FEVER FEVER FEVER....

BROAD OUT LOOK

Fevers broadly fall into three categories.

• Bacterial Infections
• Viral Fevers
• Parasitic Fevers

Bacterial Infections:

High fever with cough, sputum and shortness of breath, are typical symptoms of respiratory tract infections. Urinary tract infectionscause high fever with chills and rigour. Frequent urination accompanied by a burning sensation or discomfort in the abdomen are additional symptoms. In the case of infections of skin or soft tissueswelling occurs in the affected region, while fever associated with vomiting, loose stools with mucus or blood and abdominal pain point out to gastrointestinalinfection. These infections need antibiotic treatment.

Viral Fevers:

Dengue: Highfever accompanied by severe headache, body pains, backache and joint pains mark this disease. A red rash can also occur. In rare cases the platelet count decreases and lead to bleeding episodes, known as dengue haemorrhagic fever.

Chikunguniya: It is almost like dengue but less dangerous. Severe joint pains may last for weeks and months.

Viral hepatitis A or E: Patients have low grade fever. Appetite decreases due to nausea and yellow discolouration in the eyes can be seen on the 4^th day.

Remember The viral hemorrhagic fevers (VHFs) are a diverse group of animal and human illnesses that are caused by four distinct families of RNA viruses: the Arenaviridae,Filoviridae, Bunyaviridae, and Flaviviridae.

• The Arenaviridae include the viruses responsible for Lassa fever and Argentine, Bolivian, Brazilian and Venezuelan hemorrhagic fevers.
• The Bunyaviridae include the members of the Hantavirus genus that cause hemorrhagic fever with renal syndrome (HFRS), the Crimean-Congo hemorrhagic fever (CCHF) virus from the Nairovirus genus, and theRift Valley fever (RVF) virus from the Phlebovirus genus.
• The Filoviridae include Ebola and Marburg viruses.
• Finally, the Flaviviridae include dengue, yellow fever, and two viruses in the tick-borne encephalitis group that cause VHF: Omsk hemorrhagic fever virus and Kyasanur Forest disease virus.

Parasitic fevers:

Malaria: Patients suffer from high fever with chills and rigour. As soon as the fever subsides the sweating is profuse. Headaches and body pains is common and the fever can sometime lead to anaemia and jaundice.

Filaria: Temperatures can go up to 103-104F with chills and rigour. Pain and swelling in the groin and lower limbs is observed.

Typhoid: High grade fever with headache and body pains. The patient may also have persistentcough , constipation or diarrhoea.

Viral and parasitic fevers can be identified through requisite tests. While viral hepatitis and typhoid are caused by contaminated water and food the rest are caused by mosquito bite. All these can be prevented by taking the needed precautions.

FACT FILE:

• Avoid drugs like aspirin, ibuprofen and dyclofenac as they can cause gastrointestinal side-effects and affect the platelet count.
• Bacterial fevers respond to antibiotic treatment. Viral fevers don’t.
• All fevers don’t respond immediately to medication. Viral fevers take a week’s time to resolve.
• Vaccines are available for typhoid and Viral hepatitis A
• Infants below one-year need to be sponged to bring the fever down. High fever in infants can cause fits.