Fever
Fever as a symptom provides important information about
the presence of illness—particularly infections—and about
changes in the clinical status of the patient. The fever pattern,
however, is of marginal value for most specific diagnoses
except for the relapsing fever of malaria, borreliosis,
and occasional cases of lymphoma, especially Hodgkin
disease. Furthermore, the degree of temperature elevation
does not necessarily correspond to the severity of the illness.
In general, the febrile response tends to be greater in
children than in adults. In older persons, neonates, and in
persons receiving certain medications (eg, NSAIDs or corticosteroids),
a normal temperature or even hypothermia
may be observed. Markedly elevated body temperature
may result in profound metabolic disturbances. High temperature
during the first trimester of pregnancy may cause
birth defects, such as anencephaly. Fever increases insulin
requirements and alters the metabolism and disposition of
drugs used for the treatment of the diverse diseases associated
with fever.