in this article:
Fever is a reaction of the organism to the attack of pathogens. It is important to understand the cause because when the temperature exceeds certain limits, the risk is that the infection is of bacterial nature and therefore must be treated with antibiotics.
What’s considered a fever?
Very often, fever is a response to bacterial or viral infections that stimulate some blood cells (white blood cells) to proliferate and secrete various chemicals. Some of these substances act on the brain temperature regulators by raising the set point value; therefore they behave as pyrogens (inducers of fever).
Since increased temperature induced by endogenous pyrogens (IL-1 and TNF-α) stimulates an increase in the rate of many immune responses against invading microorganisms, within a certain limit the fever is considered beneficial as it improves the body’s ability to defend themselves.
Body temperature is one of the vital parameters that help monitor a patient’s condition: body temperature measurement can be useful in controlling whether a person is ill or if the therapeutic treatment is working. There are several ways to measure fever.
Adjustment of body temperature
Body temperature is regulated by the balance between thermogenesis and thermodispersion, ie between production and subsequent heat transfer from the body. Our body continuously produces heat (thermogenesis) as a by-product of the chemical transformations (metabolism) that occur continuously in all cells (according to the principle of thermodynamics).
If the heat produced was not eliminated, during normal muscle rest and normal environmental conditions, the average human body temperature would increase by about 34.7°F per hour. The body maintains a dynamic balance between input (thermogenesis and absorption) and heat output (thermodispersion) from the system, mainly by evaporating water from the mucous membranes (favored by breathing) and by sweating (about 30 ml of sweat / H in persistent insensibilis). For this reason, body temperature stays constantly at around 98.6°F, as the body eliminates as much heat as it absorbs and / or produces.
The body temperature regulator is located at the hypothalamic level. This physiological ‘thermostat’ is not only able to receive signals from the peripheral (cold-cold) receptors, but is also directly sensitive to the blood temperature that it is irreversible. The hypothalamus, in turn, generates efferent signals that affect the production and dispersion of heat through the sympathetic and somatomotor system.
The normal temperature of an adult is within a range of 97.5-98.9°F.
This parameter is different in the various parts of the human body and depends, to some extent, on the temperature of the environment, physical activity, and a number of other factors:
- Body temperature varies over time: during the day there are variations ranging from 41 to 33.8°F, touching the minimum at dawn, between 4 and 6 am and maximum in the late afternoon, between 17 and 20 pm (circadian rhythm).
- In woman, there is a rhythm associated with the menstrual cycle: the temperature increases by about 33°F to ovulation and is maintained until menstruation.
- Body temperature increases slightly after meals.
- Pregnancy, some hormonal changes (especially thyroid) and age can alter body temperature.
- Finally, the temperature can also increase by 33.8°F or more in case of intense physical activity or sports activity.
Body temperature is within a range of 97.5-98.9°F. Body temperature can spontaneously vary in relation to:
- Individual characteristics (sex, hormonal changes, etc.);
- Age (in children over 6 months, the daily temperature can range from 33.8 to 35.6 degrees; in the elderly it is on average less);
- Time of day (often higher in the evening);
- Body seat where the temperature was measured;
- Physical activity;
- Temperature and humidity of the environment;
- Nutrition status;
- Strong emotions;
- Menstrual cycle (in women);
- Taking some medications;
- Vaccinations (children may have a slight increase in temperature in the following days);
- Dentition (in a child);
- Wear heavy clothing.
What is fever?
Fever consists in elevation of body temperature above normal values. This alteration is caused by a shift to pathological values of the hypothalamic temperature regulation system undergoing the influence of endogenous chemical mediators: pyrogenic cytokines. These endogenous pyrogens are released in response to the action of infectious agents and their products (exogenous pyrogens) or in response to inflammatory and necrotic outbreaks of non-infectious nature. Fever is an acute phase response to various causes that can lead to infection and / or illness, so it is a clinical sign common to many medical conditions.
If the increase in body temperature reaches:
- Condition in which an adult body temperature exceeds 98.9-99.6°F is defined as fever.
A child has a fever when the temperature is equal to or higher than one of these levels:
- 4°F measured at rectum;
- 5°F measured by mouth;
- 9°F measured under the arm (axillary).
Definition of fever
By the term ‘fever’ is meant a slight rise in body temperature, which rises above normal values (97.5 / 98.9°F), remaining below 100.4°F. Generally, any body temperature increase above normal values is considered ‘fever’, of which the fever, just exceeding the physiological values, represents the minimum variation. However, it is good to point out that during the day the body may undergo some slight thermal modulation linked, in particular, to the secretion of certain substances, favored by circadian rhythms: it appears that the lowest temperature is reached at 4 am (97.5°F), while the peak is more than mid-afternoon (around 99.5°F): in this regard, some authors dare to talk about physiological afternoon fever, despite the theory being questioned by other scholars.
Low-grade fever and sports
In athletes, the aforementioned elevation of body temperature, above 98.6°F, seems to improve athletic performance, increasing metabolism, facilitating the release of energy and favoring the speed of propagation of nerve stimuli.
Low-grade fever and menstrual cycle
Many women, during the menstrual cycle, complain of a subtle rise in standard body temperature or light fever: the condition should not be alarmed, considering that throughout the ovulatory phase an increase of 32.9 / 33 degrees is considered normal. Incidentally, baseline temperature monitoring is a method used by some women as an ovulation index to understand when their body is potentially suitable (or not) for conception. In fact, the fertile woman’s physiological temperature is not constant, but it is subjected to lowering and elevation on the basis of ovulation: generally, at 57.2 / 59°F day from the beginning of menstruation (second phase of ovarian cycle), the basal temperature rises subtly, which coincides with the time when the luteal body begins to produce progesterone: a mild fever persists for the remainder of the cycle.
Some particularly sensitive subjects complain of slight basal heat fluctuation in relation to mood, fatigue and stress. Although there are no studies showing the direct connection between stress and low-grade fever, it seems, however, that strong periods of stress affect the level of the hypothalamic thermoregulation center, shifting it to a higher temperature than the physiological levels, though not true fever: in this regard, stress has been defined as ‘an inexplicable cause of basal thermal alteration’. Indeed, psychological stress may induce an increase in basal metabolism that is reflected in the excessive heat production responsible for low-grade fever.
Considering that, by definition, fever is nothing more than a defensive reaction of the body in the face of possible external aggression, stress could be perceived as a likely source of danger: in response, the defense reaction in this case is low-grade fever.
It is difficult to describe with precision and objectivity the symptomatic picture that comes from low-grade fever, since each organism reacts differently to the stimuli. For some subjects, the fever is asymptomatic so that, without causing some symptoms, it often happens that you do not even realize it: not by chance, in fact, most of the time goes unnoticed and is not recognized, if not by chance.
Low-grade fever, when not persistent, should not be overwhelmed: it may be worrying when it appears every day. For example, among all the symptoms caused by tuberculosis, there is also the chronic low-grade fever, which could easily evolve into a real fever. Obviously, tuberculosis is a serious disease, which must be treated promptly. It is not uncommon for the physician to deal with patients with chronic low-grade fever illness, the only anomalous symptom that persists for days, weeks, or even months.
In some cases, fever is a ‘friend symptom’, because it favors the timely recognition of certain diseases such as chronic infections (brucellosis), diseases affecting the blood and the pathologies of the lymph glands. Generally, fever that affects healthy, though chronic, youth is not alarming and, as already analyzed, the cause is considered psychogenic (stress); this is different for older people, where chronic, persistent, and apparently inexplicable, low-grade fever may indicate more serious diseases such as neoplasms (a similar clinical picture occurs at the onset of Hodgkin’s lymphomas). Anyway, chronic low-grade fever remains a mystery still inexplicable for many patients, because the condition that causes it remains unknown.
We can talk about high fever starting from 102.2°F, though we do not all have the same baseline temperature and we do not have to wait for the fever to be particularly high for an antipyretic, especially in subjects where elevation of temperature Bodily has major risks: elderly, cardiopathic, small children, pregnant women, diabetics, people with respiratory failure. Let’s see what to do in case of high fever.
Fever can give rise to chills, sudden muscle shock, general illness, cold feeling, headache, dry throat and inflamed throat. This and other disturbances are due to a precise end: the body itself raises its temperature, just to prevent viruses and bacteria from proliferating beyond the due.
First of all, do not panic. In most cases, both in adults and in children, the onset of fever means that our body does what it should – protect itself from infection. If you start to panic, the child will certainly notice it. Panic in this situation will not help and certainly will not contribute to lowering the fever. Try to stay calm and immediately call your family doctor or emergency room. If the fever is too high, it will be necessary. However, before using the advice of a physician, you can try to reduce the fever in your home.
The attitude is very important. Start believing that our immune system is capable of fighting all kinds of infections. Hold, cover and gently massage the sick person as often as you can. The proximity of parents or other close ones is especially important for children, because it can work miracles. Do not forget that psychics play a huge role in the treatment of diseases. If you comfort, often hug and touch your baby, you will certainly feel loved and safe. This will help to ensure the peace your body needs to fight off infection faster.
Medium and high fever causes
Fever can depend on many causes: infections, sunburn, muscle fatigue, non-infectious inflammatory states, metabolic diseases, poisoning. The temperature increase is due to a ‘recalibration’ of the hypothalamic thermostat, that is, the control area of the brain that regulates body temperature.
Fever is diagnosed in the event of a sharp rise in baseline temperature. It may happen that this increase is fluctuating and in that case it is referred to as intermittent fever, the interval between hyperthermia and apyessia has variable duration (hours / days, temperature fluctuations are at least 34°F and during periods of apyachis, the baseline temperature should drop below 99°F.
Different is the remitting fever, which occurs when body temperature fluctuates within 24 hours with fluctuations greater than 34°F, but does not fall below 99°F for a few days.
In the absence of infectious diseases in the central nervous system, febrile convulsions outline convulsive episodes, whether critical or not, typical of children aged 6 months to 6 years. Convulsions during febrile illness appear to be one of the most common neurological diseases of the pediatric age.
To define this, a feverish convulsion must be triggered by a hyperpyrexia (fever> 100.4°F) during an extra-cerebral (at least apparently) pathology. Approximate minimum thermal rise to which we refer for hypothesising a possible manifestation of feverish convulsion. It is necessary to point out that the minimum temperature rise we are discussing varies (and varied) over time based on measurement methods, statistics and scientific societies. In the context of febrile seizures, the 100.4°F value expresses the minimum body temperature value established by the American Academy of Pediatrics.
Child observation in the midst of a feverish convulsive crisis is often alarming and hot for many mothers. Many women, looking at their own baby during a feverish convulsive crisis, cannot estimate the duration of convulsion with sufficient approximation: under such circumstances, even a few seconds may seem like minutes. This parameter, as we will see in the course of the discovery, is crucial to hypothesize the possible impairment of the child’s neurological activities.
Most of the febrile convulsions are manifested in the simple variant. Complex febrile convulsions occur in 20% of affected children and epileptic seizures in 5% of these.
There is no close correlation between neonatal / pediatric seizures and the secondary development of a true epileptic form. It is estimated that the possible transformation takes place between 25% and 56% of the cases.
However, some risk factors have been identified that predispose the patient to epilepsy as a result of a febrile convulsive event. Children of epileptic parents are more at risk of developing a form of epilepsy after a first episode of feverish convulsion. Even the presence of an early anomaly in psychomotor development could somehow favor the progression (in the negative sense) of convulsive disease.
It has also been documented that a particular correlation / concatenation of particular events may affect the degeneration of feverish seizures in epilepsy:
- Repeated febrile seizures occurring within 24 hours of the first convulsive episode
- Longest seizure duration to 15 minutes
- Focus marks
- Observe transient neurological abnormalities
It is estimated that a percentage of 2-4% of children is affected by a form of feverish convulsion, the incidence rate of which is around 18 months of age. However, the vast majority of febrile convulsions are harmless to the small patient, so it is highly unlikely that a healthy baby will carry permanent lesions as a result of a similar convulsion.
What to do if …
… an infant
… an 18-month-old child manifests a first episode of febrile convulsions. In such circumstances, hospital admissions may not be necessary if the patient is stable and has no sign or symptom requiring a diagnostic test. Parents need to be carefully instructed on what to do.
… a child manifests a second feverish simple convulsion (in the context of a further fever episode). Admission is not necessary. To consider, however, the possibility – as far as possible – of a masking of infectious diseases to the SNC.
… a child presents complex febrile convulsions: hospitalization is necessary for appropriate diagnostic tests.
There is talk of intermittent fever when the baseline temperature undergoes wide fluctuations, alternating periods of apyachis (absence of fever) to others of pyrexia / hyperpyrexia (fever, even very high). In intermittent fever, the interval between the hyperthermia and apyessia phases has variable duration (hours / days) depending on the disease that induced it.
To define ‘intermittent’, thermal oscillations throughout the day must be at least 92.8°F and during baseline periods the baseline temperature should drop below 98.6°F.
Intermittent fever should be distinguished from the ‘remittent’ form, in which body temperature fluctuates within 24 hours with fluctuations greater than 1°F, but does not fall below 92.8°F for a few days.
Intermittent fever can be differentiated according to the dynamic trend of the baseline temperature:
Daily intermittent fever: the interval between hyperthermia and apyessia is short, and the thermal oscillations (> 1°F) are repeated several times over the 24 hours.
Bilateral intermittent fever: it has two feverish accesses and two drops of baseline temperature below 37°F during the day.
Tertiary intermittent fever: body temperature suddenly increases with chills shaken and lasts for 1 day, disappears the second day to reappear 24 hours later (hyperpyesis on days 1, 3, 5, 7 etc.). Fever occurs on alternate days.
Quartan intermittent fever: body temperature suddenly increases with diffuse shivers and lasts for 1 day. There are two days of apiressia; the next day, fever appears again (fever on days 1, 4, 7, 9, etc.). The trend of intermittent quartan fever is typical of malaria.
Quintile intermittent fever: the interval between the pyrexia and apiressia takes 3 days. Fever occurs on days 1, 5, 9, 13 etc.
Intermittent fever may occur on multiple occasions. Only rarely, unfortunately, intermittent fever is a symptom of benign and simple resolution; more often, in fact, the widespread fluctuation in body temperature has far more serious background pathologies. Intermittent fever is comparable to the tip of an iceberg: the actual disorder is below and you cannot see it.
What illnesses can conceal behind intermittent fever?
- AIDS: Some AIDS patients may experience symptoms such as intermittent fever, febrile or high fever
- Kidney cancer: intermittent fever is typical of malignant neoplasms, especially kidney
- Colangitis (inflammation of the bile ducts): intermittent fever is one of the characteristic symptoms of colangitis
- Gonococcal endocarditis: Infectious / inflammatory pathology endocarditis sustained by Neisseria gonorrhoeae
- SSE: fever caused by bacterial infections; The thermal excursions that characterize it are very wide
- Trench fever: infectious disease carried by fleas infested by bacteria Bartonella quintana. The bite of a flea infected by this pathogen can transmit the infection to man.
- Urinary tract infections: often accompanied by so-called urosetic fever, characterized by a transitory entry of pathogens into the bloodstream. Feverish spikes, always accompanied by moments of apyachis, are very high (39-40°F).
- Trematodes Infections (Platelet Plague Worms)
- Suppurative infections (with purulent material formation)
- Tuberculous Infections: The disease is characterized by the tertiary remitting fever, in which the temperature acne usually occurs in the morning.
- Visceral leishmaniasis: characterized by intermittent fever
- Malaria: Intermittent malaria fever has a particular trend: depending on the Plasmoidium strain involved, high fever can occur daily, appear on alternate days (tertiary) or manifest on the first day, disappear completely for two days and reoccur later (fever Intermittent quartan).
- African Sleep Disease (Tripanosomiasis): Tropical Disease Spreading in African Equatorial Lands, caused by Tripanosomabrucei, a protozoan parasite with flagellas. This is a serious health problem after malaria, AIDS and severe diarrhea. The final stage of the disease involves lethargy, cachexia, apathy, inability to get up and feed: hence the term ‘sleeping illness’.
- Infant Crohn’s Disease: complex chronic gastrointestinal tract disease, potentially auto-immune etiology. Intermittent fever completes the heterogeneous clinical picture of the affection patient. Intermittent fever is not an exclusive and typical symptom of the disease; nevertheless, in some patients this feature is constantly observed.
- Acute pielonephritis: upper urinary tract infection where sporadic or frequent episodes of intermittent fever are possible
- Rickettsia: infectious disease caused by negative gram microorganisms, known as Rickettsia. These are infectious diseases transmitted by ticks, fleas and lice. The quintain intermittent fever characterizes this variant.
- Gonococcal Sepsis: It is characterized by intermittent fever
- Septicemia: septicemia patients often complain of intermittent fever of a daily type
- Charcot’s triads (not to be confused with Charcot-Marie-Tooth disease): this is a pathology characterized by the concomitant presence of colangitis, jaundice, chills and intermittent episodes.
Intermittent fever therapy is related to the root cause, so differential diagnosis is indispensable. In the absence of clinical evidence, the patient with intermittent fever may undergo multiple diagnostic tests, such as: complete blood count, erythro-sedimentation rate, blood glucose, electrolyte research, urine examination, emoculture, transaminase, ELISA test, chest radiography, diagnostic sonography. Remember, however, that in 22-50% of cases, intermittent fever is called idiopathic, meaning no underlying cause can be traced back.
What is hyperpyrexia?
Pyrexia consists in elevating body temperature beyond 102.2 to 104°F. Hyperpyrexia is not considered a disease, but a symptom that can be caused by various types of pathological conditions, such as bacterial or viral infections.
In addition, hyperpyrexia may sometimes be an adverse effect due to drug intake; It is the case, for example, of malignant hyperthermia, a rise in body temperature that may occur in sensitive individuals following the administration of certain types of anesthetic drugs.
As mentioned, hyperpyrexia is a symptom and not a disease in itself. Hypersensitivity causes can be multiple; among these, there are the following: bacterial or viral infections, parasitosis, abscesses, autoimmune disorders, tumors, neurological disorders, respiratory system problems, kidney, liver or gall bladder dysfunction, heat stroke, encephalitis, hepatitis A, B, C, D and E, gastroenteritis, gout, inflammatory pathologies of varying origin and nature and adverse drug reactions.
Although hyperpyrexia cannot be considered a true pathology, often – regardless of the condition that caused it – is accompanied by such symptoms as: pallor, excessive sweating, chills, headache, fatigue and muscle weakness, confusion and delirium and general feeling of malaise. Also, in some cases and especially in children, hyperpyrexia can be caused the onset of so-called low-grade fever convulsions.
Home remedies for pyrexia
As this is a significant rise in body temperature, which can also have serious consequences, hyperpyrexia must be treated with appropriate medicines. However, there are some physical, non-pharmacological means that can be used in combination with drugs to help lower body temperature. Non-pharmacological treatment of hyperpyrexia with physical means generally involves spraying or bathing with just lukewarm water to promote excessive heat dispersion.
However, in the case of hyperpyrexia – given the importance of this symptom – it is always best to contact your doctor, who will identify the triggering cause and set up the most appropriate therapy to treat it.
How to measure body temperature
Measuring fever means detecting body temperature. For obvious reasons, the central temperature – that is, the inside of the hypothalamus thermoregulatory center – cannot be detected directly because of inaccessibility; however, there are devices designed to indirectly detect this parameter with a good approximation.
Different thermometers have variable capacities to measure the internal temperature and to limit the probability of errors during detection, it is best to measure the temperature under constant conditions. For example, it is important to wait at least one hour after intense physical exercise or hot bath, and at least 20 to 30 minutes after smoking, eating, or drinking a hot or cold liquid before taking body temperature. Body points commonly used in the clinic for measuring body temperature are: rectum, armpit and oral cavity. Some devices now allow you to detect fever even in the ear or on the surface of the skin.
Each detection site has some advantages and disadvantages:
Among household surveys, the rectal temperature is the one that best represents of the central temperature: the average measurement is 98.6°F with a maximum variation of 32.9°F. The ambient temperature does not affect rectal measurements, which can be performed on patients of any age. However, these benefits are associated with an uncomfortable procedure and, for some, embarrassment.
The oral cavity temperature is about 32.3-32.9°F lower than rectal. The procedure is simple and quick, but accuracy can be compromised by taking hot and cold drinks or bradypnea, that is, a decrease in the frequency of respiratory acts (which can create a false temperature increase).
The axillary temperature value is 97.8°F ± 32.9°F, slightly below the central temperature. Generally, it is the most comfortable measurement for patients, but is considered inaccurate, as it is sensitive to the temperature of the environment. The most reliable temperature would be the lower esophageal blood measured by probes.
For small patients, it is possible to use the tympanic temperature measurement, which tends to be 33.4°F below the rectal value. The procedure is comfortable, simple and uses infrared ear thermometers which, thanks to the special cone shape of the probe, can be inserted into the ear.
The skin temperature is detected by devices using infrared rays to detect the temperature of the face by contact or by distance, by means of an optical pointer. However, their reliability is very controversial.
At hospital level, fever can be measured – through specialist equipment – in other sites, such as bladder, pulmonary artery, nose-pharynx or esophagus.
Which thermometer to choose?
Until recently, mercury thermometers were the most widely used devices in medical practice since they are accurate and reliable but have been banned from the Italian market since 2009 because they are considered dangerous for the potential toxicity of the liquid metal contained therein (both for the patient in case of breakage, and for the environment in case of contamination).
Currently, different alternatives are available on the market:
Digital thermometers are reliable and low cost electronic devices. When you hear a beep, the temperature is displayed on the display. They can be used rectally, orally and asynchronously.
Infrared thermometers receive and process IR radiation naturally from the body, providing a quick (about 10 seconds) and hygienic measurement. They point to the forehead or to the ear (headset). The ear thermometer is easy to use, however it should be used correctly to provide reliable and reliable measurement.
The thermometer in contact with Galinstan is a glass device that contains a gallium, indium and tin capillary inside. Galinstan has characteristics similar to mercury as regards dilation at temperature variation but is not toxic. It can be used both for rectal measurement and for axillary. It is very precise and fast enough, but being made of glass, it is fragile.
Before measuring body temperature: hold the thermometer on the opposite side of the bulb. Rotate the thermometer until you see the red, blue or silver line (indicator). The liquid (mercury or Galistan) contained in the internal capillary should be less than 96°F, so to turn off the indicator you need to shake the thermometer several times (maybe over a couch or a bed to avoid breakage when slipping out of the hand).
Reading: Remove the thermometer from the measurement site. Slowly turn the thermometer to the colored line at the thermometer scale, where each long sign equals 33.8°F, while the short lines correspond to 32.3°F.
How to measure the oral temperature
Oral temperature measurement allows you to define fever in patients over 4 years of age. It is not intended to use a glass thermometer in a child of lower age, since it could bite the thermometer and, if it is glass, break it in the mouth.
- Clean the thermometer with water and soap or alcohol and rinse. Do not smoke, eat or drink anything hot or cold for at least 30 minutes before measuring the temperature;
- Place the probe under the tongue, towards the back and gently close the lips around the thermometer. If the mouth remains open, it can cause unclear values;
- Breathe through the nose and use the lips to hold the thermometer firmly in place for 3 minutes or until the digital device beeps.
How to measure rectal temperature
Rectal temperature is recommended in children under 3 years of age or older, as it provides accurate reading of the internal temperature. This method is especially suitable for patients who are unable to hold a thermometer safely in the mouth (infants, children and the elderly).
- Clean the thermometer with water and soap or alcohol and rinse with cold water;
- Lubricate the thermometer bulb with a small amount of vaseline;
- Place the baby with the belly facing down on a stable surface or on the back, with the legs raised to the stomach;
- After separating the buttocks, gently put the end of the thermometer about 2 cm in the infant (only the bulb) and 5 cm in the adult in the rectum. Never force the thermometer and be careful not to insert it too deeply;
- Keep the thermometer in place: hold the child with the hand and the other on the thermometer to prevent accidental penetration into the rectum. It is important that the patient is motionless during the measurement to avoid accidents;
- After 3 minutes or after the beep, remove the device and check the reading.
How to measure axillary temperature
- Axillary temperatures are not accurate as rectal or oral measurements, and generally measure 33.8 degree lower than a simultaneous oral temperature
- Always clean the thermometer before and after use with water and soap or alcohol. Rinse with fresh water.
- Place the tip of the thermometer in the bowel collar, in contact with the dry skin and keep the device with the arm pressed against the body (holding the elbow against the chest).
- Wait at least 5 minutes before reading or until you hear a beep, making sure that the tip of the thermometer is covered by the skin.
How to measure tympanic temperature
The tympanic measurement is determined by an infrared thermometer, which must be placed correctly in the patient’s ear, so that reading is valid. The tympanic temperature may not be accurate in children under the age of 3 years (36 months) and may be obstructed by both a wound closure and an inflammation. In addition, it is not advisable to use an ear thermometer in case of ear pain, infection or if the patient is still recovering from surgery at the venue.
- Hold the baby’s head or ask the patient not to move the head;
- Place the end of the thermometer by gently pulling the ear and then releasing it immediately. Do not push and do not use force. The tip of the thermometer should not touch the eardrum;
- When the device emits a beep, remove it from the ear.
Home remedies in case of fever
High fever, especially in children, can be very disturbing. There are, however, several things you can do to lower and control your fever. Here are some tips to help you learn how to deal with excessive heat using natural methods.
In the case of high fever, it is advisable to follow some common sense norms, including, of course, rest, in areas not too hot or too cold and with the right degree of humidity.
It is not advisable to cover excessively and it is very important to rehydrate the body by drinking water, tea or herbal teas.
It is not appropriate to strive to eat, if you are not appetite; if you can eat, it is advisable to prefer light and easily digestible foods.
Lots of fluids
During the fever, try to give the patient as little solid foods as possible. In return, the sick person should drink a large amount of healthy drinks. The best will be water or 100% fruit juice without added sugar. Avoid serving sweetened beverages and juice based on concentrates. Proper intake of fluids prevents dehydration of the body, which can lead to serious health problems. Otherwise, you will not do without the help of a specialist.
Use breathable and loose clothes and blankets. No matter if it is an adult or a child who suffers from high temperature, do your best to make the patient feel good. No matter if it is in bed or in the bath, make sure it is not too hot or too cold. Try to make yourself or your baby feel as comfortable as possible.
Ice should be wrapped in a clean cloth or foil bag. Do not apply ice directly to the skin. Ice poultice or cold water is applied to the forehead, temples, the back of the head, as well as to the groin, to the knees and to the neck.
The water temperature should be about 76°F lower than the body temperature if we are dealing with fever in an adult. If the fever has a baby, then the water temperature should be 19°F lower than the body temperature. Cooler baths can only worsen the condition of the patient.
Wrap with sliced raw potato or onion
Try old homemade ways to lower your fever. Place slices of onion or potato on a hot forehead. If you care for a toddler and try to avoid seeing a doctor, just use this method. You can also put onion or potato slices on your feet, wrap them with a cotton cloth or bandage and put on socks.
Linden tea with raspberry juice and lemon
Try linden tea with raspberry juice. Brew linden bark or flowers for 15 minutes, strain, add a tablespoon of raspberry juice and lemon juice. Drink 3-4 times a day.
You can also help your immune system by taking echinacea tincture. The echinacea mother dye is a herbal preparation extracted from the fresh plant of Echinacea angustifolia or Echinacea purpurea. Very useful for its protective properties, it is used to prevent infections and speed up healing. Let’s find out better. Echinacea mother tincture is extracted from the echinacea and makes its plant properties. Rich in flavonoids and essential oils, mother tincture lends itself to be useful for stimulating the immune system, it is also used in the event of stress, colds and coughs. This plant is really special: on the one hand, it prevents the onset of infections, and on the other it facilitates rapid healing. Here are the main uses: stimulate and strengthen the immune system in the production of antibodies; for this reason it is used in phytotherapy to promote the natural defenses of the organism against infectious bacterial and viral attacks; stimulate and prevent physical and psychological stress. It also helps relieve symptoms of cooling disorders such as fever, joint pain, infectious mononucleosis, respiratory tract infections (cough, sore throat) or urinary system (cystitis, prostatitis).
For internal use, general indications range from 30 to 40 drops in little water three times a day away from meals, to prevent flu syndromes and seasonal ills. To treat infections or other 30-40 drops, 2 times a day. These are indicative dosages, it’s always good to rely on a specialist for advice and how to use it.
The infusion of eucalyptus, which is rightly called “fever tree”, has been used for centuries in the treatment of fever-related conditions. Infuse 3 or 4 sheets per cup and take 4 cups per day. Rosemary, sage, verbena and chamomile are excellent febrifuges. Take an infusion of one or the other of these plants at a rate of one teaspoon per cup and drink 3 cups per day. You will also find these plants in pre-dosed sachets.
The eucalyptus leaves contain an essential oil, particularly rich in eucalyptol, terpenes (pinene, canfene, fellandrene); aldehydes; polyphenols (gallic acid, ferulic acid, gentian acid); Flavonoids (ruthoside, hyperoside) and tannins. These active ingredients give the plant a balsamic, fluidifying, and expectorant action of the catarrhal respiratory secretions. For this reason it is used in phytotherapy in inflammation and congestion, such as cough, cold, and sinusitis treatment.
In addition, due to the presence of essential oil, the eucalyptus performs an effective antibacterial and antiseptic action for the pathogenesis of urogenital pathways in the case of cystitis, leukorrhoea and candidiasis, for which it is also recommended by the deodorizing action.
Its balsamic action may be irritating to the gastric mucosa, if taken alone. For this reason it is always better to use it in blends with mucous protective plants like malva. Also for hypoglycaemic action do not take simultaneously oral hypoglycemic agents.
To fight fever, take 1/2 teaspoon eucalyptus leaves and a spoonful of malva for 1 cup of water. Pour the leaves of eucalyptus and those of mauve into boiling water and turn off the fire. Cover and leave in infusion for 10 min. Filter the infusion and drink it in case of inflammation of the respiratory system as it dissolves the catarrh and improves breathing or in the presence of urinary tract infections. Eucalyptus mother tincture: 30 – 40 drops, 2-3 times a day in case of respiratory tract and diabetes.
Other advice for alleviating fever symptoms
- Do not eat, because digestive enzymes are destroyed by high temperatures, which puts an extra strain on digestive system.
- Drink plenty of fruit juice. Drink in particular lemon juice mixed with sweet water or pear juice. Prepare a lemonade by adding the juice of a fresh lemon in a glass of water and drink hot. In addition to being refreshing, this preparation contains vitamin C, an ally for the immune system. Formerly lemon seeds were prescribed for fever.
- Take large doses of vitamin C (at least 2000 mg). Do not worry, you do not risk the overdose, the body excretes the amounts of vitamin C it does not need.
- Add garlic, parsley, thyme to your hot and cold dishes.
- On the stomach, alternate warm compresses for 3 minutes, then cold for 30 seconds, 5 times in a row, ending with a warm compress, then repeat if necessary after 40 minutes.
- Place for 30 minutes against the skin of the feet, under the socks, slices of raw onions.
- From 40 minutes to 1 hour, make a warm poultice of green or gray clay on the belly, and renew if necessary.
- Give fever a few days to fulfil its task. Pay special attention to whether your baby is not dehydrated and has no hallucination. If you notice such symptoms, specialist help will be required. Remember, however, that the most important factor that leads to lowering fever is avoiding panic. So keep calm
Most people who get fever do not need to seek care because the inconveniences usually go away by themselves. That’s how you decide when to search for care.
You should always seek care directly at a healthcare center or emergency department at the following symptoms:
- Strong fever chills.
- If you have fever and difficulty swallowing or breathing.
- If you have fever and difficulty bending your neck.
- If it feels like you are losing consciousness.
- When a child gets a fever cramp for the first time.
You should contact a healthcare center or call the healthcare counsel with the following symptoms:
- When the fever comes fast, it’s high and you feel very bad.
- When the fever continues to be high for four, five days without the obvious cause.
- If the fever first goes down and then begins to rise again, which may be due to a bacterial infection to be treated with antibiotics.
- If you get into your stomach when it comes to the fever.
- If you have difficulty peeing or if it is burning when you are kissing while you have a fever.
Fever and hyperpyrexia
Fever and hyperpyrexia represent two different pathological mechanisms, but both generate pyrexia, a non-physiological condition characterized by anomalous elevation of body temperature.
It is a fever that hyperthermia causes bodily overheating but through two completely different pathogenetic mechanisms:
Fever is triggered by chemical damage by cytokines (chemical mediators) on the ‘thermostat’ of central hypothalamic regulation, which in turn generates excessive heating.
Hyperpyrexia is generated by the imbalance between thermogenesis (body heat production) or external warming (such as solar irradiation) and the thermodispersion system (skin vasodilation, sweating, etc.), resulting in a progressive buildup of heat.
From the above, it is deducible that the therapeutic approach between the two forms of pyrexia is entirely different; In the hyperthermia it is essential to quickly cool the body (for example, cold water) while in the fever are useful the antipyretic drugs acting by restoring the hypothalamic set-point (but in this case it is not excluded the usefulness of the cooling by conduction, e.g. by means of cold water sponges).
Remedying fever and reducing pyrexia do not always follow the same therapeutic route; In case of temperature changes it is essential to identify (if possible) the etiopathologic agent (i.e. cause: inflammation, viral infection, burn, etc.) responsible for bodily alteration and then eliminate it. The use of antipyretic drugs (such as paracetamol) is useful for reducing the pyretic symptomatology of fever but is not an effective cure. Obviously, if it is not possible or indispensable to intervene on the primary cause of fever, antipyretics are the only applicable pharmacological intervention.
Fever and nutrition
Fever is an active process that deliberately searches for the increase in body temperature; this condition is metabolically critical to accelerating enzymatic processes throughout the body, in order to optimize the immune response and speed up healing. For this reason it is indispensable to reduce the fever only if it exceeds the patient’s tolerance limit.
From a metabolic point of view, fever significantly increases energy expenditure measurable through the consumption of basal oxygen; Estimates made on the general population indicate that for every degree celsius (° F) above 98.6, the body needs 13% more oxygen to meet the needs of all physiological and para-physiological processes. This means that, with the same energy as diet, fever (increasing energy oxidative processes) can favor the reduction of reserve energy substrates (adipose tissue and glycogen), thus decreasing body weight as well; that said, it may seem obvious that in the presence of fever, it is indispensable to change the diet by increasing the energy intake to cover the minimum requirement for maintaining body weight; e.g.:
Assuming that the subject ‘X’ normally has a 2,000 kcal energy expenditure, in case of a fever at 102.35.6°F (96°F above the 98.6°F threshold) they would require a calcium surplus of 26% (13% multiplied by 96°F), or 520 kcal. In conclusion, subject ‘X’ should correct their diet by increasing caloric intake as follows:
2,000 kcal + 520 kcal = 2,520 kcal
It is advisable to maintain a normal protein intake and increase proportionally of both lipids and glucids.
In case the subject ‘X’ maintains an energy input of 2,000 kcal and the fever at 102.2°F is constant for 14 days, the algebraic sum between the calories introduced with the diet and the calories burned in the presence of fever would be negative. Resulting in a weight loss:
[(2,000 × 14) – (2,520 × 14)] = (28,000-35,280) = -7,280 kcal
In addition, knowing that physiologically to eliminate 2 lbs of adipose tissue it is necessary to burn about 7,000 kcal, it can be stated that the subject ‘x’ during 14 days of fever at 102.2°F in which one who did not follow a proper diet might lose approximately 2 lbs.
Obviously, this example does not consider the presence of many variables (such as the reduction in the level of physical activity) that contribute to determining the final energy balance, and should therefore be considered as an absolute simplification.
If the reader is seduced by the possibility of facilitating slimming without curing the fever or the etiologic agent that generates it, let us remember that the increase in the cost associated with the withdrawal or the immobilization of the patient results in a non-selective weight loss that negatively affects both on trophic muscle mass and on the consistency of hepatic and muscle glycogenic reserves.
In order to have a more realistic picture of the metabolic effect of fever on the body, the following key points should also be considered:
Dehydration: Fever causes an increase in body temperature that often requires greater thermodispersion, leading to an increase in sweating; therefore, if the diet does not contain sufficient water intake, the reduction in body weight may indicate more general dehydration than depletion of energy reserves. It concludes that the fever diet must first ensure basal water needs, compensate for sweating and facilitate kidney drainage of any pharmacological catabolites
The increase in basic energy expenditure is offset by the physical inactivity of the subject: it should be considered that (usually) fever does not allow the carrying out of common work, recreational and sports activities; whereas the energy expenditure of a sleeping subject is almost overlapping with their baseline metabolism (MB), while the Physical Activity Level (PAL) oscillates between + 33% and 110% more than the baseline metabolism, it is possible to say that normally the diet for fever of a sick or recovering person should bring an energy quantity lower than that normally introduced with the diet despite the fever generating a baseline increase of 13% every 33.8°F. For example, for the subject ‘Y’ with a basal metabolism of 1,300 kcal and a Physical Activity Level that increases the energy expenditure by 55%, for a total of 2,015 kcal, stay in bed with 35.6°F of fever (+ 26% of calories) would mean a total expenditure of 1,638 kcal – 377 kcal less than normal.
Vomiting and malabsorption related to the morbid condition: in case the etiologic agent is a pathogen (viruses, bacteria, protozoa or other parasites), or an intoxication by ethyl alcohol or other nerves, and the fever is accompanied by vomiting and diarrhea, the diet should undergo drastic changes. First of all, remember that vomiting and diarrhea cause accelerated dehydration, therefore, the reduction in body weight is mainly related to the volume (volumetric) blood platelet deficit; secondly, the inability to retain food in the stomach or diminish intestinal absorption will reduce (sometimes seriously) the energy share and the essential elements introduced with the diet. In addition to a state of transient general malnutrition, a degradation of reserve energy substrates and muscle tissue (favored by patient immobility) occurs in the indiscriminate weight loss (both lean mass and fat mass). In this case, the fever diet should promote the gastric passage without inducing vomiting and providing proper digestion and absorption; in this regard, it is very useful to use moderately protein foods with a higher content of carbohydrates and vegetable oils (semolina enriched with leguminous pastries and seasoned with extra virgin olive oil and little grated cheese), easily digestible (simple and non-prolonged cooking), promote semi-liquid foods (not completely liquid because the digestive tract can react to the sense of fullness with the impulse of vomiting), with moderate and rather frequent portions; In addition, it would be best to avoid foods that contain nutritional principles that are difficult to tolerate such as lactose.
Transient anoressia: from a behavioral point of view, fever sufferers do not feel the need (or physiological stimulus) to feed and drink. If the fever diet is not drawn and followed carefully, in addition to the risk of malnutrition, reducing the water intake is worsening both the potential for thermodispersion and renal filtration capacity; on the contrary, it should be encouraged, thus facilitating the elimination of endogenous and pharmacological catabolites.
Diet in the fever needs to consider all these factors in order to optimize the healing process and to overcome any side effects linked to malnutrition; It is advisable to pay particular attention to water, saline and vitamins, but not to neglect (if possible) the taking of foods containing the other essential molecules (omega 3 fatty acids and amino acids derived from high-value biological proteins).
In the presence of fever, especially if accompanied by vomiting and / or diarrhea, the first concern is to ensure proper hydration. Generally, in adults, water – drunk in small and frequent sips – is sufficient, while specific rejuvenating formulations are recommended in the baby. In the case of prolonged fasting, rehydrating and alkalizing agents may be used, based on sodium and / or potassium citrate (e.g. bio-ketase). In the case of prolonged vomiting, rehydration may also occur intravenously.
In case of nausea and vomiting, oral solid feeding should be gradually restored as soon as possible and pursued according to the patient’s tolerability: rehydrating water and liquids → jams and fruit jelly → vegetable puree → pastas or broth rice → meat (calf, chicken and fish, possibly chopped to make it more digestible).
Associated with rest, the diet should be lightweight, thus containing easily digestible foods without fat burning. The lipids will be limited to adding oil and raw butter as a condiment to the dishes.
Fever diet prefers carbohydrates and lean proteins. Carbohydrates, easy to digest, allow you to save muscle protein from catabolic phenomena induced by calcium and glucose depletion; moreover, they prevent the ketosis from hyperactivation of lipid metabolism, typical of prolonged fasting conditions.
Partially skimmed milk, recommended by some doctors in the presence of fever, should be avoided by individuals who are intolerant to lactose. Feeding the patient with a febrile infectious disease is initially based on milk consumption – which is introduced as the main food in the average amount of one liter and a half a day (950 kcal And 46g of protein) – homogenized homogenized meat in soups, pasta, rice, semolina, biscuits, white bread, pastry and sweetened fruit, drinks, etc. (Meat broths have low caloric value). ‘Therefore, protein sources that are rich in fat and connective tissue should be avoided, preferring soft and easy digestion.
Diet for fever involves the consumption of numerous small rations, in order to avoid over-digestion of digestive functions. Special warnings in certain situations naturally imply that the last word on the adequacy of a particular diet in case of fever is for the physician; e.g.:
In case of prolonged therapy with corticosteroids, sodium intake of the diet and increased potassium content should be limited as these drugs result in sodium retention and increase potassium excretion
In case of fever associated with diarrhea, dairy foods and sugary foods (sweets, jams) should be avoided since they could aggravate the condition for osmotic issues. Fruit juices – foods notoriously useful for the hydrosaline and vitamin balance – will be preferred to those without added sugars, or rather homemade ones, as sugar substitutes in industrial products are sometimes added to sweeteners by the marked laxative effect (e.g. polyols: sorbitol, mannitol, xylitol and others).
Dairy products should be taken at least 3-4 hours after the administration of tetracycline per os, as they may inactivate the drug by precipitation in the intestine. In case of fever associated with severe hepatitis, the diet should be hypoprotein.