Determination of the cause of temperature

It's not as easy as it sometimes seems. Unexplained fevers that last for days or weeks, doctors call fevers of obscure ethnology. Most of them are the result of a latent infection. But there is also a drug fever . For example, you visited a doctor about something, he prescribed a medicine for you, and a few days later you have a fever. You are blaming everything for your illness. Perhaps you are right, but always remember that this may be due to the medications that you are taking. The temperature can also accompany any condition in which the body tissues are damaged - heart attack, stroke, cancer, autoimmune diseases or when the metabolic processes in the body are elevated , as in thyroid hyperthyroidism.

Determining the exact cause of the fever often requires thoughtful detective work, in which you, the patient, can and should participate. Take "your mark" by determining the temperature in different periods of the day and night. If it never falls below 37.6 ° C in the mouth, and there are no other painful phenomena, review all the medicines that you take. Any medicine can give a sudden jump in temperature, even if you took it for years.

The most common provoking agents are:

• Antibiotics , including sulfated derivatives. There is a bit of irony in this - you are taking medicine to fight infection and fever, and it can itself cause a fever.
• Antihistamines . You take an antihistamine medication, and you suddenly have a fever. If you stop taking and you do not have an obvious infection, the temperature will usually return to normal.
• Barbiturates . These soothing, the name of most of them ends in al (phenobarbital, nembutal, seconal), are very widely used for insomnia or epileptic seizures. From time to time they cause a rise in temperature.
• Drugs that reduce blood pressure . Hydralazine, methyl-DOPA and thiazide diuretics (hydrodiuril, diazide) are used every day in hundreds of thousands of cases to control hypertension or remove excess fluid from the body. All of them can give a fever.

Although these are the most common medicines that can raise the temperature, remember that each medicine can do this regardless of the fact that you tolerate it well in all other respects.

Another important cause of unexplained chronic fever is subacute bacterial endocarditis , an infection of vulnerable heart valves. By "vulnerable" we consider a valve that was with a congenital defect or damaged later, usually as a result of rheumatism. Such valves can be infected already because of such innocent procedures as cleaning the teeth, squeezing out the pimple or pulling the hair out of the inflamed skin follicle. Any of these actions opens the way to the bacteria in the bloodstream, then they settle in the valves and eventually destroy them. Before the era of antibiotics, endocarditis often led to death.

A small temperature, sometimes lasting for months, may be the only sign of subacute bacterial endocarditis. If you have such a temperature and you know about the noises in your heart, try to remember when you last visited a dentist. Or recently squeezed a pimple or pulled out the grown hair? Were you with a urologist or gynecologist and you were given a catheter because of some trouble with urination? Any of the above happened before the elevated temperature started? If so, endocarditis is very possible.

Here are some other indications of the causes of fever.

If you fever the whole day, but at least once a day, the temperature drops to normal, the source may be an abscess (a clotted accumulation of pus), hiding somewhere in the paranasal sinuses, gums, liver, kidneys, lungs, abdomen, under the diaphragm - Virtually anywhere in the body. But cancer can also give you this type of fever.

Have you visited the countries of the "third world" or the tropics in the last six months? If "yes", then you could become infected with malaria or amoebiasis .

The answer to the question of where you live may be an important clue to unraveling the temperature rise. In the United States, for example, five infections cause a mysterious increase in temperature. Each is peculiar to a specific geographical area: coccidiomycosis (valley fever), a fungal infection prevalent in the southwestern states; Spotted fever in the Rocky Mountains; Tick ​​infection of the western states, northeastern and mid-Atlantic; Blastomycosis - an infection caused by yeast fungi in the East and Midwest; And, more recently, Lyme disease is a tick-borne infection of the Northeast.

Let's describe a case from medical practice: the young man had an incurable disease: he constantly increased and decreased the temperature, also against the background of this there was a loss of weight. He made all conceivable and unthinkable analyzes, and none of them revealed the cause. For several months he was getting worse and worse. Finally, a repeated chest x-ray revealed a "shadow" in the lungs. Skin analysis and biopsy have proven that it is coccidiomycosis. After treatment he recovered.

Your profession or way of rest can help you figure it out. Workers at plastics plants get a fever if they breathe fumes in production; Those who cut meat can become infected with brucellosis , a chronic infection from slaughtered animals, in which patients have fever and diffuse pain. There are countless factors that only you can know about, indicating a diagnosis or, at least, directing a survey along the right path. For example, if you are a hunter and have touched the skin of a wild animal, you could catch tularemia ; If you are fond of birds and breathed in the dust of decaying avian excrement, you could get a pulmonary disease called psittacosis . Did you walk recently in the forest and you were bitten by a tick? Perhaps you visited the farm and you were persuaded to taste "fine" unpasteurized milk or cheese to see how great it was until a person spoiled everything with his fictions. Everything tasted really good, but was it worth your brucellosis or listeriosis ? And what about a small, in a secluded street, a Chinese restaurant that you love so much? Last time you ordered pork "mu-shu" and it was not completely fried? Well, yes, your fever may well be due to infection with Trichinella .

If you are a drug addict, do not hide it from your doctor, because you are especially vulnerable to AIDS, ulcers and bacterial endocarditis. Most doctors very carefully examine the skin in patients with a temperature of unclear ethnology, seeking not only a rash, but also traces of injections. If the doctor did not notice them from you, do not play games with him. Show him what he is looking for, and tell him what he needs to know.

While you are undergoing medical examination, you can help the doctor by reporting any of the following symptoms.

Throbbing chills that very clearly indicate a bacterial infection - abscess, endocarditis, gall bladder disease or some disorders of the urinary system.

Profuse sweat at night is suspicious for tuberculosis. Today it is not very common, but do not think that it disappeared completely. With an increasing number of people suffering from impaired immunity, especially those with AIDS, and with an increase in the number of poor and homeless, tuberculosis is once again gaining strength and predominates among the elderly living in shelters and boarding houses. Unlike the death sentence 50 years ago, in our time, tuberculosis can almost always be cured by antibiotics.

If you fever and lose weight , cancer is possible. However, it can be just a hidden and curable infection.

The combination of temperature and diarrhea with pus or blood indicates the possibility of parasitic intestinal infection. Repeated stool tests may be required to find bacteria, so do not drop the test after the first negative result. Tumor or inflammation of the intestine (ulcerative colitis, ileitis) can give similar symptoms.

Painful urination , a burning sensation or the need to "retire" every few minutes almost certainly indicates an infection of the urinary tract, especially if the fever is accompanied by a chilling chill.

Enlarged lymph glands are another important symptom for fevers. But do not put a hasty diagnosis of a malignant tumor (lymphoma) simply because some glands have increased. This diagnosis, of course, is possible, but the cause could be viral, but in fact any infection and fever caused by medications. As always, do not forget to check your medicine cabinet.

Show any skin manifestations immediately to your doctor. A rash can reflect a tick fever, such as Lyme disease, or spotted fever in the Rocky Mountains, another infection or a malignant tumor of the lymph glands.

One symptom is characteristic for many autoimmune diseases , in which the body directs its defense mechanisms against its own healthy tissues, is joint pain, arthritis. A prolonged low temperature, together with sensitivity, swelling, redness, or joint pain, largely indicates an autoimmune disorder, such as polyarthritis, rheumatic polymyalgia, rheumatoid arthritis, or systemic lupus erythematosus.

Your heredity is an important factor. Ask each member of your family whom you can find, even those with whom you do not communicate often, whether they have seizures of recurring low temperature and joint pain. There is a condition called familial Mediterranean fever , which is mostly revealed, as the name suggests, in families whose roots go to the countries of the Mediterranean. For the disease are characterized by bouts of pain in the abdomen, in the joints and a slight increase in temperature, lasting each time for weeks.

Elderly fever, accompanied by muscle pain , can mean any of the following: a viral infection, trichinella infection from poorly cooked or raw pork, toxoplasmosis from raw meat (it can also catch cat feces), leaferellosis and related contamination from unpasteurized dairy products, Lyme disease After a tick bite or an autoimmune disease.

When the temperature is accompanied by pain in the back , first you should think about the infection in either the kidneys or the vertebrae. Bacteria can penetrate into these structures from the bloodstream and settle there.

Tiny blood clots ( emboli ) in the lungs, usually coming from the legs or pelvis, can cause chest pain and low fever. This happens more often in women, especially those with varicose veins, who take birth control pills, smokers, after recent births or in women with gynecological infection (inflammatory process in the pelvic organs).

When an unclear temperature accompanies the abdominal pain in the right upper quadrant, coming in waves, this is probably the result of a gallbladder disease (stones or infection). But this combination of pain and temperature can also be caused by an infection of the pelvic organs, an abscess in the liver or cancer.

In addition to telling the doctor about these symptoms, take the initiative yourself and examine the parts of your body that are accessible to you.

Look very carefully at your skin, fingers and toes . Bacterial endocarditis can produce tiny hemorrhages that look like splinters under the skin and under the fingernails of the hands and feet. Their presence practically gives you a diagnosis. Make sure, of course, that these are not real splinters!

Feel if there are any bumps on the neck, under the arms, in the groin, on the abdomen and anywhere on the skin, especially after you've been to the doctor and he has not found anything. Very often, "talking" symptoms appear between visits.

Press down on the sternum . If it is sensitive, you should think about bone cancer.

In addition to a very thorough external examination, complex analyzes may be required to establish the source of an unclear temperature. They start with a complete blood test. The number and type of cells in your blood is the key to unraveling. For example, eosinophils will witness allergies. If the temperature rise depends on the parasite, the number of eosinophils will increase dramatically. The total number of white blood cells is also important. If there are a lot of them, rather, the cause of the temperature rise is a bacterial infection , rather than a viral infection , in which the blood can remain normal, despite the dashing radish.

Various malignant neoplasms, including leukemia, are detected with a normal blood smear. You will be checked for hemoglobin (a combination of temperature and anemia indicates a chronic and serious process), will make an analysis for the presence of an autoimmune disease. A culture of blood may also be required. Incubation under strictly sterile conditions to ensure that any organisms will not grow in it (normal blood does not contain them, it is sterile). Your doctor can also do an analysis of feces, urine, saliva for the presence of bacteria or cancer cells.

If there is still no response, additional examinations of the head, chest, abdomen or spine may be performed, depending on the suspected area.

If you have bone pain, the doctor will scan the bones to establish an infection, arthritis or the presence of a tumor.

Scanning of the lungs is required if they suspect blood clots.

Scanning with gallium will help to locate the hidden abscess.

From the bone marrow a needle can take a few cells in search of a malignant. This examination sounds scary, but in fact it is completely painless, if carried out by an experienced hematologist.

And the last thing: do not let all of the above set you off. In 90% of cases the cause of your unclear temperature will be established and treated. The rest will pass fever itself.

Symptom: fever