan of action in case of fever.

Fever in Children vs. Adults

It’s crucial to note that fever in children, especially infants and young children, is often treated with more urgency than in adults. Why is this the case?

Children’s immune systems are still developing, making them more vulnerable to certain infections. Additionally, young children may not be able to communicate their symptoms effectively. As a result, even a slight fever in a baby or young child may warrant immediate medical attention.

Some key differences in fever management between children and adults include:

• Lower temperature thresholds for concern in children
• Different dosages and types of fever-reducing medications
• More emphasis on monitoring hydration status in children with fever
• Greater risk of febrile seizures in young children

Parents and caregivers should always consult with a pediatrician for guidance on managing fever in children.

The Future of Fever Management

As medical science advances, our understanding and management of fever continue to evolve. What developments can we expect in the future of fever management?

Some potential areas of advancement include:

1. More sophisticated wearable devices for continuous temperature monitoring
2. Development of new antipyretic medications with fewer side effects
3. Better understanding of the role of fever in different disease processes
4. Improved diagnostic tools to quickly identify the cause of fever
5. Personalized fever management strategies based on individual genetic profiles

These advancements could lead to more precise and effective fever management strategies, potentially improving patient outcomes and reducing unnecessary medical interventions.

The Role of Artificial Intelligence in Fever Management

Artificial Intelligence (AI) is increasingly being applied in various areas of healthcare, including fever management. How might AI contribute to improved fever diagnosis and treatment?

AI could potentially assist in fever management through:

• Pattern recognition in temperature data to predict fever onset or resolution
• Analysis of symptoms and patient history to suggest potential causes of fever
• Optimization of fever treatment protocols based on large-scale data analysis
• Remote monitoring and alert systems for high-risk patients

While these applications are still in development, they hold promise for enhancing our ability to understand, predict, and manage fevers more effectively in the future.

In conclusion, while fever can be concerning, it’s often a sign that your body is effectively fighting off an infection. Understanding when a fever warrants medical attention and how to manage it at home can help you navigate this common symptom with confidence. Remember, when in doubt, it’s always best to consult with a healthcare professional for personalized advice and care.

Fever & Temperature In Adults: When To Worry

Karen Justiniano, DO, MS, Stamford Health Medical Group

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A friend of mine whose father is 70 years old told me her story. It went something like this:

“My father never gets fevers. Out of nowhere the other day, he developed a 103 temperature with no other symptoms. He is also fully vaccinated against COVID-19. My mother brought him to the emergency room. Did she do the right thing, or would he likely have been fine if he stayed home and let the fever run its course?”

As a physician who cares for a variety of people with a variety of conditions, I have to say of course she did the right thing! When in doubt or when concerned, seeking medical attention is the smart thing to do.

But the longer answer is a little more complicated than that. It all starts with breaking down the purpose of a fever, and when you should truly worry. Please note—fevers in infants or young children are sometimes a different story—what you are about to read relates to adults only.

What is a fever and why do we get them, and sometimes with no other symptoms?

Fever is an elevated body temperature which means your temperature is 100.4 degree F or higher. A fever is the body’s way of fighting an infection by naturally raising your body’s temperature to “kill the germ.” The medical community likes to say that fever is a “good thing,” in most cases.

And yes, it’s completely possible for adults to develop a fever with no other symptoms, and for doctors to never truly find the cause. Viral Infections can commonly cause fevers, and such infections include COVID-19, cold or the flu, airway infection like bronchitis, or the classic stomach bug.

That’s why you often hear the word “viral” as an explanation because these types of infections often go away on their own after a few days.

What is considered a high fever in adults?

A high-grade fever in adults is 103 degrees F or higher.

Is it possible that a fever could be a sign of a “breakthrough case” of COVID-19 even if the person is fully vaccinated?

Yes, but not highly likely. Breakthrough cases of COVID-19 in fully vaccinated people have been reported, but symptoms tend to be milder than in non-vaccinated people, including fever.

First, make sure you are taking your temperature the right way. Taking your temperature by mouth is the most accurate method, and wait at least 30 minutes after you eat or drink anything hot or cold. Get medical attention for your fever if:

• Your temperature is high and has not gone down after taking Tylenol or Advil
• Your temperature lasts several days or keeps coming back
• You live in an area where people have COVID-19
• You have serious health conditions like diabetes, heart disease, cancer, lupus, or sickle cell anemia. (Non-infections like these can cause fever as well.)

You should also seek medial attention if you have a fever and you:

• Are pregnant
• Recently returned from travel overseas
• Get infections often
• Are on chemotherapy, in which case you should seek medical attention immediately if the fever lasts for more than one hour.
• Have recently been bitten by a tick

Is 98.6 still considered “normal” body temperature?

Yes and no. You’ve probably always heard that the average body temperature is 98.6, but the truth is there’s a much wider range—from about 97 to 99 degrees F.

So why is 98.6 suddenly a myth after all these centuries? Research suggests body temperatures are falling overall. Doctors have a few ideas about why this is, including lower metabolic rates, lower rates of infection and more advanced thermometers.

A couple of helpful reminders:

1. As the saying goes, “Don’t fear the fever.” A fever is your body’s first line of defense in fighting off an infection.
2. If you are not fully vaccinated against COVID-19, and have developed a high-grade fever, please call your doctor right away.

Characteristics, Types, and When It’s Serious

A fever is a common side effect of illness like the flu. It happens when there is a temporary rise in body temperature. A fever is usually a sign that your immune system is busy fighting an infection or other illness.

In babies and toddlers even a slight fever may be a sign of a serious illness. In adults a fever is not usually serious or life-threatening.

However, sometimes a fever in adults can be a warning signal that something is not right. A high or persistent fever might be a sign of a serious health condition.

A fever is normally a short-term rise in temperature that helps your body get rid of illness. A fever begins when your immune system makes more white blood cells to fight an infection. The increase in white blood cells triggers your brain to heat your body up.

This causes a fever. In response, your body tries to cool itself off by tightening up on blood flow to your skin and contracting muscles. This makes you shiver and may cause muscle aches.

Your normal body temperature ranges from 97°F to 99°F (36.1°C to 37.2°C). You may have a fever if your temperature rises above this.

Adults typically have a fever if their body temperature increases to 100.4°F (38°C). This is called a low grade fever. A high grade fever happens when your body temperature is 103°F (39.4°C) or above.

Most fevers usually go away by themselves after 1 to 3 days. A persistent or recurrent fever may last or keep coming back for up to 14 days.

A fever that lasts longer than normal may be serious even if it is only a slight fever. This is because a recurrent fever might be a sign of a more serious infection or health condition.

Common fever symptoms in adults include:

• sweating
• chills (shivering)
• headaches
• muscle pain
• loss of appetite
• fatigue
• weakness

Call your doctor immediately if you have a high grade fever — when your temperature is 103°F (39.4°C) or higher. Get medical help if you have any kind of fever for more than three days. Let your doctor know if your symptoms get worse or if you have any new symptoms.

Serious symptoms

A fever may be a sign of serious illness if you have:

• a severe headache
• dizziness
• sensitivity to bright light
• stiff neck or neck pain
• skin rash
• difficulty breathing
• frequent vomiting
• dehydration
• stomach pain
• muscle cramps
• confusion
• seizures

Other signs that a fever may be serious are:

• pain when urinating
• not urinating enough
• passing dark urine
• passing urine that smells bad

If you have serious fever symptoms, let your doctor know if you have recently traveled to a different country or attended an event that had lot of people. This may help your doctor find out the cause.

Common causes of a fever in adults are:

• viral infection (like the flu or a cold)
• bacterial infection
• fungal infection
• food poisoning
• heat exhaustion
• serious sunburn
• inflammation (from conditions like rheumatoid arthritis)
• a tumor
• blood clots

Some adults may have a higher risk of getting a fever. If you have a chronic health condition or have been treated for a severe illness, you may be more likely to get a serious fever.

Let your doctor know about any fever symptoms if you have:

• asthma
• rheumatoid arthritis
• diabetes
• Crohn’s disease
• heart disease
• sickle cell disease
• liver disease
• kidney disease
• chronic lung disease
• cystic fibrosis
• cerebral palsy
• stroke
• multiple sclerosis
• muscular dystrophy
• HIV or AIDS

Some medications and treatments can also lead to a serious fever, these include:

• antibiotics
• blood pressure drugs
• seizure medications
• DTaP vaccine
• pneumococcal vaccine
• steroids
• chemotherapy
• radiation treatment
• methotrexate
• azathioprine
• cyclophosphamide
• post-transplant medications

A fever is not normally harmful on its own. Most fevers go away within a few hours to days as your body defeats an infection.

Help yourself feel better with these at-home flu remedies:

• stay hydrated by drinking plenty of fluids, such as:
  • water
  • juice
  • soup
  • broth
• eat light foods that are easy on the stomach
• rest
• use a cool compress, like a damp towel
• take a warm sponge bath
• dress in light, comfortable clothing
• turn down the temperature in your room

Over-the-counter medications can help ease your fever and symptoms, like headaches and muscle pain:

• ibuprofen (Advil, Motrin)
• acetaminophen (Tylenol)
• naproxen (Aleve, Naprosyn)

You may need treatment from your doctor for more serious causes of a fever. The treatment depends on the cause. Your doctor may prescribe medications to treat serious infections:

• antibiotics
• antivirals
• antifungals

A fever may be a sign of serious illness. A high fever can also cause serious side effects.

Emergency Symptoms

Get emergency medical attention by going to the ER or calling an ambulance if you have any of these symptoms:

• seizure or convulsions
• fainting or loss of consciousness
• confusion
• hallucinations
• severe headache pain
• stiff or painful neck
• difficulty breathing
• hives or a rash
• swelling in any part of the body

A fever in adults is usually not harmful on its own. It is a sign that your body is dealing with an infection or other illness. In some cases a high or long-lasting fever can be a sign of a serious illness. You may need urgent medical treatment.

Do not ignore a fever. Get plenty of rest and fluids to help your body heal. See your doctor if you have a fever that lasts longer than 3 days or if you have other severe symptoms.

If you have a chronic condition or have been treated for a serious illness, let your doctor know if you have any kind of fever.

Fever

The state of the body, characterized by a rise in body temperature above normal, is called fever. Normally, the temperature of the human body is maintained at a level of about 37 ° C, however, in some (often infectious) diseases, a protective and adaptive reaction occurs, which is based on an increase in body temperature with the obligatory preservation of the thermoregulation mechanism. This property is a hallmark of fever from hyperthermia (overheating). Pyrogens cause fever – substances that enter the body during infection (exogenous pyrogens) or are formed by cells of the immune system as a result, for example, of inflammation (endogenous pyrogens).

Fever always passes in three stages:

1. Rise in temperature – blood vessels constrict, skin becomes pale, chills, muscle trembling, metabolism in muscles increases. At this stage, heat production is much higher than heat transfer.
2. Temperature retention – the mechanisms of heat production and heat transfer are balanced – the temperature can be fixed for hours, days or weeks. Skin vessels dilate, the skin ceases to be pale and becomes hot to the touch, chills and trembling go away. At this time, a person experiences a feeling of heat.
3. Drop in temperature – both sudden and gradual decrease in body temperature is possible. At this stage, heat transfer significantly exceeds heat production, profuse sweating occurs and diuresis increases. This stage begins in case of exhaustion of exogenous reserves or cessation of production of endogenous pyrogens.

There are several types of fever:

• Remittent (laxative) type is characterized by diurnal changes in temperature, which does not drop to normal;
• Intermittent (intermittent) type characterized by rapid diurnal fluctuations in temperature, which falls to normal and rises again;
• Constant fever – slight fluctuations in elevated temperature during the day;
• Relapsing fever – constantly elevated temperature for one or more days, then its reduction to normal and repeated increase;
• Perverse fever – a rise in temperature in the morning is characteristic;
• Incorrect fever – temperature fluctuation during the day occurs without any dependence.

Most often, fever indicates the presence of an infectious disease, but it can also be a symptom of cancer.

Fever is treated by identifying and eliminating the source of the infection. If necessary, fever is removed with the help of antipyretics: Nurofen, Aspirin . For children, Nurfen suspension , Panadol suppositories are recommended. Also, to reduce the temperature, you can use alcohol compresses or cold lotions, body wraps and immersion in a cold water bath.

Pankratova Evgenia Igorevna

The material is for informational purposes only. Medicinal products, biologically active supplements and other products are indicated as an example of their possible use and / or application, which in no way constitutes a recommendation for their use. Before using drugs, dietary supplements and medical equipment and other products, be sure to consult a specialist.

Temperature in oncology, what is the temperature in case of cancer in an adult in the early stages?

Is there a fever in cancer? Yes, an increase in body temperature in oncological diseases is a common phenomenon, and its causes are different. The temperature in cancer does not belong to the typical signs of a malignant process, only in rare cases, cancer cells are able to independently initiate a temperature reaction by releasing, as expected, active substances. One cannot but agree that an oncological patient has more reasons for an increase in body temperature, both internal and iatrogenic – arising as a result of therapeutic measures.

Causes of fever

There are several reasons for fever in a cancer patient, but most often the temperature in oncology is a consequence of some processes:

• Vital activity of tumor cells producing biological products. This leads to systemic hyperthermia, which occurs in some types of lung adenocarcinoma, when a paraneoplastic syndrome develops with debilitating fever and joint pain. After removal of the tumor, all pathological manifestations disappear.
• Existence of a cancer conglomerate in tissues. Due to a decrease in local immunity and impaired blood supply, inflammatory changes develop, for example, with lung carcinoma or lung metastases.
• Reactions of the body to the absorption of toxic substances from a decaying cancer node.
• Aggressive therapeutic measures. As a rule, these are complications of immune suppression after a course of chemotherapy. From this list, we can conclude that fever is most common in metastases, when malignant cells have spread throughout the body and the disease requires more aggressive treatment.

In all cases, it is necessary to quickly understand, without an accurate understanding of the pathogenetic mechanism of the temperature reaction, it is impossible to prescribe adequate treatment. Sometimes the identification of causal relationships requires more effort than the diagnosis of a malignant tumor.

Temperature indicators in cancer

Does the temperature always rise in oncology? A fever in an oncological patient, as well as a decrease in the thermometer below 35.5 ° C, is an abnormal condition, the body temperature in cancer should be normal, and this should be strived for when choosing a treatment.

Daily fluctuations in heat transfer are natural in healthy people, the difference between morning and evening thermometer readings can reach up to one degree. Active movements and eating, nervousness and a nightmare also change degrees, but this is imperceptible to a person.

Failure of adaptive mechanisms in a cancer patient slows down the normalization of temperature fluctuations, stretching in time. Even a slight change in heat transfer affects the work of all organs: the nervous system is depleted, the cardiovascular system reacts, immune mechanisms and reparative processes are inhibited.

The normal range is two degrees between 35.5° and 37.4°, the rest is pathological.

Subfebrile temperature in cancer

Subfebrile body temperature in oncology is limited to 37.5°C to 38°C. This is a pre-febrile condition, but it is believed that short-term subfebrile condition does not require therapeutic intervention.

A prolonged increase – more than 5-7 days without a tendency to normalization will not be resolved without the complicity of a doctor, its cause may be inflammation and even sepsis, requiring the appointment of antibacterial drugs.

When a zone of reduced blood supply appears in the center of the cancer conglomerate with the formation of necrosis – the collapse of the tumor tissue can begin with local hyperthermia – local heating of the soft tissues above the focus, and with an increase in the volume of decay products absorbed into the general bloodstream, lead to persistent low-grade fever.

High fever in cancer

High temperature or febrile fever is detected when the thermometer is above 38°C. On the one hand, this indicates a protective reaction of the body, but the temperature after chemotherapy is usually an unfavorable consequence of a significant decrease in neutrophilic granulocytes, a subtype of leukocytes.

Fever with a decrease in immune cells in eight out of ten cases is due to a septic condition in the absence of “classic” signs of blood poisoning and requires emergency treatment.

Quite often, a prolonged fever slightly above 38°C manifests multiple liver lesions with cancer metastases with the development of liver failure.

A high temperature can manifest a malignant brain tumor located near the center of thermoregulation, or perforation into the abdominal cavity of a carcinoma of the colon or stomach.

Low temperature in cancer

Is there a temperature below normal in oncology? Yes, it happens, and it is also dangerous. A decrease in the thermometer below 36 ° C with an increase or decrease in the number of leukocytes, along with persistent tachycardia or shortness of breath, can also be a manifestation of systemic inflammation syndrome – sepsis. Moreover, low body temperature in oncology does not necessarily have to be accompanied by a pronounced decrease or increase in the number of leukocytes, less than 4 thousand or more than 12 thousand is enough, but functionally incapable of an adequate fight against infectious agents.

Temperature during chemotherapy

Chemotherapy requires a normal body temperature – a marker of the normal state of the body at a given time. Any deviations of thermoregulation from the norm can be a manifestation of sluggish inflammation or intoxication. Chemotherapy for a decaying cancer conglomerate can aggravate the pathological process and cause internal bleeding.

An increase in temperature during chemotherapy and the development of a feverish state a week after the course indicates hematological complications that are life-threatening in case of insufficient immunological protection.

Is it necessary to bring down the fever in oncology?

To begin with, let’s figure out what temperature is acceptable for oncology. Do not needlessly ask the question: “What temperature is not dangerous for cancer?” – in a malignant disease, any violations of heat transfer are unfavorable. In part, degrees above the norm are not even important, it is enough that there is a temperature in cancer when it should not be.

If the temperature rises due to oncology: what to do? You can reduce the temperature reaction by taking NSAIDs if it is hard for the patient’s body, but it is more correct to immediately consult a doctor. Primary differential diagnosis is carried out at the patient’s bed, the main thing is to exclude blood poisoning against the background of a malignant process.

The development of cancer without an increase in temperature is quite possible, but at different periods of the disease, its increase may be a complication of the treatment or progression of the tumor lesion. It is necessary to quickly figure out if the patient has a temperature with cancer, and most importantly, accurately diagnose and offer the best solution to the problem. Euroonco has all the conditions for adequate medical care for any patient and at any time of the day.

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References

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2. Ptushkin VV/ Treatment and prevention of infections in patients with neutropenia// Mater. III Ross. oncol. conf.; 2003.
3. Sakaeva D.