What is considered a dangerous fever. Dangerous Fever: Understanding High Temperature Risks and Treatment Options
What is considered a dangerous fever. How high should a temperature be before seeking medical attention. When does a fever become life-threatening. What are the symptoms of a dangerously high fever. How to treat high fevers at home and when to see a doctor.
What Defines a Fever and When Does It Become Dangerous?
A fever is generally defined as a body temperature above the normal 98.6°F (37°C). But at what point does an elevated temperature become concerning? Let’s explore the different levels of fever and their potential risks.
Low-grade fevers range from 98.6°F to 100.4°F (37°C to 38°C). These are usually not cause for alarm in healthy adults and often indicate the body is fighting off a minor infection. High-grade fevers, on the other hand, are temperatures above 103°F (39.4°C) and may require medical attention, especially if persistent or accompanied by other concerning symptoms.
For infants under 3 months, any fever can be serious and warrants immediate medical evaluation. In older children and adults, the duration and associated symptoms are often more important than the number on the thermometer.
When to Seek Medical Care for a Fever
- Temperature over 103°F (39.4°C) that doesn’t respond to treatment
- Fever lasting more than 3 days
- Severe headache or neck stiffness
- Confusion or difficulty waking
- Shortness of breath or chest pain
- Abdominal pain or frequent vomiting
- Skin rashes or bruising
Remember, these guidelines are general. Trust your instincts and don’t hesitate to contact a healthcare provider if you’re concerned about a fever, regardless of the temperature reading.
Understanding the Body’s Temperature Regulation
Our body temperature isn’t static; it fluctuates throughout the day. The hypothalamus, a small region in the brain, acts as our internal thermostat. During a fever, it essentially “resets” our body to a higher temperature as part of the immune response.
Why does our temperature rise during illness? The increased heat creates an inhospitable environment for many pathogens and enhances immune system function. While uncomfortable, a moderate fever can actually be beneficial in fighting off infections.
Factors Affecting Body Temperature
- Time of day (typically lower in the morning, higher in the evening)
- Physical activity
- Hormonal changes (e.g., menstrual cycle)
- Environmental conditions
- Recent food or fluid intake
- Certain medications
Given these variations, it’s important to consider context when interpreting temperature readings. A slight elevation might be normal for some individuals or at certain times of day.
Fever Symptoms and Associated Conditions
While an elevated temperature is the primary indicator of a fever, it often comes with a constellation of other symptoms. Understanding these can help gauge the severity of the illness and determine appropriate care.
Common Fever Symptoms
- Chills and shivering
- Sweating
- Headache
- Muscle aches
- Weakness and fatigue
- Loss of appetite
- Dehydration
- Irritability
Is it possible to have a fever without feeling hot? Yes, particularly in the early stages when chills may be more prominent. As the body works to raise its temperature, you might feel cold despite having an elevated internal temperature.
Conditions That Can Cause High Fevers
While infections are the most common cause of fevers, other conditions can lead to elevated body temperatures:
- Viral infections (flu, COVID-19, etc.)
- Bacterial infections (strep throat, urinary tract infections, etc.)
- Certain inflammatory conditions (rheumatoid arthritis, lupus)
- Heat exhaustion or heat stroke
- Some medications and vaccinations
- Malignant tumors (rarely)
Identifying the underlying cause of a fever is crucial for proper treatment. If a fever persists or is accompanied by concerning symptoms, professional medical evaluation is recommended.
Fever in Children: Special Considerations
Fevers in children often cause more concern than those in adults, and for good reason. Young bodies can be more vulnerable to rapid temperature changes, and high fevers in infants and toddlers can sometimes lead to complications.
Age-Specific Fever Guidelines
- 0-3 months: Any fever (100.4°F/38°C or higher) requires immediate medical attention
- 3-6 months: Fever above 102°F (38.9°C) warrants a call to the doctor
- 6 months to 2 years: Fever lasting more than 24 hours should be evaluated
- 2 years and older: Fever lasting more than 3 days or accompanied by concerning symptoms needs medical attention
How can you tell if a child’s fever is serious? Beyond temperature, observe their behavior. A child who is still playing and eating normally is likely coping well, even with a relatively high fever. Lethargy, refusal to eat or drink, and extreme irritability are more concerning signs.
Febrile Seizures: What Parents Should Know
Febrile seizures can occur in some children between 6 months and 5 years of age when they have a fever. While frightening to witness, these seizures are generally harmless and don’t indicate epilepsy or brain damage.
If your child experiences a febrile seizure:
- Place them on their side on a flat surface
- Remove any nearby objects that could cause injury
- Loosen tight clothing
- Do not try to stop the seizure or put anything in their mouth
- Time the seizure – if it lasts more than 5 minutes, call emergency services
After the seizure, contact your pediatrician for guidance on next steps and to rule out any underlying conditions.
Measuring and Monitoring Fever Accurately
Accurate temperature measurement is crucial for assessing the severity of a fever and deciding on appropriate treatment. Different types of thermometers and measurement methods can yield varying results.
Types of Thermometers
- Digital thermometers: Fast, accurate, and suitable for oral, rectal, or axillary (armpit) use
- Tympanic (ear) thermometers: Quick and convenient, but can be less accurate if not used correctly
- Temporal artery thermometers: Non-invasive and good for all ages, but may be affected by environmental factors
- Infrared non-contact thermometers: Convenient for screening but less accurate for diagnostic purposes
Which method of temperature measurement is most accurate? Rectal temperatures are considered the gold standard, especially for infants. However, oral temperatures using digital thermometers are sufficiently accurate for most situations in older children and adults.
Tips for Accurate Temperature Readings
- Wait at least 30 minutes after eating, drinking, or exercising before taking oral temperatures
- For oral readings, place the thermometer under the tongue towards the back of the mouth
- Ensure proper placement for ear thermometers by gently pulling the ear up and back
- Take multiple readings to confirm results, especially if the temperature seems unusually high or low
- Clean thermometers thoroughly between uses to prevent spread of infection
Remember that normal body temperature can vary by up to 1°F (0.6°C) throughout the day. Keeping a log of temperature readings along with the time and any accompanying symptoms can provide valuable information for healthcare providers.
Treatment Options for Managing Fevers
While fevers are often a sign that your body is fighting an infection, there are ways to alleviate discomfort and prevent complications. The approach to treating a fever depends on its severity, underlying cause, and the individual’s overall health.
Home Remedies for Fever Relief
- Rest: Allow your body to conserve energy for fighting the infection
- Hydration: Drink plenty of fluids to prevent dehydration
- Cool compresses: Apply to forehead, wrists, or back of neck
- Lightweight clothing: Dress in breathable fabrics
- Room temperature: Keep the environment comfortable, not too hot or cold
Is it better to bundle up or stay cool when you have a fever? Contrary to the old adage of “sweating out a fever,” it’s generally better to stay comfortably cool. Excessive bundling can prevent heat dissipation and potentially raise body temperature further.
Over-the-Counter Medications
Fever-reducing medications can help manage discomfort, but they don’t treat the underlying cause of the fever. Common options include:
- Acetaminophen (Tylenol)
- Ibuprofen (Advil, Motrin)
- Aspirin (not recommended for children due to risk of Reye’s syndrome)
Always follow dosage instructions carefully and consult a healthcare provider before giving any medication to infants or young children.
When should you not treat a fever? Mild fevers (below 101°F/38.3°C) in otherwise healthy individuals often don’t require treatment. The elevated temperature can actually help your body fight off the infection more effectively.
Prevention and Long-Term Health Considerations
While fevers are often unavoidable, there are steps you can take to reduce your risk of infections that lead to fevers and to maintain overall health that supports your immune system.
Strategies for Preventing Infections
- Practice good hand hygiene
- Stay up to date on vaccinations
- Maintain a healthy diet rich in fruits and vegetables
- Get adequate sleep and manage stress
- Exercise regularly to boost immune function
- Avoid close contact with individuals who are ill
How can you strengthen your immune system naturally? While no single action can guarantee immunity, a combination of healthy lifestyle choices can support your body’s defenses. Regular exercise, a balanced diet, adequate sleep, and stress management all play crucial roles in maintaining a robust immune system.
Long-Term Effects of Recurrent Fevers
Occasional fevers are a normal part of the body’s immune response. However, frequent or prolonged fevers may indicate an underlying health issue that requires medical attention. Conditions that can cause recurrent fevers include:
- Chronic infections
- Autoimmune disorders
- Periodic fever syndromes
- Certain cancers
If you experience fevers more often than seems normal, keep a detailed log of your symptoms and consult with a healthcare provider. They may recommend further testing to identify any underlying causes and develop an appropriate treatment plan.
Remember, while fevers can be uncomfortable and sometimes concerning, they are often a sign that your body is working as it should to fight off infections. By understanding what constitutes a dangerous fever, knowing how to accurately measure and monitor temperature, and implementing appropriate treatment strategies, you can navigate fever episodes with confidence and seek medical care when necessary.
What Is Considered a Fever? Symptoms & Treatment
It’s relatively common knowledge that the normal body temperature is 98.6° F (37° C), but your core body temperature actually varies by a degree or so throughout the day. For instance, your body temperature will be slightly lower in the morning and higher in the late afternoon into the evening. However, certain factors may cause your body temperature to dive below what’s considered normal or spike to pyrexia, more commonly known as a fever.
Unlike hypothermia, an emergency condition that develops when your body temperature reaches 95° F (35° C) or lower, a fever is fairly common and, in most cases, not very dangerous. Developing an elevated body temperature—whether it’s a high or low grade fever—is usually your body’s response to infection. Luckily, fevers typically last only a few days and there are several treatment options that can help you feel more comfortable.
What Is a Fever?
The normal human body temperature is 98. 6° F (37° C), but other factors, including illness, certain medications, and specific medical conditions, can cause your temperature to rise. A fever is your body’s natural response to fighting an infection.
Any temperature between 98.6-100.4° F (37-38° C) is considered a low-grade fever, while any temperature above 103° F (39.4° C) is considered a high-grade fever. Unlike a significantly lower-than-normal body temperature, having a higher temperature isn’t necessarily dangerous.
One factor that differentiates what is considered a low or high body temperature is age. For adults and children, 95.1-96.9° F (35-36° C) is low and 100.4-103° F (38-39.4° C) is high, but neither case is necessarily an emergency. However, if a baby less than three months old experiences a temperature in either range, it may indicate a serious infection that requires immediate medical care.
This easy-to-read chart shows what various body temperatures mean and when to seek care. The measurements in this chart were made by mouth with the thermometer under the tongue.
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Fever in Children
When adults develop a fever, they usually feel uncomfortable, but there’s typically no cause for concern, although an exception to this rule arises when an adult is undergoing chemotherapy treatment or has any condition which impairs the body’s ability to fight infections. When infants, toddlers, and children develop fever symptoms, they are more likely to need medical care.
If your toddler or child has a fever, but is still responsive, eating, drinking fluids, and playing, there’s no cause for concern. However, if your infant, toddler, or child experiences the following, you should either call your doctor or seek immediate care:
- More Irritable than usual
- Vomiting repeatedly
- A fever lasting more than three days
- Appears listless and unresponsive
Complications in children
Although fevers in children are quite common, some children between the ages of six months and five years may experience complications, such as febrile seizures or convulsions. Luckily, most children who experience fever-induced convulsions suffer no lasting effects and are not thought to be at higher risk of developing seizures or epilepsy later in life.
If your child has a seizure resulting from a fever, do the following:
- Lay your child on the floor on his or her side or stomach
- Clear the vicinity of any sharp objects
- Loosen any tight clothing
- Do not try to stop the seizure yourself
- Hold your child in place to prevent injury
Fever symptoms generally cause discomfort because your body is working to fight off an infection.
When you develop pyrexia, the most common symptoms you might experience include sweats, shivers, and headaches. Other common fever symptoms include:
- Chills
- Muscle aches
- Loss of appetite
- Irritability
- Dehydration
- Lethargy
What Causes a Fever?
Your body’s internal thermostat is controlled by a small area in your brain called the hypothalamus. When your hypothalamus sets your internal body temperature higher than usual, this results in a fever. Usually the hypothalamus will reset this internal thermostat to normal within a few days. Although infection (which can be caused by either bacteria or viruses) is more often than not the cause of your fever, other causes include:
- Heat exhaustion
- Inflammatory conditions, such as rheumatoid arthritis
- Malignant tumors
- Drugs for high blood pressure and/or seizures
- Specific immunizations, such as diphtheria, tetanus, and pneumococcal vaccines
Diagnosing a Fever
Unlike many other illnesses, diagnosing a fever is something you can do at home. You should only seek medical attention if your high fever lasts more than a few days or is accompanied by any concerning symptoms.
Taking a temperature
The most obvious indication of a fever is a body temperature that’s higher than normal. The best way to measure your temperature is to take it using a thermometer. There are several different types of thermometers, but the most popular is a digital one, which you can use orally, rectally or axillary (under your armpit). Regardless of which type of thermometer you use, always be sure that the batteries aren’t expired as that may skew the results.
Other types of thermometers include a tympanic thermometer, which measures the temperature inside of the ear by reading the infrared heat. Most pediatricians use this method to take babies’ temperature if they’re three months or older.
Here’s how to use a digital thermometer:
- Make sure your hands and the thermometer are clean.
- Do not eat or drink anything for at least five minutes before you take your temperature because the food/drink may skew the results.
- Place the thermometer tip under the tongue, into the anus (using a petroleum jelly), or into your armpit and wait about 40 seconds. Most thermometers will beep when they have an accurate reading.
- Remove the thermometer and clean it with soap and water or with alcohol. Afterwards, be sure to rinse it.
Treatments for Fever
If you have a low-grade fever (up to 100.4° F and 38° C ), the best treatment may be letting the fever run its course. Having a slightly elevated body temperature can help get rid of the illness-causing microbes that are responsible for your cold, flu, or other viral infection. In cases of a high fever, there are a number of actions you can take to help lower your body temperature.
How to break a fever
As previously mentioned, having a fever isn’t necessarily a bad thing. It’s a sign that your body is fighting off an infection. However, in some cases, breaking your fever, or reducing your body’s temperature, can be helpful in making you feel more comfortable. Some of the most common ways to break a fever include:
- Over-the-counter medications: There are a variety of over-the-counter medications, such as acetaminophen and ibuprofen, that can help break your fever. However, taking too much of these medications or using them regularly over a prolonged period of time can cause liver and kidney damage. Children should never take aspirin, as it can cause a potentially fatal disorder called Reye’s syndrome.
- Antibiotics or antivirals: Depending on what’s causing your fever, your doctor may prescribe an antibiotic for a bacterial infection and an antiviral for a viral infection. Taking either, as directed by your doctor, can help break your fever.
- Hydrate: Drink plenty of non-alcoholic or caffeinated fluids to counteract the dehydration associated with fever.
- Let your body rest: Getting ample rest and staying cool can also help lower your fever.
What to eat when you have a fever
While your body and immune system need nutrients to fight off infection, your illness may be accompanied by nausea or lack of appetite. In that case, do not force yourself to eat. In fact, you should only eat if you are able to keep down food and if you feel hungry. Although the best thing you can do for a fever is to drink plenty of fluids, eating chicken soup has proven helpful as well. Other helpful foods include:
- Greek yogurt: If you can tolerate dairy, greek yogurt is an excellent food to eat when you have a fever because it contains a lot of probiotics, which help your immune system.
- Coconut water: Coconut water is naturally rich in electrolytes and potassium.
- Fruits with vitamin C: Most fruits are at least 80% water, making them an excellent source of hydration. Fruits containing vitamin C, such as oranges, can also help improve your immune response.
- Protein-rich foods: Foods including beans, nuts, lean meat, and poultry are high in protein, which your immune system needs in order to produce antibodies and fight off an infection.
Fever Prevention
The most effective way to prevent a fever is to avoid contracting an infection. While that’s not always possible, you can take the following steps to minimize your exposure to germs and diseases:
- Wash your hands: Wash your hands often with an antibacterial soap for at least 20 seconds.
- Use hand sanitizer: If you’re traveling and water and soap aren’t immediately available to you, using a hand sanitizer with at least 60% alcohol will help kill any germs.
- Avoid touching your face: Even if you wash your hands or use hand sanitizer, you may still be at risk, so avoid touching your nose, eyes, and mouth to prevent contracting an infection.
When to See a Doctor
Just because you have a fever doesn’t mean you need to pay a visit to the doctor. However, if you have a fever of 103° F (39.4° C), you should call your doctor, especially if your fever is accompanied by any of the following:
- Severe headache
- Skin rash that worsens quickly
- Sensitivity to light
- Stiff neck and/or pain when you bend your head forward
- Mental confusion
- Consistent vomiting
- Difficult breathing and/or chest pain
- Abdominal pain and/or pain when urinating
- Convulsions and seizures
- Severe sore throat or difficulty swallowing
- You are undergoing chemotherapy or other treatments for cancer or have any underlying chronic condition which suppresses your immune system
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How K Health Can Help
While most fevers you can handle at home, sometimes you may need to speak to a doctor to make sure nothing more serious is going on.
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K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
Fever – normal and high body temperature, fever medicines and more
Key facts
- Fever is a part of your body’s immune response and is usually caused by infection.
- A fever causes a high temperature but can also cause sweating and chills.
- You can take your temperature with a thermometer to check if you have a fever.
- If you or your child has a fever, rest, keep cool and stay hydrated.
- If you experience other symptoms like severe headache, vomiting, confusion or a stiff neck, see a doctor.
Fever is one of the symptoms of COVID-19. Even if your symptoms are mild, get tested for COVID-19 immediately — use the fever Symptom Checker if you’re not sure what to do.
What is a fever?
A fever is when your body temperature is higher than normal. Having a fever can also be called ‘having a temperature’.
A normal temperature is around 36°C to 37°C, although it depends on:
- your age
- what you’ve been doing
- the time of day
- how you take the measurement
What are the symptoms of a fever?
If you have a fever, you will have a high temperature. A high temperature is usually considered to be above 38°C. You may also have other symptoms, such as:
- sweating
- chills
- shivering
- aching muscles and joints
What causes a fever?
Fever is a part of your immune system response. If you have a fever, it is a sign that your body is working hard to get well.
A high temperature is most often caused by a viral infection such as:
- colds and flu
- COVID-19
- gastroenteritis
However, fever can also be caused by bacterial infections, such as:
- ear infections
- throat infections
- pneumonia
- urinary tract infections
- meningitis
CHECK YOUR SYMPTOMS — Use the fever Symptom Checker and find out if you need to seek medical help.
How is fever diagnosed?
Fever is diagnosed by taking your temperature. You can do this yourself. You probably have a fever if your temperature is 38°C or higher.
A doctor can find the cause of your fever by:
- asking questions about your symptoms
- examining you
- perhaps doing some blood tests
Taking your temperature
You can take your temperature quickly and easily using a thermometer.
You can buy a thermometer from a chemist or supermarket. Different types of thermometers measure temperature through different parts of your body, such as:
- touchless forehead thermometers
- in the ear
- under the armpit
- under the tongue
- in the rectum
Make sure the thermometer is clean.
Check the manufacturer’s instructions to find out how to use your thermometer.
Digital thermometers
Digital thermometers can measure temperature faster than a glass thermometer.
Ear thermometers
Ear thermometers can be used to measure the temperature of children over 6 months.
Tape thermometers
Plastic tape thermometers, which you hold on your forehead, aren’t an accurate way of taking your temperature.
Mercury thermometers
Mercury thermometers were used in the past. You shouldn’t use mercury thermometers today. They can break, releasing small shards of glass and mercury fumes.
If you break a mercury thermometer, there are steps you can take to stay safe.
- Get any people or animals out of the room.
- Clean the spill using gloves.
- Pick up any broken glass with paper towel.
- Scrape up any mercury using cardboard.
- Place waste into zip lock bags or a sealable container.
- Keep the waste stored until you can take it to a household hazardous waste disposal facility.
- Call the Poisons Information Centre on 13 11 26 if anyone is exposed to mercury.
If you have a mercury thermometer, don’t throw it in your household bin.
How is fever treated?
If you have a high temperature there are several things you can do to help manage your condition.
Keep hydrated
It’s important to stay well hydrated. Try to drink plenty of clear, non-alcoholic fluids, such as:
- water
- juice
- cordial
Keep cool
Wear lightweight clothing, and avoid using bedding such as blankets, doonas and quilts. These can make you too hot and increase your temperature. Keep the room at a comfortable temperature.
Avoid taking cold baths or sponging. This can actually make you feel more uncomfortable.
Rest
If you have a fever, you should rest and avoid heavy activity until your symptoms go away. If your fever doesn’t go away, or you are concerned, see your doctor.
Fever in children
If you are caring for a sick child, learn more about fever and high temperature in children here or view this infographic.
Medicine
Don’t take medicines for fever unless you are experiencing discomfort.
If you’re experiencing discomfort, you can consider pain relief medicines such as:
- paracetamol
- ibuprofen
Before taking any medicine, you should check that it’s safe to take them:
- with any medical conditions that you may have
- with any other medicines that you are taking
- if you are pregnant or breastfeeding
Infographic: fever in babies and children
To check this, read the information leaflet inside the medicine packet. You can also ask a pharmacist.
When should I see my doctor?
Adults with a fever should see a doctor straight away if they have symptoms such as:
- a severe headache
- sensitivity to bright light
- an unusual skin rash
- a stiff neck
- vomiting
- confusion
- drowsiness
- difficulty breathing
- abdominal (tummy) pain
- hallucinations
- seizures or muscle spasms
If your child has a fever, see a doctor right away if they:
- are under 3 months
- are getting sicker
- seem dehydrated or won’t drink
- are vomiting
- are drowsy or unresponsive
- have difficulty breathing
- seem very distressed
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Can fevers be prevented?
If your fever doesn’t go away, or you experience other symptoms mentioned above, you can prevent further complications by seeking medical attention.
Lowering or preventing a fever won’t help treat the cause of your fever.
Resources and Support
You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.
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Fever | Didkovsky N.A., Tanasova A.N.
L fever – an increase in body temperature as a result of a non-specific protective and adaptive reaction of the body, characterized by a restructuring of thermoregulation processes and occurring in response to exposure to pathogenic stimuli. There are fever infectious and inflammatory nature (viruses, bacteria, intracellular parasites) and non-infectious genesis (autoimmune processes, allergic diseases, tumors, metabolic disorders, the use of certain drugs, etc.) [2]. The regulation of body temperature is carried out with a complex interaction of the nervous, endocrine and immune systems. The most common trigger in the development of hyperthermia are exogenous pyrogens (bacteria, viruses, toxins, etc.), which, when ingested, stimulate the production of endogenous pyrogens by blood cells [4].
Fig.1. The mechanism of development of fever under the influence of exogenous and endogenous pyrogens. ACTH – ACTH, CRF – corticotropin-releasing factor, PGE2 – prostaglandin E2 (CECIL Textbook of Medicine, 19 h edition).
Currently, 11 cytokines are known to have pyrogenic activity, the most important of which are interleukins – IL-1 and IL-6, as well as tumor necrosis factor – TNF-a [4]. Endogenous pyrogens are produced by stimulated monocytes and macrophages. The properties of pyrogens are also possessed by a-, b- and g-interferons. IL-1 and TNF-a are transported with the blood stream to target cells that carry specific receptors for these cytokines, and act on thermosensitive neurons in the preoptic region of the hypothalamus through increased prostaglandin (PG) synthesis E 2 and PGF 2a from arachidonic acid.
Fig. 2. Metabolism of arachidonic acid (according to A.A. Yarilin) [3]. International abbreviations for prostaglandins (PG), leukotrienes (LT) and thromboxanes (Tx) are used.
The exact mechanism of “switching” of the thermoregulation center under the action of PG has not yet been established. The direct effect of cytokines on the nervous tissue is not excluded. An increase in body temperature activates metabolic processes, the functions of the nervous, endocrine, and immune systems (an increase in the production of antibodies, interferon, an increase in chemotaxis, phagocytic and bactericidal activity of neutrophils), an increase in the antitoxic function of the liver, and an increase in renal blood flow. IL-1 and TNF-a are able to enhance the immune response by activating T-cells and stimulating the production of IL-2. Under the action of IL-1, B-cell proliferation is enhanced, which is accompanied by an increase in antibody formation. It is important to note that these processes proceed most intensively at a temperature of 39°C. Under the action of endogenous pyrogens, the synthesis of “acute phase” proteins (fibrinogen, C-reactive protein, complement fractions B, C 3-4, alpha-glycoprotein, serum amyloid A, proteinase inhibitors) is stimulated by the liver, which play an important role in specific and non-specific protection. Hyperthermia is accompanied by a decrease in serum levels of iron, zinc and copper, which inhibits the growth and reproduction of microorganisms.
In a typical course, fever goes through the following phases or periods – a prodromal period, a period of temperature rise, a period of relative stability, a period of decrease in body temperature, each of which is accompanied by certain vegetative reactions. What changes accompany the development of fever?
1) Tachycardia. With an increase in body temperature by 1 ° C, an increase in heart rate by 10–15 beats per minute occurs.
2) It is possible to develop extrasystole, which is due to both the direct toxic effect of bacteria and viruses, and the activation of the sympathetic-adrenal system under the influence of cytokines.
3) In the phase of temperature rise, an increase in blood pressure is possible, and in the phase of temperature decrease, blood pressure drops to a collaptoid state against the background of a decrease in TPS.
4) Upon reaching the maximum body temperature, the process of sweating increases significantly (up to 1 liter of sweat per day is possible), which can contribute to a decrease in BCC and lead to a deterioration in the condition of patients with pathologies of the cardiovascular system. Fluid losses are also aggravated by a compensatory increase in respiratory rate at the height of fever.
5) At the height of fever and even after normalization of temperature, transient appearance in the urine of protein, casts and an increase in creatinine levels is possible. These changes are associated with the direct damaging effect of fever.
6) Fever affects the activity of various parts of the gastrointestinal tract, which is manifested by impaired secretion of digestive juices, impaired motility and absorption processes. As a result, there may be a decrease in appetite, the development of a syndrome of impaired absorption and constipation (the latter has a particularly adverse effect on elderly patients). Loss of appetite during fever is associated both with functional disorders of the gastrointestinal tract and with the direct influence of cytokines. So, with prolonged exposure to high concentrations of TNF-a (which has a second name in Western literature – “cachectin”) and partially IL-1, depletion may develop due to the suppression of hunger / appetite (which is most typical for chronic infections and oncological processes).
7) Against the background of fever, metabolic processes in cells increase sharply (with an increase in body temperature by 0. 6 ° C, the level of basal metabolism increases by approximately 10%), redox processes accelerate, and oxygen consumption increases. Hyperthermia can increase blood glucose levels, increasing protein catabolism (negative nitrogen balance). Loss of protein up to 300-400 grams per day is possible. A decrease in diuresis against the background of a reduced BCC can lead to the development of metabolic acidosis.
8) Changes in consciousness (from minor to the development of a delirious state) are associated with the release of b-endorphins under the influence of TNF-a and IL-1. The risk group includes young children, the elderly, patients with pathology of the cardiovascular system, as well as people who abuse alcohol.
9) Due to the immaturity of the central nervous system and the imperfection of the thermoregulation system in children under the age of 5 years, the development of febrile convulsions is possible.
10) An increase in body temperature can lead to the activation of latent herpesvirus infection (HSV-1). For reasons that are not completely clear, most often herpetic eruptions accompany diseases caused by a pyogenic bacterial infection (pneumococci, streptococci, meningococci), malaria, and rickettsiosis. Nasolabial herpes is a marker of reduced cellular immunity. It is important to note that subjective sensations during fever are of a different nature. Some patients are sensitive to even small fluctuations in body temperature, while others do not experience discomfort with a significant increase in temperature (for example, with pulmonary tuberculosis). However, in most cases, patients complain of weakness and malaise, headache, pain in the muscles and joints, chilling or excessive sweating, which “pushes” the doctor to prescribe antipyretics. When deciding on the need to prescribe non-steroidal anti-inflammatory drugs (NSAIDs), it is necessary to take into account both positive and potentially dangerous manifestations of fever. It must be remembered that fever, like any protective-adaptive reaction, with the depletion of compensatory mechanisms or with a hyperergic variant, can cause the development of pathological conditions. So, an excessive increase in temperature leads to inhibition of immune responses, impaired function of parenchymal organs, the development of febrile convulsions, functional and degenerative disorders in the cardiovascular and central nervous system. A critical decrease in body temperature can contribute to the development of collapse due to a sharp drop in total peripheral resistance and aggravate the condition of patients with pathology of the cardiovascular system.
So in what case is it necessary to use antipyretics?
An increase in body temperature within 3°C does not have a damaging effect on the human body, however, its increase by more than 6°C (i.e. more than 42.2°C) leads to irreversible changes in brain structures, which is a condition incompatible with life. When deciding on the need to prescribe NSAIDs, it is necessary to take into account the age of the patient, the severity of the underlying and concomitant diseases, as well as the subjective tolerance of fever.
Currently NSAIDs are widely used in the symptomatic treatment of fever in ARVI. However, little attention is paid to non-drug (physical) methods of lowering body temperature, which is especially important in pediatric practice. I would like to remind you that physical methods of lowering the temperature (such as wiping the body with a weak solution of vinegar, applying cold to the area of large arteries, wet wrapping, a warm (not cold!) bath, an enema with water at room temperature) are recommended not only in domestic, but also in modern foreign literature, they can be quite effective and have no side effects. It is necessary to remember such rules for caring for patients with fever, such as an adequate drinking regimen, a sparing diet, mandatory ventilation of the room, and the prohibition to “wrap up” the patient, since the latter prevents heat transfer.
In febrile conditions on the background of infectious and inflammatory diseases, rectal suppositories Cefecon N are used as an antipyretic, anti-inflammatory and analgesic. Cefecon N suppositories are a unique combination of naproxen, caffeine and salicylamide, which ensures high antipyretic, analgesic activity. Cefecon H has a number of advantages over oral NSAIDs.
Before entering the systemic circulation, medicinal substances must pass through the stomach, small intestine, liver, where they are destroyed and adsorbed to a certain (sometimes significant) degree, which can lead to damage to this organ. Even if taken on an empty stomach, drugs enter the systemic circulation on average no earlier than 30 minutes later. When taking drugs orally in the form of powders and especially tablets, there is the greatest likelihood of their local irritating effect on the gastric mucosa.
With the rectal route of administration, the intake of substances adsorbed in the rectum is carried out simultaneously through the circulatory and lymphatic systems, which are especially developed in this area. In this case, an insignificant part of the adsorbed drugs enters the portal vein, which carries blood from the internal organs to the liver. Moreover, bioavailability from the rectal mucosa for a number of drugs is equivalent to that after intravenous administration. Thus, the introduction of NSAIDs in suppositories can reduce the risk of side effects from the gastrointestinal tract and ensure that the full dose of the drug is delivered, regardless of food intake and concomitant therapy (for example, antacids). In this regard, the use of NSAIDs in the form of rectal suppositories (Cefecon N) seems to be a very promising direction.
Despite the fact that, in the understanding of the patient, fever is often an undesirable manifestation of the disease, the doctor, when determining the strategy for treating the patient, must take into account the positive factors of the hyperthermic reaction. Moreover, the elimination of fever should not be the main goal of the therapy (which often occurs in the presence of SARS). It is well known that the course of an infectious disease without a temperature reaction may indicate that the patient has an immunodeficiency state and is an unfavorable prognostic factor.
1. Luchsheva Yu., Cold. How to deal with it. The effectiveness of symptomatic therapy for acute respiratory viral infections // Pharmaceutical Bulletin No. 37 (236), 2001.
2. NSAIDs: the role of rectal suppositories.//Russian Medical Journal, Vol. 10, No. 21(165), 2002, pp. 982–986.
3. Yarilin A.A., Fundamentals of immunology, M. “Medicine”, 1999, pp. 163–168.
4. Bruce Beutler, Steven M. Beutler, The Pathogenesis of Fever// CECIL Textbook of Medicine,19th edition, 1994, p.1568–1571.
5. Cranswick N, Coghlan D., Paracetamol efficacy and safety in children : the first 40 years// Am J Ther, 2000, 7(2): 135–41.
6. Glasow.J.F.T., Middleton B., Reye syndrome – insights on causation and prognosis// Arch Dis Child, 2001, 85, 351–353.
what to do, what temperature is considered high and why it is dangerous, causes and symptoms
Fever, fever – this is what we call an increase in body temperature. This is the most important defense mechanism of the human body and one of the main symptoms of infection. Most often, we encounter a fever with colds and flu. High temperatures cause some discomfort, but it helps to cope with the disease faster. We will tell you why adults have a fever, when it is necessary to bring down the temperature, and in what cases it is not worth it.
Why the temperature rises
1
Body temperature can rise for various reasons: due to overheating, inflammation, hormonal imbalance. The processes of heat transfer in the human body are regulated by a small part of the brain – the hypothalamus. The temperature rises with any physical or chemical impact on it.
An increase in body temperature associated mainly with infections is called a fever. It develops when biologically active substances, cytokines, act on the hypothalamus. The immune system releases them into the blood in response to the inflammatory process. The production of cytokines is also enhanced by the waste products of microbes.
Fever is one of the main symptoms of an acute respiratory viral infection (ARVI). But it is also a protective reaction of the body, aimed at fighting the virus. When the temperature rises, the immune system synthesizes more leukocytes, which destroy or inactivate pathogenic microbes, and interferons, natural antiviral substances.
What temperature is considered high
2.3
A temperature above 37˚C measured in the armpit is considered elevated. When measuring temperature in the oral cavity, a temperature of more than 37.2˚C is considered elevated, and in the rectum – more than 37.8˚C.
Types of fever:
● Subfebrile – 37.5–38˚C. Accompanies a chronic or easily flowing acute infection.
● Febrile – 38-39˚C. A frequent companion of most acute inflammatory processes – infectious and non-infectious.
● Pyretic (high) – 39-41˚C. This is one of the signs of a moderate flu. High fever is accompanied by symptoms that worsen well-being.
● Hyperpyretic (critically high) – more than 41˚C. It occurs in a severe form of influenza, causes life-threatening disorders of body functions.
What symptoms accompany fever
4, 5
Subfebrile temperature is accompanied by weakness, feeling of weakness, headache, drowsiness, chills. At a temperature of 38˚C, the skin becomes hot, the cheeks turn red, the patient feels intense heat, dry mouth. Lips dry out and crack. With pyretic fever, nausea and vomiting may join. Hyperpyretic temperature is often accompanied by a disorder of consciousness, delirium.
Fever increases blood pressure and heart rate. An increase in temperature by one degree increases the pulse by 10-15 beats per minute.
What diseases occur with fever
6
The most common cause of fever in adults is acute respiratory viral infections (ARVI):
● Coronavirus, rhinovirus infection. This is SARS, affecting mainly the mucous membranes of the nasal cavity and pharynx. Symptoms: runny nose, redness and sore throat, sneezing, coughing. The temperature is subfebrile (37–38˚С) or febrile (38–39C).
● Influenza. Influenza viruses can immediately affect the lower respiratory tract and cause a deep chest cough. Infection is most often accompanied by severe intoxication, which is manifested by headache, aching throughout the body, and severe weakness. The temperature can reach pyretic (39-41˚C) and hyperpyretic (over 41˚C).
● Respiratory syncytial virus infection. It often affects the trachea and bronchi, in a quarter of the patients it leads to pneumonia. Symptoms are similar to the flu, with the difference that intoxication is less pronounced, signs of inflammation of the lower respiratory tract come to the fore – a deep cough with pain behind the sternum.
● Parainfluenza. The virus infects the nasal cavity, pharynx, larynx. The infection is accompanied by a runny nose, bouts of painful coughing, hoarseness, and sometimes a short-term loss of voice.
● Adenovirus infection. Runs with severe runny nose, sneezing, conjunctivitis. The eyes turn red, watery, there is pain and burning in the area of the eyeballs and eyelids. Unlike other acute respiratory viral infections, adenovirus infection is often infected in spring and summer.
Other causes of fever:
● any infectious disease of a viral, bacterial, parasitic nature;
● non-infectious inflammations: acute pancreatitis, aspiration pneumonitis;
● allergic and autoimmune diseases: reaction to vaccination, rheumatoid arthritis, systemic lupus erythematosus;
● diseases of the thyroid gland, adrenal glands;
● oncological diseases: malignant tumors of internal organs, leukemia, lymphogranulomatosis;
● neurological pathologies: traumatic brain injury, cerebral hemorrhage;
● thermal (solar) stroke;
● psychogenic: prolonged emotional stress, neuroses, hysteria.
When temperature is dangerous
Fever poses a threat to health with a strong rise in temperature, when the thermometer shows 40˚C or more. This condition leads to dehydration, disruption of vital organs, and significantly increases the risk of thrombosis.
For healthy adults, an increase in temperature during SARS by 3˚C from the norm (36.6˚C) is not dangerous. However, for some people, even a febrile temperature can be harmful. At risk:
● Elderly people. After 65 years, it is more difficult for the body to adapt to an increase in temperature due to the age-related decrease in the ability to thermoregulate, the acquisition of chronic diseases.
● People with chronic diseases of internal organs: kidneys, cardiovascular, nervous system. Fever increases the load on these organs and can lead to an exacerbation of the disease.
What to do when the temperature is high
7
Fever helps to defeat the infection faster. With ARVI without fever, the infection takes longer, is accompanied by a pronounced deterioration in well-being, and is more often complicated. Therefore, it is worth suffering malaise for 2-3 days and not bringing down the temperature, provided that the body temperature does not exceed 38.5˚C. To make it easier to transfer the condition, avoid any physical activity, drink plenty of fluids, do not wrap yourself in blankets and excessively warm clothes that impair heat transfer.
But there are times when it is better to bring down the temperature:
● The thermometer reads over 39˚C.
● The rise in temperature is accompanied by a strong deterioration in the condition: loss of strength, poor sleep, nausea, vomiting.
● The patient is at risk.
Fever above 40˚C in adults requires emergency medical attention.
Non-drug methods. Wiping with a damp cloth or a weak vinegar solution will help to reduce the temperature. It is recommended to drink more warm drinks, such as tea with raspberry jam. Raspberries contain natural salicylates – substances that reduce fever. Drink should be moderately warm. Excessively hot or cold drinks and foods should be avoided.
Antipyretics. If non-drug remedies do not help, take antipyretics. The safest drugs are paracetamol-based, which can be taken even by small children and pregnant women. Paracetamol is included in most combined anti-cold complexes, which additionally relieve nasal congestion and symptoms of intoxication in acute respiratory viral infections.
Antivirals. Lowering the temperature is not an end in itself in the treatment of SARS. Antiviral therapy should fight the causative agent of the infection. To do this, develop specific antiviral drugs that prevent the reproduction of the virus and infection of healthy cells. In the treatment of colds and flu, enisamium iodide has proven itself well. Its use reduces the acute clinical manifestations of viral intoxication. 8
Enisamia iodide at a dosage of 500 mg is part of the drug Nobasit ® Forte 8 . Nobasit ® Forte begins to act within 2 hours after taking the tablet 8. In addition to the direct antiviral effect, enisamia iodide has a pronounced anti-inflammatory activity 9, 10 . The combined action leads to a decrease in the severity of fever and other symptoms of intoxication (headache and muscle pain) by 3 times, starting from the second day of treatment 11 . Also Nobasit ® Forte helps to reduce the duration of the disease. 8
Briefly about the main
● Elevated is defined as a temperature above 37˚C measured in the armpit. If it is caused by an infection, this temperature is called a fever.
● The most common cause of fever in adults is SARS. Other causes – infections, non-infectious inflammation, heat stroke, stress, malignant tumors – are much less common.
● Fever brings recovery closer, but often it greatly affects well-being: it is accompanied by weakness, headache, body aches. In the elderly and people with common chronic diseases, fever often causes dangerous complications.
● Cool down in healthy adults should be above 38.5˚C and in at-risk people above 38˚C. If the temperature rises above 40˚C, it is worth calling an ambulance.
● First, try to bring down the temperature with home remedies – cool body wraps, tea with raspberry jam. If that doesn’t help, take an antipyretic medicine.
● Antipyretics will ease the fever but will not speed up recovery. To defeat the infection as soon as possible, take antiviral drugs, for example, Nobasit ®
Forte.
1 Tatochenko V.K., Uchaikin V.F. Fever // Pediatric pharmacology – 2006 – https://cyberleninka.ru/article/n/lihoradka
2 Fugol D.S. An increase in body temperature in children and approaches to its correction // BC – No. 24, 2013 – https://elibrary.ru/item.asp?id=20603056
3 Vasilenko V.V. Measurement of body temperature // RMJ. – No. 29, 2008, S. 1948. https://www.rmj.ru/articles/istoriya_meditsiny/Izmerenie_temperatury_tela/
4 Dvovetsky L.I. Fever: to treat or not to treat // BC – No. 14, 2003 – https://www.rmj.ru/articles/obshchie-stati/Lihoradka_lechity_ili_ne_lechity/
5 Cheshik S.G., Vartanyan R.V. Respiratory syncytial viral infection: clinic, diagnosis, treatment // Children’s infections – No. 1, 2004 – https://cyberleninka.ru/article/n/respiratorno-sintsitialnaya-virusnaya-infektsiya-klinika-diagnosti…
6 Kalyuzhnaya L.I., Zemlyanoy D.A. Heat transfer disorders and fever // Pediatrician – T.6, No. 1, 2015 – https://cyberleninka.ru/article/n/narusheniya-teploobmena-i-lihoradka
7 Didkovsky N.A., Tanasova A.N. Fever. breast cancer. 2003; 4:189.
8 Instructions for medical use of the drug Nobasit® Forte LP-006416.