Explore the world of adult fevers – understand causes, symptoms, and effective remedies. Your guide to managing fever on Meri Sehat.

Fever (Adults)

A. JABBAR DENTAL CLINIC KARACHI

Sadia Khan

Overview

Fever is a temporary increase in body temperature in response to an illness. 
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The normal body temperature is typically 37&deg;C (98.6&deg;F), but it can fluctuate slightly throughout the day. When the body temperature is more than 37&deg;C, it is considered a fever.

It is important to note that fever is not a disease itself; rather, it is a symptom of an underlying condition, including infections, inflammatory disorders, and malignancies.

For instance, in Asian countries, it may be a response to enteric fever, which is a significant public health concern in South Asia due to a lack of access to clean water and sanitation facilities.<a href="#accordion">[4][5]</a> 
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Based on its duration and underlying cause, fever is categorized into: 
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<ul>
	<li>
	<h5>Intermittent Fever</h5>
	</li>
</ul>

This type of fever is characterized by temperature spikes that occur at regular intervals. The temperature returns to normal between these spikes.

<ul>
	<li>
	<h5>Remittent Fever</h5>
	</li>
</ul>

Remittent fever is characterized by a fluctuating body temperature. However, the temperature does not return to normal. This type of fever is often seen in infective endocarditis and <a href="https://merisehat.pk/disease/typhoid-fever">typhoid fever</a>.

<ul>
	<li>
	<h5>Continuous Fever (Sustained Fever)</h5>
	</li>
</ul>

A continuous fever is characterized by a prolonged increase in body temperature with little or no fluctuations. It is commonly associated with bacterial infections, such as urinary tract infections and pneumonia.

<ul>
	<li>
	<h5>Low-Grade Fever</h5>
	</li>
</ul>

Low-grade fever refers to a mild elevation in body temperature, usually ranging between 37.5&deg;C and 38.3&deg;C (99.5&deg;F and 100.4&deg;F). It is often seen in respiratory infections.

<ul>
	<li>
	<h5>High Fever</h5>
	</li>
</ul>

High fever is characterized by a significant elevation in body temperature, often exceeding 39.4&deg;C (103&deg;F). Some non-infectious conditions typically associated with this type of fever include sepsis and heatstroke. 
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Note: Call your doctor or rush to an emergency room if you have a fever over 39.4&deg;C (103&deg;F). 
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Sign and Symptoms

Fever in adults is often accompanied by other manifestations such as chills, sweating, headache, muscle aches, and fatigue. Individuals may also experience loss of appetite, dehydration, and general malaise. 
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Causes

The most common causes of fever in adults include:

<ul>
	<li>Bacterial and viral infections, such as urinary tract infections, respiratory tract infections, and influenza, account for 37-74% of cases.<a href="#accordion">[1][2]</a></li>
	<li>Autoimmune disorders, such as rheumatoid arthritis and systemic lupus erythematosus</li>
	<li>Certain malignancies, such as lymphomas and leukemias 
	&nbsp;</li>
</ul>

Diagnosis

Laboratory investigations, including blood cultures, serologic tests, and polymerase chain reaction (PCR), play a crucial role in identifying the causative agents of fever, especially in cases of fever of unknown origin.

Furthermore, imaging studies such as chest X-rays may be employed to detect focal sources of infection. 
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Treatment

The treatment of fever in adults aims to address the underlying cause while managing the symptoms. 
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The majority of cases are treated with acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and aspirin. However, in cases where a bacterial infection is suspected, doctors may prescribe appropriate antibiotic therapy.

Additionally, supportive measures such as adequate hydration and rest are important for individuals with fever. In severe cases, hospitalization and intravenous administration of fluids and antimicrobial agents may be necessary. 
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Prolonged fever can result in dehydration, electrolyte imbalances, and metabolic disturbances.

Furthermore, a high fever can lead to neurological complications such as confusion, hallucinations, and even death.

In critically ill patients, fever can contribute to hemodynamic instability and organ failure 
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Common risk factors include a weak immune system and recent travel to regions endemic to specific infectious diseases.

Occupational exposures, such as working in healthcare settings or handling animals, also pose a risk for certain febrile illnesses, such as Q fever.<a href="#accordion">[3]</a> 
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Preventive measures for reducing the risk of fever in adults primarily focus on infection control and vaccination.

Good hygiene practices, including regular handwashing and proper food handling, can help prevent the spread of infectious agents that cause fever. 
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Vaccination against common infectious diseases, such as influenza, pneumococcal disease, and Q fever, is essential for reducing the incidence of fever in adults, especially in high-risk populations.

Additionally, individuals with underlying medical conditions should adhere to their prescribed treatment regimens to minimize the risk of fever-associated complications. 
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Key Points

<ul>
	<li>Fever is a temporary increase in body temperature in response to an illness.</li>
	<li>The types of fever in adults include intermittent, remittent, continuous, low-grade, and high fever.</li>
	<li>Common causes of fever in adults include infectious diseases, autoimmune disorders, and certain malignancies.</li>
	<li>Treatment of fever in adults focuses on addressing the underlying cause and providing supportive care.</li>
	<li>The complications of fever in adults can range from dehydration and electrolyte imbalances to neurological issues and death.</li>
	<li>Risk factors for fever in adults include weak immune systems, occupational exposures, and recent travel to endemic regions.</li>
	<li>Preventive measures for reducing the risk of fever in adults emphasize good hygiene practices, vaccination, and adherence to prescribed treatments.</li>
</ul>

[1] Falsey, A., Baran, A., & Walsh, E. (2015). Should clinical case definitions of influenza in hospitalized older adults include fever?. Influenza and Other Respiratory Viruses, 9(S1), 23-29.

[2] Kaul, D., Flanders, S., Beck, J., & Saint, S. (2006). Brief report: incidence, etiology, risk factors, and outcome of hospital-acquired fever a systematic, evidence-based review. Journal of General Internal Medicine, 21(11), 1184-1187.

[3] Sloan-Gardner, T., Massey, P., Hutchinson, P., Knope, K., & Fearnley, E. (2016). Trends and risk factors for human q fever in australia, 1991–2014. Epidemiology and Infection, 145(4), 787-795

[4] Meltzer, E. and Schwartz, E. (2010). Enteric fever: a travel medicine oriented view. Current Opinion in Infectious Diseases, 23(5), 432-437.

[5] Basnyat, B. (2022). Tackling typhoid fever burden in south asia. The Lancet Global Health, 10(7), e932-e933.

[6] Date, K., Newton, A., Medalla, F., Blackstock, A., Richardson, L., McCullough, A., … & Mahon, B. (2016). Changing patterns in enteric fever incidence and increasing antibiotic resistance of enteric fever isolates in the united states, 2008–2012. Clinical Infectious Diseases, 63(3), 322-329.

[7] Parry, C. M., Ribeiro, I., Walia, K., Rupali, P., Baker, S., & Basnyat, B. (2019). Multidrug resistant enteric fever in south asia: unmet medical needs and opportunities. BMJ, k5322.