FEVER...FEVER... FEVER.

ITS THE SEASON OF FEVER.

DOCTORS ARE AMUSED AND GET TENSIONED BY THE VARIOUS WAYS OF FEVER. THE FOLLOWING ARE THE TIPS HELPFUL AS READY RECKONER FOR FAMILY PHYSICIANS.

COURTESY :DR.KK.AGGARWAL.

Fever Tips
1 Fever with chills and rigors unless proved otherwise, is Malaria, Urinary tract infection or Filaria.
2Malaria chills are usually in the afternoon and filaria chills are usually in the evening.
3 Malaria fever patients invariably will be non-toxic in between fever attacks and typhoid patients will be toxic.
4 Fever with single episode of chills unless proved otherwise is pneumococcal pneumonia.
5 Abrupt high grade fever with pain in the eye movement is dengue.
6 Fever with pain in joins which improves with flexion is Chikungunia.
7 In viral Hepatitis, jaundice will always appear after fever subsides. If patient has fever and jaundice together, look for other causes.
8 In SLE fever patients will always have negative CRP. Positive CRP, look for associated TB
9 Evening rise fever lasting more than 6 weeks invariably is TB. These patients may have mild derangement of SGOT and SGPT.
10 In dengue fever, SGOT will be more than SGPT by day 3.
In dengue, only after fever subsides, capillary leakage syndrome starts.
11 No fever no flu. No cough no flu.
12 Viral fever will invariably last 7 to 10 days.
13 Fever with rash with lymph nodes behind the ear, unless proved otherwise, is Rubella.
14 Nasal discharge and cough rules out Rheumatic fever. Rheumatic sore throat will have red anger looking throat, throat pain while swallowing food, fever and enlargement of lymph nodes around the jaw.
15 Fever only responding to indomethacoin, look for Hodgkin?s disease.
16 ESR more than 100, look for TB, pus collection inside the body or cancers
17 Fever low grade, chronic diarrhea, weight loss, rule out HIV-AIDS.
18 High fever no sweating: sense danger
19 Hypothermia no chills : sense danger
20. Pulse will rise by 10 for every one degree rise of temperature. Relative bradycardia look for typhoid
21 Absence of fever in sepsis is a bad sign
22 Rectal temperature is more reliable for hypo and hyperthermia.
23 Do not give NSAID for fever in children less than 18 years of age. It can cause fatal liver damage.
24 Chloroquine has anti-viral properties. It is now being investigated for HIV also.
25. In dengue fever, do not give NSAID as with low platelets it can precipitate bleeding.