Signs and symptoms of Fever
Anyone can develop fever at any stage of their life. However, some people with an underlying disease (immunocompromised, chemotherapy or transplant patients) or who have undergone surgical or endoscopic procedures, are more prone to suffer infections and present a greater risk of complications. In this respect, a detailed medical history is essential when diagnosing fever.
If you have fever, then you must take the following signs and symptoms into consideration:
General characteristics of fever. Chills or shivering; fever pattern (at what time of day the fever appears) and duration (a few hours or several days).
Medical background. Toxic habits (tobacco, alcohol, other recreational drugs), regular medicines, drug allergies, epidemiological background (visits to tropical countries), past illnesses (neoplasms, chemotherapy), patients who wear a urinary or central venous catheter, recent surgical interventions, endoscopic tests and vaccination status.
Generalised pain. Muscle pain (myalgia) is typical of viral diseases and may be accompanied by fever.
Abdominal pain and gastrointestinal symptoms. When fever is the result of a visceral abdominal process it is usually accompanied by either continuous or fluctuating abdominal pain, nausea and vomiting, and may sometimes present with symptoms of yellow discoloration of the skin and mucous membranes (jaundice) and occasionally with changes in bowel movement frequency (diarrhoea or constipation).
Respiratory symptoms. If the fever is caused by an upper respiratory tract process, then it usually presents with a runny nose, nasal congestion, dry cough and/or pain when swallowing (odynophagia). If it is due to a respiratory condition affecting the lower tract (acute bronchitis or pneumonia), then it tends to be accompanied by a productive cough and sometimes pleuritic chest pain (i.e., it worsens with breathing movements).
Urinary symptoms. Fever that presents with symptoms of discomfort while urinating, lower back pain or pelvic pain is generally the result of a urinary infection.
Neurological symptoms. Infections of the central nervous system are typically severe and produce a characteristic set of symptoms in addition to fever: intense headache, decreased level of consciousness, focal neurological deficit and even epileptic seizures. In the most severe cases, these infections are accompanied by small purple lesions which are mainly observed on the lower extremities.
Skin eruptions. Fever sometimes manifests with rash-like skin eruptions (reddish in colour and of varying extension), especially in children who often suffer from contagious viral infections. These infections mainly occur in unvaccinated (or partially vaccinated) patients (whether children or adults).
Fever in elderly or immunocompromised patients
Special cases are when fever develops in an elderly or immunocompromised patient (e.g., hemato-oncological, chemotherapy, solid organ or bone marrow transplant patients, and those with primary or secondary immunodeficiencies such as HIV infection).
In these instances, the infections tend to course with very few or no accompanying symptoms, that is, they are paucisymptomatic, and often do not even present fever. Any change in these patients’ general condition (loss of appetite, weakness, disorientation, etc.) should arouse suspicion of an infection.
In the case of patients who have undergone a surgical intervention or diagnostic endoscopic test, especially if this included any type of biopsy, then fever is a clear sign of a potential complication and they should visit emergency services as soon as possible.
What is the first thing to do?
When someone feels hot and cold or has chills, the first thing to do is place a thermometer under their armpit and check their temperature. If it is higher than 37.7 °C, then they have fever. If it is less than this value but the symptoms mentioned above persist, remeasure their temperature after half an hour.
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