Excerpts From Homeobuzz (3)

RH J.J. Patel.qxd

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 Viral Infection.  Myco bacterium Tuberculi. Collagen Disorders:  Rheumatoid Arthritis  S.L.E.  P.A.N. Auto Immune Disorders:  Acute Rheumatic Fever  Acute Glomerulonephritis Inflammation:  Burns  Trauma  Collagen Group  Auto Immune Miscellaneous:  Thyrotoxicosis  Heat Stroke  Sun Stroke  Malignancy  Anxiety  Alcohol Intoxication  Dhatura Poisoning  Atropine Overdoses

TYPES OF FEVER

An Approach to a Case of Fever DEFINITION Elevation of the external/internal body temperature beyond 98.6 degreeF or 38.6 degree C. Internal body temperature i.e. oral temperature > 1 degree F than external body temperature. Rectal

Temperature is > 1.5 degree F than external body temperature.

AETIOLOGY 1. Microbes:  Bacterial Infection.

1. Continuous Fever: Elevation of the body temperature more than normal which do not fluctuates more than 1 degree C or 2 degree F during 24 hours. E.G. Typhoid Fever, Infective Endocarditis. 2. Remittent Fever: Elevation of the body temperature more than normal which fluctuates more 2 degree F but does not touch the normal once in 24 hours. E.G. Viral Fever, Rabies. 3. Intermittent Fever: Elevation of the body temperature above normal which touches normal at least once in 24 hours. E.G. Malarial Fevers. 4. Periodical Relapsing Fevers: Elevation of the body temperature more than normal and comes at periodical interval and lasts for few a days; between the two episodes temperature is normal. HOMEOBUZZ

August 2008

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which fluctuates not more than 1 degree C or 2 degree F during 24 hours. E.G. Hodgkin’s Lymphomas. 5. P.U.O. (Pyrexia of Unknown Origin): When fever is investigated thoroughly but causes of fever is still unknown, then it is called P.U.O. There is no fixed pattern of presentation of the fever. E.G. Collagen Disorders, Malignancy, Auto Immune Disorders.

HYPERPYREXIA It is a condition of elevated body temperature (more than 105 degree F) whereby the brain function starts deteriorating and the person develops delirium, convulsions and sometimes coma.

HEAT STROKE Person starts getting symptoms and signs of shock due to exposure of extreme heat. E.G. Exposure to furnace.

SUN STROKE Person starts getting symptoms and signs of shock due to exposure of extreme heat of sun. E.g. Exposure to heat of sun in summer.

QUESTIONS TO BE ASKED 1. SINCE WHEN? (DURATION): A. Short – Viral, Bacterial B. Long – e.g. Tuberculosis C. Very Long – Occult Malignancy 2. HOW SEVERE? (ELEVATION): Very High: e.g. Bacterial, Viral, Septicemic. Low Grade: e.g. Tuberculosis, Auto Immune, Collagen Disease 3. TEMPERATURE DURING DAY AND NIGHT FOR TYPES OF FEVER: Examples: Continuous  Intermittent  Remittent  Relapsing Fever 

Examples:  P. Falciparum Infection  Bacterial Infections  Heat Stroke  Sun Stroke  Tetanus

It is the decrease in body temperature below 95 degree F at which the foundation of vital organs and brain starts deteriorating.

    

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Examples: Fever Peripheral Shock Myxoedema Shock Sever Dehydration Ice cold water bath Very high Altitude. Excess of anti Pyretics.

HOMEOBUZZ

6. ASSOCIATED COMPLAINTS:  Headache, Bodyache, Nausea, Vomitting.  Leg cramps and loss of Appetite. ROUTINE INVESTIGATIONS: (Depends upon Clinical Findings.) 1. Total Count: Increase in Bacterial Infection and Decrease in Viral Infection. 2. Peripheral Smear for M.P., Widal Test 3. X Ray Chest, Urine- Routine Test. Dr. J. J. Patel M. D. (Bom.), M.C.P.S. (Bom.), A.F.I.C.A. (U.S.A.). (Specialist in Cardiology, Diabetes & Rheumatic Diseases)

Hey Students!!

HYPOTHERMIA



Evening rise of temperature e.g. Tuberculosis, Filariasis. 4. WITH RIGORS OR CHILLS: E.g. Malaria, Urinary Tract Infection, Filarial Infection. 5. SPECIFIC ASSOCIATED SYMPTOMS:  Urinary in U.T.I.  Cough in U.R.T.I.  Vomiting and Loose motion in Gestro-Entritis.  Convulsions in Hyperpyrexia and Meningitis. 

August 2008

HB plans to start a new column “By the Students” in few months. This section will have articles written by the students persuing BHMS. The best selected articles will be published in the magazine and awarded as well. Send in your suggestions and articles.