Medicine

An inbuilt defence mechanism

No need to panic: A high temperature may not always mean fever. Photo: K.V. Srinivasan   | Photo Credit: K_V_Srinivasan

It's probably the most used word after “pain” in a medical conversation. Outside consulting rooms, “fever” has applications that spill into performing art, love, why, life itself.

Your teen kid has Justin Bieber fever; your own temperature races when you hear Elvis Presley, Peggy Lee, Madonna or Michael Buble croon “Everybody's got the fever, that is something you all know/Fever isn't such a new thing, fever started long ago. Oh, what a lovely way to burn.” Ever had the exam fever, Saturday night fever? And feverishly busy days?

What is fever?

That's about heartache. The one that comes with body ache, itchy/dry throat, exhaustion or cold is equally widespread. And well-understood. “Fever, aka controlled hyperthermia or pyrexia, is a generalised increase in body temperature above its normal range of 97-99°F,” says Mumbai-based Dr. Himanshu Doshi.

Gastroenterologist Padmashri Dr. Ahmed Ali defines it as, “Fever is a symptom of a disease, infection or injury. Malaria, typhoid, viral infection, bronchitis... all these manifest themselves as fever. It's a reaction to a bacteria, virus or malignancy. A fever of unknown origin (FUO) could have its basis in cancer. HIV patients too run a fever.”

Adds Dr. Doshi, “The commonest cause of fever is infection, but it can be due to allergic reactions. Strenuous exercise or exposure to hot climate can raise temperature, but this is not ‘fever'. When exercise/exposure to hot climate is stopped, body regains its normal temperature without any medical aid.”

Fever is not an illness, it's not an enemy. It's our defence against viral/bacterial invasion. Usually the rise in body temperature helps the individual resolve an infection. Most bacteria and viruses that cause infections thrive best at 98.6°F. So our temperature regulatory mechanism sets the body thermostat high to give it a winning edge. Fever activates the body's immune system to make more white blood cells, antibodies, and other infection-fighting agents. The body shivers and reduces blood supply to the skin to prevent heat loss. Finally, the temperature plateaus.

Try as we might, it's difficult to stop those pesky viral and bacterial armies attacking our systems. So we get the inflammatory rheumatic fever from polyarthritis and strep throat, rising temps in bouts of flu, chickenpox. We get feverish with medication, silicosis, amphetamine abuse and alcohol withdrawal. Arizona has its Valley fever, a lung infection from an airborne fungus. You know of dengue/Congo/Nile varieties. High fever could be a symptom of ear/kidney infection, gastroenteritis, meningitis or pneumonia.

Cause for concern

Worry is when the kid wakes up with fever. In a less-than-three-months old infant it's cause for concern, but when an older kid has a tummy ache, it's the number on the thermometer that sends us into a tizzy. “I panicked when my eight-year-old with fever couldn't get up,” said Sumana, a stay-home mom. “The healthcare provider suspected it was mononucleosis.” Husband Srinivas stepped in to deal with it. “I gave her Belladona homeopathic medicine (for mono) and she was jumping around the house in a few hours. She had a similar recovery after high fever due to ear infection. Belladona had worked wonders then as well,” he said.

The “fever phobia” springs from the belief that untreated fevers might have neurological effects (brain damage). Yes, some kids are at risk for seizures with fever, but doctors say these are not generally harmful and do not cause epilepsy. Simple febrile seizures are over in moments with no lasting consequences. Even untreated fevers rarely rise higher than 104-105° F.

“Treat fever like a warning sign that something is wrong,” says Dr. Doshi. “Note the frequency and duration of temperature spells, symptoms like shivering, body ache, nausea, vomiting, loose motions, cough, running nose, localised pains etc. This helps doctors taper down to the cause.” When the fever gets high there may also be extreme irritability, confusion, delirium and convulsions.

What to do

Home care should be the first choice. If the fever is mild with no associated problem, no medical treatment is required. If the kid is playing around and drinking fluids, treatment is not necessary.

If the child is vomiting, dehydrated or won't sleep, try to lower, not eliminate, the fever. Monitor to check improvement. Given time, the body's own defence mechanism usually takes care of the situation. Do not go by the “feeling warm” syndrome to decide its fever, says Dr. Ali. Pull out the thermometer and record the temperature.

“If the fever doesn't come down in three days in spite of care, consult a physician,” he says. You will need blood/urine test, x-rays, even ultra sound for a possible liver abscess. The respiratory tract should be checked for phlegm.

“Meantime, take plenty of liquids, rest. If nausea and vomiting accompany the temperature, you'll need intravenous fluids. Don't take anything cold. Bacteria thrive in cold.”

Ah, there's no fever-free life, but it helps to think it's a curative process.

What you should know

Learn to take accurate temperature

Acute bronchitis, AIDS/HIV infection, forms of cancer, collagen vascular disease, rheumatoid diseases, auto-immune disorders, ear infections, mononucleosis, inflammatory bowel disease, pneumonia, appendicitis, tuberculosis, and meningitis can result in fever

Upper respiratory infections (tonsillitis, pharyngitis, laryngitis, urinary tract infections can cause fever

Call a doctor if there are symptoms like irritability, confusion, difficulty breathing, stiff neck, inability to move an arm or leg, or first-time seizure

There is no medical evidence that fevers from infection cause brain damage. The body limits a fever caused by infection from rising above 106°F (41.1°C)


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Printable version | Jun 13, 2021 2:10:34 AM | https://www.thehindu.com/sci-tech/health/medicine-and-research/An-inbuilt-defence-mechanism/article14677049.ece

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