Low-grade body temperature ( low-grade fever low-grade fever ) - Causes, Symptoms and Treatment .MF .
Subfebrile body temperature (low-grade fever low-grade fever) - a constant increase in body temperature between 37.1 ° C to 38.0 ° C, long-term notes, from two weeks to several months or years.
reasons sbfebrilnoy temperature
Possible causes low grade temperature, not associated with the disease
1. Increased body temperature can be caused by a decrease in heat transfer, for example, the introduction of atropine, or gain of heat by overheating.
2. Increasing the energy of formation and heat in the body, followed by low-grade fever occurs when stress reactions and the introduction of certain drugs (amphetamine, muscle relaxants).
3. Functional disorders of thermoregulation may be hereditary (about 2% of healthy children are born with a body temperature above 37 ° C).
4. emotional stress can lead to a violation of thermoregulation due to hypothalamic activation.
5. Premenstrual syndrome - increased body temperature due to an increase in blood steroid hormones and their metabolites (etioholanolon, preg
6. Pregnancy can result in an increase in body temperature up to 37,2 ° C - 37,3 ° C.Most often, the body temperature returns to normal by the end of the first trimester, but some women may remain elevated and throughout pregnancy, which is associated with an increase in progesterone production.
7. The transient increase in body temperature can be during intense exercise in a hot room.
Possible causes low grade temperature-related disease
All the diseases that lead to low-grade increase in body temperature can be divided into two major groups:
I. Increase in body temperature associated with the action of pyrogens - substances that are entering the body from the outsideor forming inside it, causing fever.
1. From infectious diseases the most common cause of chronic nonspecific subfebrile is a focal infection (chronic rhinitis, sinusitis, empyema of the gall bladder, pancreatitis, adnexitis, chronic cholecystitis, lung abscess, empyema, prostatitis, etc..).However, a chronic infectious process is not always accompanied by an increase in body temperature to subfebrile.Therefore, only after the disappearance of low grade temperature readjustment allows the infection to establish a connection between them.Under certain conditions (weak immune response due to various reasons, the lack of activity of pathogenic microorganisms or her significant suppression of antibacterial drugs and others.) Instead of febrile fever will be a low-grade body temperature even in patients with severe purulent and septic processes.In modern conditions often have hidden forms of sepsis (blood poisoning).Infective endocarditis (inflammation of the lining of the heart - endocarditis) sometimes develops slowly and can occur for a long time only malaise and fever within subfebrile without the expressed symptoms of intoxication, with the ability to work preservation.Low-grade fever may be one of the first manifestations of the small forms of tuberculosis:.. Bronhoadenita, primary complex, early tuberculous intoxication, focal, infiltrative tuberculosis, etc. These forms of tuberculosis are often erased the beginning and take place under the guise of various diseases.fever usually occurs in the late afternoon to 37,2 ° C - 37,3 ° C for several hours, followed by a decrease to normal values and below.Low-grade fever may also occur when infected by parasites and worms.
Do not forget about infections, sexually transmitted diseases.The widespread uncontrolled use of antibiotics in modern life can lead to a prolonged asymptomatic number of diseases (eg, hlamidiazah, syphilis and others.) When subfebrile temperature rise will be the only sign of the disease.HIV infection may also be accompanied by low-grade fever, which is possible even before the appearance of positive laboratory tests.
reason for increase in body temperature to subfebrile in infectious processes is the production of endotoxins specific pathogenic flora weak pyrogenicity (ability to increase body temperature) and poor ability to induce an adequate immune response.
2. Of the diseases related to the immune response of the body changes and , low-grade fever accompanied by rheumatism, rheumatoid arthritis, collagen diseases, sarcoidosis, chronic enteritis, ulcerative colitis, Dressler syndrome, drug allergies.The mechanism of subfebrile in this case, is the following: enhanced synthesis of endogenous (internal) pyrogen-specific cells (monocyte-macrophage cells) and increased their activity due to the increased sensitivity of the organism.Also have processes aseptic value (in the absence of infection) tissue melting, causing the so-called resorptive fever, such as recurrent myocardial infarction, pulmonary infarction, hemorrhages in the body cavity and tissue, etc..
It is also possible temperature increase in allergic reactions (egon drugs, vaccination).
3. In malignant tumors low-grade fever may be one of the earliest manifestations of the disease, sometimes for 6 - 8 months, outstripping its other symptoms.In the development of plays a role subfebrile formation of immune complexes that trigger an immune response, but the earliest fever associated with development of tumor tissue protein having pyrogenic properties.In most tumors, the protein can be detected in blood, urine, tumor tissue.In the absence of local manifestations of cancer diagnostic importance is the combination subfebrile increase in blood with specific changes in body temperature.Low-grade fever is characteristic of acute myeloid leukemia and chronic lymphocytic leukemia, lymphoma and lymphosarcoma.
II.Low-grade fever that occurs without the participation of pyrogens , is observed in diseases and conditions that violate the function of thermoregulation.
When violations of the endocrine system (pheochromocytoma, thyrotoxicosis, pathological menopause, and others.) Low-grade fever may be due to the gain of energy and heat production in the body.
allowed the existence of the so-called thermoneurosis , characterized by the presence subfebrile, as a manifestation of heat-resistant functional disorders as a result of the defeat of the center of the temperature occurring during the autonomic dysfunction in children, adolescents and young women.Such a low-grade fever is often dependent on the intensity of physical and mental activity, often characterized by a large range of daily temperature fluctuations (about 1 °) and a normalization of her during the night.
Disorders of thermoregulation may be a manifestation of an organic disease of the nervous system at the level of the brainstem.Also in the event of low grade fever can have a definite value mechanical stimulation of the hypothalamus.Head injuries, endocrine changes are factors that provoke breach of thermoregulation.Cases subfebrile temperature increase during iron-deficiency anemia.
Difficulty in diagnosing functional reasons subfebrile temperature increase is that about half of the patients there are pockets of chronic infection.
survey with low-grade fever
In a study of patients on the low grade temperature is necessary to exclude a false low-grade fever.We must bear in mind the incorrect readings of the thermometer that does not meet the standard, the possibility of simulation, artificial fever patients with psychopathy and hysteria, caused by a variety of ways.In the latter case, attention is drawn to the temperature discrepancy and pulse.
If false subfebrilitet excluded, it is necessary to hold the epidemic and clinical examination of the patient.In view of the extensive list of causes of low grade fever requires an individual approach to each patient examination.The patient is not only trying to find out information about previously postponed diseases and surgical interventions, but also life and professional data conditions.Be sure to find out the hobbies, recent travel, the use of any drugs or alcohol, possible contact with animals.Be sure to carry out a detailed physical examination.Next, conduct standard laboratory tests.
1. Complete blood count: possible increase in the number of leucocytes in infectious diseases, hemolytic anemia of malignancy.
2. Urinalysis: chronic infections of the urinary tract in the urine appear white blood cells, protein.
3. Chest X-ray - will be visible to specific signs of gangrene lung, lung abscess, tuberculosis (in the presence of this disease).
4. ECG changes may be specific to bacterial endocarditis.
5. Blood for HIV infection.
6. Blood on viral hepatitis B and C.
7. The blood on RW (syphilis).
8. Blood cultures with sensitivity to antibiotics is carried out for suspected sepsis.
9. Urine culture with sensitivity to antibiotics should be carried out with urinary tract infections.
10. sputum seeding on Mycobacterium tuberculosis.
If the survey did not help to establish a diagnosis, it is necessary to conduct ultrasound of the abdomen and pelvis, to donate blood for tumor markers, blood rheumatoid factor, thyroid hormones (TSH, T3, T4), the application of more invasive diagnostic procedures (biopsy).In some cases, may be informative computer tomography and magnetic resonance imaging.
Treatment subfibrilnoy temperature
increase in temperature within subfebrile practically does not worsen the overall condition of the patient and, therefore, does not require symptomatic treatment.The temperature is reduced by the elimination of the disease or the reasons that led to this state.For example, when adnexitis, prostatitis and other foci of chronic infection is necessary to conduct antibiotic therapy.If neuropsychiatric disorders used sedatives and antidepresantnye funds.However, we must remember that the self (especially antibacterial agents, hormonal agents, salicylates and OE), without clarifying the reasons for low grade temperature is unacceptable, because these drugs can affect the course of the disease, "smeared" the severity of specific symptoms that may cause harm to the patient, insubsequently heavier course of the disease, as well as difficult to correct diagnosis.
The dangerous low-grade fever
subfebrile condition is dangerous because a long period of time can not be seen and the patient is detected by chance.But due to the fact that the symptom does not bring physical suffering to the patient, examination, and, consequently, the full treatment is postponed for an indefinite period.However, long-term low-grade fever may be a symptom of such life-threatening diseases such as HIV infection, cancer, bacterial endocarditis, and others.
the way physicians treat with low-grade fever
therapist.Depending on the associated symptoms and identify the causes of temperature increase may need help doctors: infectious disease specialist, endocrinologist, cardiologist, otolaryngologist.
therapists Kletkina Y.