{"id":462,"date":"2019-11-29T00:39:43","date_gmt":"2019-11-28T19:09:43","guid":{"rendered":"https:\/\/abhinavkr.com\/blog\/?p=462"},"modified":"2023-12-13T03:27:20","modified_gmt":"2023-12-12T21:57:20","slug":"types-of-fever","status":"publish","type":"post","link":"https:\/\/abhinavkr.com\/musings\/2019\/11\/types-of-fever\/","title":{"rendered":"Types of fever"},"content":{"rendered":"\n

Types of fever is a frequently asked viva question but a concise and complete answer is not available for it anywhere. I’ve tried to come up with a complete list which I have gotten verified by a Medicine SR and partly by a prof. However, if any errors are found, feel free to inform and I’ll add the corrections.<\/p>\n\n\n\n

Based on pattern of fever<\/h3>\n\n\n\n
Type<\/strong><\/td>Character<\/strong><\/td>Example<\/strong><\/td><\/tr>
Continued\/ Persistent<\/td>Diurnal variation <1\u00b0C (1.5\u00b0F) in 24 hrs. Does not<\/strong> touch baseline.<\/td>Lobar pneumonia, Miliary TB, meningitis, Acute Rheumatic Fever, SLETyphoid: Step ladder fever (rising temperature over the course of each day that drops by the subsequent morning)Borellia- low grade Relapsing<\/strong> Fever.<\/td><\/tr>
Intermittent<\/td>Diurnal variation, Temperature touches baseline at least once a day<\/td>EBVQuotidian<\/strong>: daily. Eg: Double infection of p.vivax, UTI, Septicemia, Amoebic liver abscess, TBDouble quotidian<\/strong>: 2 peaks in one day. Eg: Kala-azar, Gonococcal endocarditis, Still\u2019s diseaseTertian<\/strong>: Fever peaks every other day (one spike in 2 days). Eg: Benign tertian: (Plasmodium vivax, P. ovale rarely); Malignant tertian (P.falciparum)Quartan<\/strong>: Fever peaks every 3rd day (gap of 2 days) Eg: P. malariae. (rare in india)<\/td><\/tr>
Remittent<\/td>Diurnal variation >=1\u00b0C, temperature does not<\/strong> touch baseline<\/td>Amoebic liver abscess, Acute bronchopneumonia, acute tonsillitis, Septicemia, Empyema thoracis<\/td><\/tr>
Periodic<\/td>Temperature returns to normal for days before rising again<\/td>Hodgkin\u2019s disease: Pel-Ebstein<\/strong> fever(3 weeks of fever then 3 weeks normal)Brucellosis: Undulant<\/strong> fever (the fever is typically undulant, rising and falling like a wave)Dengue: Saddleback<\/strong> fever (fever abates for a day and then returns)<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

The use of antipyretic and antibiotic drugs has made these patterns unusual today. <\/p>\n\n\n\n

Note<\/em>:<\/p>\n\n\n\n

    \n
  1. Continuous step ladder pattern of fever is classical of typhoid fever.<\/li>\n\n\n\n
  2. High grade fever: <\/em>Temp >100\u00b0F, or if it’s fever with chills.<\/li>\n<\/ol>\n\n\n\n

    Based on fall of fever on treatment<\/h3>\n\n\n\n
      \n
    1. Fall by Lysis <\/strong>(Slowly comes down) Eg<\/em>: Typhoid. Takes 5 days to become afebrile. Malaria- One more cycle of fever occurs after rx.<\/li>\n\n\n\n
    2. Fall by Crisis<\/strong>\u00a0 (Give med- Falls- Doesn’t rise again) Eg:<\/em> Pneumonia<\/li>\n<\/ol>\n\n\n\n
      Hypothermia<\/td><35C<\/td>Eg: Hypothyroid, Severe Sepsis<\/td><\/tr>
      Hyperthermia<\/td>>104 (42C), Set point is normal<\/td>Heat stroke,

      Drugs:

      Malignant Hyperthermia- Succinylcholine for anesthesia
      Neuroleptic malignancy (excess muscle breakdown, pain, renal failure)- Antipsychotics<\/td><\/tr>
      HyperPyrexia<\/td>Set Point Reset, so temp rises upto that point and falls<\/td><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

      Causes of fever other than infections<\/strong>: Malignancy, Connective tissue disorder, Hyperthyroid, All drugs (except digitalis), Thrombosis (like in brain, DVT), thrombophlebitis, Bleed in brain or abdomen, Blood transfusion, serum sickness, Mediterranean fever<\/p>\n","protected":false},"excerpt":{"rendered":"

      Types of fever is a frequently asked viva question but a concise and complete answer is not available for it anywhere. I’ve tried to come up with a complete list which I have gotten verified by a Medicine SR and partly by a prof. However, if any errors are found, feel free to inform and…<\/p>\n","protected":false},"author":2,"featured_media":486,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[254],"tags":[272,274,284,288,316,318],"class_list":["post-462","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-stuff","tag-fever","tag-flu","tag-kala-azar","tag-malaria","tag-typhoid","tag-virus"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/abhinavkr.com\/musings\/wp-content\/uploads\/2019\/11\/1024px-Clinical_thermometer_38.7.jpg?fit=1024%2C634&ssl=1","jetpack_shortlink":"https:\/\/wp.me\/p4KGvB-7s","jetpack-related-posts":[{"id":648,"url":"https:\/\/abhinavkr.com\/musings\/2014\/11\/whats-an-expert-i-sincerely-want-to-know\/","url_meta":{"origin":462,"position":0},"title":"What’s An Expert? 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