What fever means for the clinical settings, prognosis and diagnosis

What I mean by fever is the measurement by traditional thermometer, either in the armpit, mouth rectum or in the ear. While it is a very simple measure, people usually thinks it means infection, regardless.

Clinical settings, or complaints are just trickier for the diagnosis of fever. Patients usually complain - uneasiness, generalized muscle soreness, chills, or hot body - need a wet towel to lower temperature, as fever. You need to clarify.

Frequently, patients don't complain anything about fever at all, yet you get a fever measurement at the ER or OPD.

For patients who cannot talk, and there is no-one to tell the history of fever, there is a different story.

There are different causes of fever, but you need to be aware of infections. Even so, antibiotics don't always help.

True etiologies of fever - changes in the thermostat at hypothalamus.

True etiologies of fever

1. Peripheral (extracranial causes) - metabolic chemicals that travels to brains, be it chemicals from leukocytes (from inflammation), exo/endotoxins from bacteria, or medications
2. Central (cranial causes) - herniation, intracranial hemorrhages, mass effects and stuff
3. Hot environment
4. Thermometer drops from the armpit to the hot environment

Causes of fever by treatment

1. Bacterial infection - usually need antibiotics, and need even stronger antibiotics for those with low immunity; Atypical pathogens will need a different kind of antibiotics.
2. Fungal infection - may be confused with colonization which should not cause fever. Occurs more often for those with poor immune status. If it does infect, it needs antibiotics.
3. Viral infection - need antibiotics only sometimes, rarely.
4. Inflammation - prognosis varies actually. Needs proper diagnosis to clarify prognosis and treatment.
5. Drug fever - probably there is no problem with prognosis even if you continue the drug and live on with the fever. But it is advisable to stop the suspected drugs or all drugs; or you would not know that it is not an infection. It is said that pulse does not raise with this kind of fever.
6. Central fever, I mean brain fever - you usually cannot do a thing about it. Aim at treating the cause.
7. Hot environment - you just need to be aware of it, and you say, "I don't care."
8. Other complaints that patients claim, "It's an infection." - make sure it is not an infection. Treat according to the cause.