Fever!!

(This is the first in a series of articles that will address things that we often see folks coming in or calling us to see how to handle. This article is going to be on fever. We will also do one on cough, congestion, etc.)

In an adult, a fever can be a common side effect of illnesses like the flu. It represents a temporary rise in body temperature. A fever can be a good sign that your immune system is hard at work fighting an infection or other illness.

Most of the time, a fever is nothing to worry about and will go away on its own. But if you're ever unsure, it's always best to check with your doctor. Here are some general guidelines on when a fever may be cause for concern in an adult:

- A body temperature above 100.4 degrees Fahrenheit is considered a fever.

- A Fever that lasts more than three days or that isn't responding well to treatment may be cause for concern.

- A Fever accompanied by other symptoms like chest pain, shortness of breath, or severe headache could be serious and should be evaluated by a doctor right away.

- If you have a Fever and are pregnant, elderly, or have a chronic illness like cancer or HIV/AIDS, you should also see a doctor right away.

Fever can be a sign of something serious, but it's also often just a harmless side effect of an infection or other illness. It can even be caused by certain medicines and your reaction to them. If you're ever unsure, it's always best to check with your doctor. With their help, you can figure out what's causing your fever and how to treat it.

What is a fever?

A fever is described as a normally short-term increase in your body temperature that helps your body get rid of illness. It IS part of your immune system. A fever can start when your immune system starts to make more white blood cells to fight an infection. The increase in white blood cells can "message" your brain to heat your body up or initiate a fever.

This causes a fever. and in response, your body will try to cool itself off by altering blood flow to your skin and contracting muscles. This makes you shiver and may cause muscle aches, and pain that anyone who has had the flu can remember...the time they were sick and "ached allover"

Our normal body temperature ranges from 97°F to 99°F (36.1°C to 37.2°C). You are considered to have a fever if your temperature rises above this.

Types of fevers

Adults typically have a fever if their body temperature is equal to or above 100.4°F (38°C). This is called a low-grade fever. A high-grade fever happens when your body temperature is 103°F (39.4°C) or above according to most medical texts.

Simple fevers usually go away by themselves after 1 to 3 days. A persistent or recurrent fever may last or keep coming back for up to 14 days. Some diseases (like malaria, etc) can have relapsing fevers for weeks or longer

A fever that lasts longer than normal may be serious even if it is only a slight fever. This is because a recurrent fever might be a sign of a more serious infection or a more serious health condition.

Common fever symptoms in most of us adults include:

• muscle pain

• loss of appetite

• fatigue

• weakness

• sweating

• chills (shivering)

• headaches

When is a fever considered serious?

Many medical providers suggest that you should call your medical provider sooner than later if you have a high-grade fever — that is if your temperature is 103°F (39.4°C) or higher. Many suggest that you seek medical help if you have any kind of fever for more than three days, or if your symptoms get worse, or change. What are the more serious symptoms to worry about or watch for? A fever may be a sign of serious illness if you have:

• a severe headache

• dizziness

• sensitivity to bright light

• stiff neck or neck pain

• skin rashes

• muscle cramps

• confusion

• seizures

• pain when urinating

• not urinating enough

• difficulty breathing

• frequent vomiting

• dehydration

• stomach pain

• passing dark urine

• passing urine that smells bad

What types of things can cause simple fevers and serious fevers in adults

• viral infection (like the flu or a cold)

• bacterial infection (of the skin, the urinary, gi or other body systems)

• fungal infection

• food poisoning

• heat exhaustion

• serious sunburn

• inflammation (from conditions like rheumatoid arthritis)

• a tumor

• blood clots

Some adults that have a chronic health condition or have been treated for a severe illness, may be more likely to get a fever that can be something more serious. Some of those conditions include-

• asthma

• sickle cell disease

• liver disease

• Kidney Disease

• chronic lung disease

• cystic fibrosis

• rheumatoid arthritis

• diabetes

• Crohn’s disease

• heart disease

• cerebral palsy

• stroke

• multiple sclerosis

• muscular dystrophy

• AIDS

As I mentioned previously some medications and treatments can also suggest a more serious fever, or one more difficult to diagnose, like:

• antibiotics

• blood pressure drugs

• seizure medications

• DTaP vaccine and other vaccines

• pneumococcal vaccine

• steroids

• chemotherapy such as methotrexate, Cytoxan, and azathioprine

• radiation treatment

• post-transplant medications (after kidney, liver, heart etc)

Treatment for fever- is it necessary?

A fever is not normally harmful on its own. Most fevers go away within a few hours to days. Many look upon the fever as evidence that the body is fighting to protect itself from infection and other things. You can always help yourself feel better with these at-home fever remedies (useful with viral infections like flu, or with bacterial infections, like UTI's or strep throat etc..)

stay hydrated by drinking plenty of fluids, like juices, water, broths etc..

• soups

• try to eat "lighter foods" that are easier on an upset stomach

• get plenty of rest

• You can use a cool compress, like a damp towel to help cool the body

• take a warm or room temperature sponge bath

• dress in lighter, more comfortable clothing

• keep your thermostat lower

Over-the-counter medications can help ease your fever and symptoms, like headaches and muscle pain:

• ibuprofen (Advil, Motrin)

• acetaminophen (Tylenol)

• naproxen (Aleve, Naprosyn)

Are there other natural or homeopathic treatments for fever?

You can also try these:

teas- chamomile, ginger, lavender

herbs and supplements- echinacea, garlic, goldenseal, ginseng

more fluids- water with honey and lemon, fruit juices like cranberry or blueberry juice etc..

soups- chicken soup, vegetable soup

yogurt- plain yogurt with honey (for adults only)

honey- one tablespoon 3 times a day ( for children one year and older)

warm compress on the forehead or neck area for 20 minutes at a time every few hours as needed.

What is the bottom line?

A fever is not usually harmful, but it might be a sign of something more serious.

Some patients may need treatments for more serious causes of a fever. The treatment depends on the causes. You may need medications to treat serious infections, etc: Things like antivirals, antibiotics (and probiotics) or antifungals.

When to come to the office, urgent care or the ER

A fever can be a sign of serious illness. A high fever can also cause serious side effects if it persists for a longer time. So, when is it an emergency, or when should I see my medical provider?

Somethings that suggest that you are having Emergency Symptoms

• seizure or convulsions

• fainting or loss of consciousness

• difficulty breathing

• hives or a rash

• swelling in any part of the body

• confusion

• hallucinations

• severe headache pain

• stiff or painful neck

In closing, let me summarize-

A fever in most healthy adults is usually not harmful on its own. But it can be a sign that your body is dealing with an infection or other illness. In some cases, a high or long-lasting fever can be a sign of a serious illness that could mean that you may need urgent medical care.

Do not ignore a fever. Get plenty of rest and fluids to help your body heal and rid itself of the cause of the fever and the fever too... It is a good rule of thumb to see your medical care provider if you have a fever that lasts longer than 3 days or if you have other severe symptoms.

Most experts agree that if you have a serious chronic condition or have been treated for a serious illness, or if you have recently undergone surgery or other medical procedure, you should let your medical provider know if you have any kind of fever.

Thanks for reading this and sharing. We also welcome your feedback. Dr. P

Author

Robert W. Patterson MD ND Founder of Back to Basics Medical Practice who has practiced family medicine for 40 years and dedicated his professional life to serving his patients ( and not the insurance companies)