Fever/ Pyrexia Diagnosis

Fever / Pyrexia Diagnosis Details

1.Define Fever বা জ্বর

Fever বা জ্বর: শরীরের স্বাভাবিক তাপমাত্রা ৯৮.৬ ডিগ্রি ফারেনহাইট বা ৩৭ ডিগ্রি সেলসিয়াস বা এর বেশি হলে তাকেই আমরা জ্বর বলি।

2.Mention the types of fever

Three types of fever

• Continued fever
• Intermittent fever
  • Tertian fever
  • Quartan fever
  • Quotidian fever
• Remittent fever

3.Mention the character and example of continued fever

Character

Dose not touch the baseline (dose not remit), fluctuation less than 2 degree C

Example

• Typhoid fever
• Typhus
• Drug fever
• Malignant hyperthermia

4.Mention the character and example of tertian fever

Character and example of tertian fever

Character

• Quartan fever: Character 4 days pattern
• Fever: 2 days normal fever

Example

Plasmodium malaria

6.Mention the character and example of Quotidian fever

Character

Quotidian fever: Periodicity of fever within 24 hr

Example

• Plasmodium falciparum malaria
• Kala- azar

7.Mention the character and example of Remittent fever

Character

Daily fluctuation greater than 2 degree C, temperature does not return to normal.

Example

• Infective endocarditis

8.Mention the grading of fever

Grading of fever

• Grade Degree F
• Low grade 100.4-102.2 D.F
• Moderate grade 102.3-104.0 D.F
• High grade 104-106 D.F
• Hyperpyrexia >106 D.F

9.mention the temperature of mild fever, moderate fever and severe fever. Define hyperpyrexia.

• Mild fever 100.4 – 102.2 D.F
• Moderate fever 102.3 – 103.9 D.F
• Severe fever 104 D and above

Hyperpyrexia

দেহের তাপমাত্রা ১০৬ ডিগ্রি ফারেনহাইট এর উপরে গেলে তাকে hyperpyrexia বলে।

10.জ্বরের রোগের কি কি points note করতে হয়? (What are the points to be noted in a patient with fever?)

• Duration : Acute or Chronic
• Intensity : Low grade or high grade
• Character: Continued , Intermittent or Remittent
• Diurnal variation: eg evening rise of temperature (tuberculosis)
• Associated symptoms : eg
  • Chills and rigor (malaria) pyelonephritis, ascending cholangitis
  • Unconsciousness (cerebral malaria, meningitis encephalitis)
  • Night sweat (Lymphoma , TB)
  • Dysuria (UTI)
  • Rash (measles, enteric fever, infective endocarditis, meningococcal meningitis, rickettsia, dengue, infectious mononucleosis)
  • Reliving factors : eg subsided by taking paracetamol

11.What is acute and chronic fever? Mention some causes of acute and chronic fever.

Acute fever

Fever persisting less than 2 weeks is called acute fever.

Causes of acute fever

• Enteric fever
• Abscess anywhere in the body
• Pyogenic or viral meningitis
• Malaria
• Pneumonia
• Upper respiratory tract infection
• Urinary tract infection

Chronic fever

Fever persisting more than 2 weeks is called chronic fever.

Causes of chronic fever

• Kala- azar
• Tuberculosis
• Lymphoma
• Chronic malaria
• Enteric fever persisting more than 2 weeks
• Leukaemia
• Aplastic anaemia

12.A 40 years old male presented with one month history of fever and hepatosplenomegaly. Mention three common causes

Common causes of chronic fever with hepatosplenomegaly.

• Kala-azar
• Chronic malaria
• Lymphoma
• Tuberculosis
• Leukaemia

13.What is fever? Mention the causes and treatment of fever.

Fever

দেহের তাপমাত্রা দেহের স্বাভাবিক তাপমাত্রার চেয়ে বেড়ে গেলে তাকে fever বা জ্বর বলে।মানব দেহের স্বাবাবিক তাপমাত্রা ৯৮.৪ D.F

Causes of fever

• Infection (RTI, UTI, GTI)
• Inflammation ( cholecystitis, pancreatitis)
• Auto immune diseases
• Hormone disorder
• Others (vaccination)

Treatment of fever

• Paracetamol ( বেশি জ্বর হলে Paracetamol suppository)
• Tepid sponging (হালকা গরম পানি দিয়ে গা মুছে ফেলানো)
• Vitamin – C
• Treatment of cause

Advice

• Bed rest
• প্রচুর পানি পান করতে হবে

14.Mention the mechanism of fever

Mechanism of fever

• Endotoxin, inflammation & other pyrogenic stimuli
• Activation of monocytes & macrophages
• Release of cytokines
• Pre optic area of hypothalamus
• Release of prostaglandins
• Elevation of temperature set point

Fever collection from: Internet and endavour medicine

15.Define dengue. Mention the causes of dengue fever

Dengue virus সংক্রমনের ফলে যে জ্বর হয় তাকে dengue fever বলে।

Causes of dengue fever

Infection with dengue fever (flavi virus ) এই virus এর বাহক হলো এডিস মশা।

16.Mention the types of dengue fever with symptoms.

Types of dengue fever with symptoms

Classical dengue fever

• Nausea , Vomiting
• গা মেজ মেজ করে
• ৪ দিন পর জ্বর কমে আবার বাড়বে
• ৯ দিনে জ্বর ভাল হবে

Hemorrhagic dengue fever

• দেহের বিভিন্ন অংশে রক্ত বের হবে
• ত্বকে লালচে বা কালচে ছোপ ছোপ দাগ
• Nausea , Vomiting
• দেহের বিভিন্ন অংশে রক্ত ক্ষরন হবে

17.Mention the investigation and treatment of dengue fever

Investigation of dengue fever

• platelet and RBC count
• Antibody test

Treatment of dengue fever

• Paracetamol 1+1+1
• Antihistamine once daily
• Hospitalization