kupdf.net_pedia-fever.pdf - 1 YOU GIVE ME FEVER \u2022 \u2022 \u2022 \u2022 \u2022 By Lester A Deniega MD Thermosensitive neurons(Anterior hypothalamus(Pedia2 Module4

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YOU GIVE ME FEVER!!! By Lester A. Deniega, MD (Pedia2 Module4/ Lecture Date: June 15, 2006) Fever definition o Elevation of body temperature to above normal (98.40F) or 370C orally or 99.80F or 37.60C rectally) Challenge to fever o To establish the causative agent – distinguish viral from bacterial disease o Identify the site of a localized infection Temperature Variability o Individual to individuals o In each individual o Diurnal variation in temperature o Oral, axillary or rectal temperatures o Responses among children and adults o Physiologic states causing fever: digestion exercise ovulation pregnancy warm environment emotion o Pathologic causes Infection Inflammation e.g. connective tissue disease Neoplasms Vaccines Dehydration Common causes of fever o Minor illness URTI Viral exanthems Gastroenteritis o Major illnesses Bacterial meningitis UTI Pneumonia Malaria Mechanisms of a Protective Effect of Fever o Enhanced neutrophil migration o Increased production of antibacterial substances by neutrophils o Increased production of interferon o Increased antiviral and antitumor activity of interferon o Increased T-cell proliferation o Decreased growth of microorganisms in iron-poor environment “Fever”: Infectious Disease Clinics Of North America, 1995 Extreme hyperpyrexia and hypothermia (>410C) Extreme pyrexia Hypothermia Central fevers (neoplastic, trauma or infection) Drug fever Heat stroke HIV Malignant hyperthermia Malignant neuroleptic syndrome Elderly Cold exposure Hypothyroidis m Overwhelming infection Sepsis in CRF Overzealous treatment with antipyretics Pathogenesis of fever Exogenous pyrogens: Microbes, microbial toxins, Other microbe products Endotoxins PML, Monocytes, Macrophages Endogenous pyrogens: IL-1;IL-6;TNF- a & IFN – B and Y Thermosensitive neurons (Anterior hypothalamus) FEVER Thermoregulatory responses: Redirection of blood to and from Cutaneous vascular beds Increased or decreased sweating ECF volume regulation Behavioral changes Why Fever Occurs Exogenous pyrogens: e.g.infectious agents, drugs White blood cells
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