Fever symptoms

Fever is characterized not only by a temperature rise. Fever is accompanied by such fever symptoms as cardiac acceleration and tachypnoea; arterial pressure is often reduced; patients complain of a high temperature, thirst, headache; urinary output is decreased. Fever conduces to metabolism promotion, and as at the same time the appetite is decreased the patients suffering from fever for a long time often grow thin. High fever may be accompanied by delirium being present mostly in such patients as old men and alcoholics.

The main fever symptoms are:

Tachycardia

The temperature-pulse relation deserves much attention as it is quite constant ceteris paribus. Commonly, a heart rate increases at least by 8 to 12 beats per minute with a body temperature rising by one degree. For instance, if one has a pulse rate is of 70 beats per minute at a body temperature of 36 °C, the pulse rate will increase up to 90 beats per minute at a body temperate at 38 °C.

A discrepancy between a high temperature and a pulse rate either way shall be analyzed, because it is an important diagnostic character in some diseases (e.g. typhoid fever, on the contrary, is characterized by relative bradycardia).

Hyperhidrosis

Sweating is one of the heat elimination mechanisms. Excessive sweating occurs if a temperature is decreased; on the contrary, with an increase of a temperature the skin is commonly hot and dry. Sweating is not present in all fever events; it is a characteristic of purulent infection, infective endocarditis and some other diseases.

Shivering

The term “shivering” is used in order to indentify the state when a patient feels shakes and chill inside the body. The shivering is accompanied by peripheral arteriolar constriction and “gooseflesh”. Sometimes muscular tremor is so evident that it impedes a speech and is accompanied by teeth chattering (masseteric tremor), and a cold which is felt by a patient remains even after dressing of warm clothes. Despite the fact that the skin and the extremities are still cold, the body temperature rose.

Shivering occurs at the moment of fast rearrangement of a hypothalamic thermostat to maintain a higher body temperature. In this case the body temperature jumps at 2 to 40 С. If the body temperature rises gradually, little chilling may be present.

Shivering occurs approximately in an hour after an entry of the infectious (viral, parasitic) agent or any other foreign protein into the blood and commonly lasts for 30 minutes.

The periodicity of shivering has a certain diagnostic value. Schematically it may be observed the diseases characterized by singly shivering (e.g. lung fever, incompatible blood transfusion or contaminated intravenous infusion response), and the diseases accompanied by a series of such attacks.

Commonly, recurrent shivering is present in sepsis, pyogenic lung, urogenital system, gall bladder and bile ducts diseases, erysipelatous inflammation, cancerous diseases (carcinoma of lung, hypernephroma, leukemias, lymphogranulomatosis).

Regular interchange of febrile attacks (shivering, high temperature, temperature drop with sweating) and afebrile periods is a characteristic of malaria. This disease may be accompanied by daily attacks (quotidian fever), every other day attacks (tertian fever) or every third day attacks (quartan fever).

Some sources say that any shivering may be promptly ceased by intravenous introduction of vasodilators (e.g. papaverine).

Herpes

It is no wonder that fever is often accompanied by herpetic eruption: from 80% to 90% of people are infected with herpesvirus although the clinical presentations are observed in 1% of people; herpesvirus activation occurs in case of decrease in immunity.

Some types of fever have so frequent herpetic eruption that its presence is considered as a diagnostic character of the disease, such as croupous pneumococcal pneumonia, meningococcal meningitis.

Febrile convulsions

Febrile convulsions are observed in 5% of the children from 6 months to 5 years. Convulsive disorder probability depends on the rate of body temperature rise rather than on the absolute level of the temperature rise.

Commonly, duration of febrile convulsions does not exceed 15 minutes (average 2 to 5 minutes). In many cases the convulsions are observed in the beginning of the development of fever and as a rule clear up of their own accord.

The convulsive disorder may be associated as fever symptom in the following cases:

• children under 5;
• if there is no any disease which may cause the convulsions (e.g. meningitis);
• if the convulsions were not observed when there was no fever.

If a child has febrile convulsions you should think of meningitis in the first instance (lumbar puncture is indicated in the relevant clinical presentation). In order to avoid spasmophilia nurslings’ calcium rate should be measured. If the convulsions last more than 15 minutes it is advisable to do electroencephalogram in order to avoid epilepsy.