Fever In Children & Adults

FEVER

This is not a disease. This is an indication that some micro-organisms have entered into our system. Generally virus, bacteria, parasites in-vade our body and produce Toxic substances for which body reacts in the form of fever. First of all we need not get worried about it. All that requires is a Tepid sponging with cold water on body surface all over repeatedly. With this the fever will come down, but not the disease. It is doctor’s duty to find out the cause & treat the cause. Forget about old method of forehead strape with cold water.

COMMENEST CAUSES:-

11)    Viral

22)    Malaria

33)    Bacterial Infection (specially respiratory tract)

Rarely Chickun-gunea, Dengue, Leptospirosis (in tamil rat fever)

Specific treatment should be given if it is malaria as per WHO standarad. Blood smear report will be negative in majority of cases. It will be positive only if blood contains large number of parasites (2500 parasites per ml of blood) WHO advises antimalarial treatment if there are not enough causes for other fever. Sometimes malaria can co-exist with another cause.

In females (adults & childrens) all cases need urine culture test to rule out urinary tract infection. Female, fever & fine rigor (chills) means almost urinary tract infection. If there are no other attributable cause. Typhoid is rarest cause. Blood widal test will be positive even in non-typhoid cases. It is only an indirect test. Only culture of stool, urine or blood is a proof. In children respiratory infections is commonest & may require suitable antibiotics for a course. Children from 6months to 6yrs may throw a fit (convulsion) during febrile episodes. Such children need scientific lab studies to rule out brain infections.

Children, who get fits during fever, may have repeated attacks when they are febrile. They may need prophylactic anti-convulsant treatment for a course or during febrile episodes. Unneccessary antibiotics should be avoided in children or adults. Whenever respiratory infection suspected, x-ray chest is a must for children & urine culture for female children.

If urinary infection in female children, not treated in childhood, it may damage the kidneys and cause high blood pressure, leg edema (swelling) & fits during their adult life specially during pregnancy.

Relevant stories in Google website:-

1a)    Typhoid Mary

2b)    Dr.Alexander Fleming – who discovered penicillin (1881)

Nobel Prize winner in 1945. 50yrs back penicillin was top selling drug in all countries, as it was used for 90% illness of all human beings.

Conclusion:-  

         Above diseases are main causes for fever production, but there are innumerable causes for fever & the clinician has to first see the case, Examine, Investigate & finally make final diagnosis & treat the case as per the cause of fever. Eg. Rhumatoid disease may present as fever, but actually it is a bone, joint, muscle, fascia inflammation.

DR.P.SELVARAJ

MD.,DCH.,FRSH (LONDON)

Email – id of author:-

drselvarajp@yahoo.com

Consultant – Child specialist

Consultant – General Medicine (Adult)

Velammal Family Clinic

TVS Colony 1^st main road,

Annanagar West Extn,

Chennai – 600 101.

Ph. No. 7299005901