Cases that puzzle doctors and which are not accompanied by any abnormality need special investigation, says Dr. T.V. Devarajan

It never is ‘just a fever’. An elevated body temperature is a response the body sends out that all is not well. A fever is an indication that there is an infection in the body or an abnormality that needs to be investigated. Good for you if the body sorts it out all by itself after a few mild medications. But if the fever is prolonged, unrelenting, or recurring, clearly it must be investigated.

Since fever can be so common, one hardly thinks of establishing a dedicated, 24-hour, super specialty clinic for it. Usually, fever clinics are set up as a public health response, in order to catch all cases during an epidemic, for instance, of dengue or malaria.

The Tamil Nadu health department, for instance, establishes fever wards in all government hospitals as a response to a seasonal flu or virus.

About 416 mobile medical units conduct camps on a daily basis in various parts of the State, and minor ailments including fever are attended to. Those with fever can also report to the outpatient units in the government hospitals, according to officials from the Public Health department.

But it is the kind of fever whose causes baffle the patient and the doctor that are important, especially because what starts as a fever, if untreated over a period of time, can even be fatal for the patient. It is to tackle these cases, fever of unknown origin, as they are called that Apollo First Med Hospitals has launched an Advanced Fever Clinic.

The brain behind the show, T.V.Devarajan, senior consultant physician says, the time was ripe for opening a clinic. “We have been working on this over a few years now. In the last five years, we have observed many patients coming in with fever, where the causes are undiagnosed, and therefore lead on to several complications. This clinic will not see normal fever cases, only those that require special investigation.

Cases that have puzzled other doctors, or patients (with fever) whose results continue to indicate no apparent abnormality, or simply those with prolonged high fever are the right candidates. “We have seen about five cases of scrub typhus, a relatively rare condition in urban areas. The clue we had was that these people had all been trekking in the wild or had been in forest areas (where the disease-causing mite lives) recently. They all came undiagnosed, and had that situation continued they would have died,” Dr. Devarajan explains.

“Unless diagnosis is done at the right time, a whole bunch of complications can ensue,” adds Preetha Reddy, MD, Apollo Hospitals. Also, it is essential for a multi-disciplinary team to be available on call in order to do a thorough investigation that will reveal the real cause of the fever, she says.

“You cannot really call a fever ‘ordinary’. Some thing as simple as malaria can cause lung injury and turn out to be fatal,” says R.Sathyabhama, Director of Medical Services, Apollo Hospitals, Chennai.