Pyrexia Its Definition Cause Type And Management

PYREXIA:

Definition:

A high temperature or fever, known as pyrexia, occurs when the body temperature rises above the normal level of 37 C if measured in the mouth, or 37.7 C if measured in the rectum.

Cause:

• Most fevers are caused by pyrogens fever-inducing toxins released by viruses or bacteria. Pyrogens act on the temperature regulating centre in the brain. Common illnesses caused by such infection are the common cold, tonsillitis, influenza and urinary tract infections cystitis. Fever may also occur in non-infectious conditions such as dehydration, heart attack or cancer.

• In addition you can develop a high fever from over-exposure to heat, and especially to the sun. This is known as heat stroke.

• In children, a high temperature may be caused by infections such as measles or an upper respiratory tract infection such as tonsillitis. For some children a high temperature can lead to convulsions or seizures which are caused by the effect that the fever has on the brain.

Symptoms:

A fever may be accompanied by:

• Shivering
• Headache
• Sweating
• Thirst
• Flushed face
• Hot skin
• Rapid breathing 
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Types:

• Intermittent fever: The temperature elevation is present only for a certain period, later cycling back to normal, e.g. malaria, kala-azar, pyaemia, orsepticemia. Following are its types 
• Quotidian fever, with a periodicity of 24 hours, typical of Plasmodium falciparum.
• Tertian fever (48 hour periodicity), typical of Plasmodium vivax and Plasmodium ovale.
• Quartan fever (72 hour periodicity), typical of Plasmodium malariae.
• Remittent fever: Temperature remains above normal throughout the day and fluctuates more than 1 °C in 24 hours, e.g., infective endocarditis.
• Pel-Ebstein fever: A specific kind of fever associated with Hodgkin's lymphoma, being high for one week and low for the next week and so on. However, there is some debate as to whether this pattern truly exists.

• A neutropenic fever, also called febrile neutropenia, is a fever in the absence of normal immune system function. Because of the lack of infection-fightingneutrophils, a bacterial infection can spread rapidly; this fever is, therefore, usually considered to require urgent medical attention. This kind of fever is more commonly seen in people receiving immune-suppressing chemotherapy than in apparently healthy people.

• Febricula is an old term for a low-grade fever, especially if the cause is unknown, no other symptoms are present, and the patient recovers fully in less than a week.

Management Of  Pyrexia :

• First step is to assess the temperature of the person using a thermometer.
• Take off the excessive or warm clothing of the person.
• Loosen the tight or restrictive clothing.
• Allow for good air and ventilation.
• Provide a tepid sponge bath to the person (tepid means the tap water that is neither too warm nor too cold).
• Give plenty of the clear fluids to replenish the fluids lost as a result of the heat evaporation.
• Ensure complete bed rest.
• Apply cold compresses on the forehead if advised by the physician.
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• Administer the anti- pyretic over the counter medications such as the acetaminophen or paracetamol. Avoid giving the aspirin drug to the adult or a child.