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High fever

SYMPTOMS

What is high fever?

High fever refers to a phenomenon where the body's temperature rises above the normal range (approximately 36°C to 37°C) due to various pathogenic factors, typically indicating an oral temperature of 39.1°C to 41°C. It is sometimes referred to as "high fever." If the body temperature continues to rise above 41°C, it is termed hyperpyrexia[1].

The occurrence of high fever is related to the activation of the human immune system, indicating that our immune system is working to eliminate various pathogenic factors. It can also be associated with damage to the thermoregulatory center in the central nervous system [2]. High fever may persist until the pathogenic factors are cleared and gradually return to normal, or it may recur intermittently, with varying intervals depending on the nature of the causative factors.

TREATMENT

How to Relieve High Fever?

When a patient develops a high fever, it often indicates the presence of an underlying disease. They should seek medical attention promptly to identify the cause and receive appropriate treatment, rather than blindly attempting to reduce the fever and delay care. It is particularly important to distinguish between high fever and hyperthermia (e.g., heat stroke, serotonin syndrome), as the latter can be rapidly fatal and requires different management approaches [2].

For most patients, the fever will subside on its own once the underlying cause is treated. During the diagnosis and treatment period, measures similar to those for fever can be taken to alleviate high fever symptoms [3,4]:

  1. General Measures:
    • Strict bed rest to reduce activity, as rest minimizes energy expenditure and aids recovery.
    • Maintain a suitable indoor temperature (20°C–25°C), ensure proper ventilation, and keep the surroundings quiet.
    • Remove excess clothing, choose appropriate bedding, and keep the skin clean and dry. Change clothes or sheets promptly to avoid chilling.
  2. Lowering Body Temperature:
    • Physical Cooling: For temperatures above 39°C, localized cold therapy (e.g., ice packs on the forehead, armpits, or groin) can be applied using cold towels, ice bags, or ice caps. For temperatures above 39.5°C, cold therapy such as lukewarm water or alcohol sponging may be used to reduce fever [2-4].
    • Medication: Antipyretics (e.g., ibuprofen suspension) can help lower fever by reducing the excitability of the thermoregulatory center and promoting heat dissipation through vasodilation and sweating [3]. Follow dosage instructions on the label or consult a doctor.

Dietary Considerations for High Fever Patients

  1. Choose foods that are appealing and easy to eat. For fever caused by gastrointestinal infections, opt for easily digestible, nutrient-rich options like steamed egg custard or vegetable and lean meat porridge.
  2. Eat small, frequent meals to replenish energy lost due to fever (individual needs vary based on basal metabolic rate, body temperature, and activity level). This helps boost immunity [3,4].
  3. Stay hydrated—aim for 3000 mL of water daily to prevent excessive fluid loss and facilitate the elimination of toxins and metabolic waste [3,4].

DIAGNOSIS

Under what circumstances should a high fever patient seek medical attention at a hospital?

If a high fever is detected (self-measured temperature exceeding 39.1°C with a thermometer), the patient should go to the hospital.

If accompanied by any of the following conditions, seek medical attention immediately:

  1. Persistent high fever or recurrent episodes of high fever;
  2. Chills, convulsions, headache, cough, sputum production, difficulty breathing, etc.;
  3. Pale complexion, cold and clammy limbs, impaired consciousness, limb twitching, etc.;
  4. Abdominal pain, diarrhea, lower back pain, bloody urine, frequent urination, urgency, or pain during urination, etc.;
  5. Conjunctival congestion, rash, etc.;
  6. Swollen lymph nodes, bleeding, etc.

Which department should a high fever patient visit?

General Internal Medicine.

POTENTIAL DISEASES

What are the possible causes of high fever?