Hyperthermia according to microbiology 10. Fever of unknown origin - description, causes, symptoms (signs), diagnosis, treatment. R60 Edema, not elsewhere classified

12.09.2020 Insulin

Sometimes there are cases when a patient's body temperature rises (more than 38 ° C) almost against the background of full health. Such a condition may be the only sign of a disease, and numerous studies do not allow determining any pathology in the body. In this situation, the doctor, as a rule, makes a diagnosis - a fever of unknown origin, and then prescribes a more detailed examination of the body.

ICD code 10

Fever of unexplained etiology R50 (except for labor and postpartum fever, as well as neonatal fever).

R 50.0 - fever accompanied by chills.
R 50.1 - persistent fever.
R 50.9 - unstable fever.

ICD-10 code

R50 Fever of unknown origin

Symptoms of a fever of unknown origin

The main (often the only) present symptom of fever of unknown origin is considered to be an increase in temperature indicators. Over a long period, an increase in temperature can be observed without accompanying symptoms, or proceed with chills, increased sweating, cardiac pain, shortness of breath.

An increase in temperature values is imperative.
The type of temperature rise and temperature characteristics, as a rule, do not help much to reveal the picture of the disease.
There may be other signs that usually accompany a fever (headache, drowsiness, body aches, etc.).

Temperature readings vary depending on the type of fever:

subfebrile (37-37.9 ° C);
febrile (38-38.9 ° C);
pyretic (39-40.9 ° C);
hyperpyretic (41 ° C>).

Prolonged fever of unknown origin can be:

acute (up to 2 weeks);
subacute (up to one and a half months);
chronic (more than one and a half months).

Fever of unknown origin in children

Fever in a child is the most common problem with which a pediatrician is consulted. But what temperature in children should be considered a fever?

Doctors separate fever from just a high temperature, when rates exceed 38 ° C in infants, and above 38.6 ° C in older children.

In the majority of young patients, fever is associated with a viral infection, a smaller percentage of children suffer from inflammatory diseases. Often, such inflammations affect the urinary system, or latent bacteremia is observed, which can be further complicated by sepsis and meningitis.

Most often, pathogens of microbial lesions in childhood such bacteria become:

streptococci;
gram (-) enterobacteria;
listeria;
hemophilic infection;
staphylococci;
salmonella.

Diagnosis of fever of unknown origin

According to the results of laboratory tests:

complete blood count - changes in the number of leukocytes (with purulent infection - shift leukocyte formula to the left, with a viral lesion - lymphocytosis), acceleration of ESR, change in the number of platelets;
general urine analysis - leukocytes in the urine;
blood biochemistry - increased content CRP, increased content of ALT, AST (liver disease), D-fibrinogen dimer (PE);
bacterial culture - demonstrates the possibility of bacteremia or septicemia;
bacterial urine culture - to exclude renal tuberculosis;
bacterial culture of bronchial mucus or feces (according to indications);
bacterioscopy - if malaria is suspected;
complex diagnostics for tuberculosis infection;
serological reactions - with suspicion of syphilis, hepatitis, coccidioidomycosis, amebiasis, etc.;
AIDS test;
examination of the thyroid gland;
examination for suspected systemic diseases connective tissue.

According to the results of instrumental studies:

radiograph;
tomographic studies;
bone scan;
ultrasound procedure;
echocardiography;
colonoscopy;
electrocardiography;
bone marrow puncture;
biopsies of lymph nodes, muscle or liver tissue.

An algorithm for diagnosing fever of unknown origin is developed by the doctor on an individual basis. For this, at least one additional clinical or laboratory symptom... It can be a disease of the joints, reduced level hemoglobin, increase lymph nodes and so on. The more such auxiliary signs are found, the easier it will be to establish the correct diagnosis, narrowing the range of alleged pathologies and defining a targeted diagnosis.

Differential diagnosis of fever of unknown origin

Differential diagnosis is usually divided into several main subgroups:

infectious diseases;
oncology;
autoimmune pathologies;
other diseases.

When differentiating, attention is paid not only to the symptoms and complaints of the patient at a given moment, but also to those that were before, but have already disappeared.

It is necessary to take into account all diseases that preceded the fever, including surgical interventions, trauma, psychoemotional states.

It is important to clarify the hereditary characteristics, the possibility of receiving any medicines, the intricacies of the profession, recent travels, information about sexual partners, about the animals present at home.

At the very beginning of the diagnosis, it is necessary to exclude the intentionality of the febrile syndrome - it is not so rare that there are cases of the planned introduction of pyrogenic agents, manipulations with the thermometer.

Skin rashes, heart problems, enlargement and soreness of the lymph nodes, signs of fundus disorders are of great importance.

Treatment for fever of unknown origin

Experts do not advise blindly prescribing drugs for fever of unknown origin. Many doctors are in a hurry to apply antibiotic therapy or corticosteroid treatment, which can lubricate clinical picture and complicate further reliable diagnosis of the disease.

Despite everything, most doctors agree that it is important to establish the causes of the febrile condition using all possible methods. In the meantime, the reason is not established - symptomatic therapy should be carried out.

As a rule, the patient is hospitalized, sometimes isolated if an infectious disease is suspected.

Drug treatment can be prescribed taking into account the detected underlying disease. If such a disease is not found (which happens in about 20% of patients), then the following medications can be prescribed:

antipyretic drugs - non-steroidal anti-inflammatory drugs (taking indomethacin 150 mg per day or naproxen 0.4 mg per day), paracetamol;
the initial stage of taking antibiotics - penicillin series(gentamicin 2 mg / kg three times a day, ceftazidime 2 g intravenously 2-3 times a day, azlin (azlocillin) 4 g up to 4 times a day);
if antibiotics do not help, start taking more strong drugs- cefazolin 1 g intravenously 3-4 times a day;
amphotericin B 0.7 mg / kg per day, or fluconazole 400 mg per day intravenously.

Treatment continues until complete normalization. general condition and stabilization of the blood picture.

Prevention of fever of unknown origin

Preventive measures are to timely detect diseases that may later become the reasons for an increase in temperature. Of course, it is equally important to correctly treat the detected pathologies, based on the doctor's recommendations. This will allow avoiding many adverse consequences and complications, including fever of unknown origin.

What other rules must be followed in order to avoid diseases?

Contact with carriers and sources of infection should be avoided.
It is important to strengthen the immune system, increase the body's resistance, eat well, consume enough vitamins, remember to be physically active and follow the rules of personal hygiene.
In some cases, specific prophylaxis in the form of vaccinations and inoculations can be used.
It is desirable to have a permanent sexual partner, and in case of casual relationships, barrier methods of contraception should be used.
When traveling to other countries, it is necessary to avoid eating unknown foods, strictly observe the rules of personal hygiene, do not drink raw water and do not eat unwashed fruits.

An increase in body temperature is an important symptom of many diseases, but in some cases it is not possible to find out the exact origin of the fever.

You need to know that fever of unknown origin according to ICD 10 has code R50... International classification of diseases of the tenth revision is used by practicing physicians for registration medical records... Fever of unknown origin is considered a serious medical condition that requires timely diagnosis and correct treatment, therefore, with a prolonged increase in body temperature, you should consult a doctor and undergo a comprehensive examination.

Clinical picture and features of the disease

The most common cause of fever is an infection or inflammatory process in the human body. However, with fever of unknown origin (lng), high temperature is often the only symptom, the patient no longer worries about anything. It is important to understand that temperature rise is never unreasonable, therefore, a number of additional studies should be carried out and the patient should be observed in dynamics in order to establish an accurate diagnosis.

Subfebrile condition unclear etiology can develop against the background of such diseases:

infectious diseases with an atypical or latent course;
the development of malignant neoplasms;
systemic connective tissue diseases;
pathology of the central nervous system.

An increase in body temperature may be the only manifestation of the above pathologies on early stages... It is possible to diagnose and use the R50 fever code if the temperature above 38 degrees is observed for 3 weeks or more, and conventional research methods have not helped to establish the exact cause of hyperthermia.

Differential diagnosis

In the ICD 10, fever of unknown origin is in the section of general symptoms and signs, which means that it can occur in many diseases of different etiologies. The physician's job is to rule out both common and rare causes of hyperthermia.

Fever of unknown origin (LNG) is a clinical case in which an increase in body temperature is the leading or only symptom, and its causes cannot be established using standard research and additional techniques.

ICD-10	R50
ICD-9	780.6
MeSH	D005335
MedlinePlus	003090

Causes

Thermoregulation human body carried out reflexively. Fever (hyperthermia) is diagnosed if the body temperature exceeds:

when measured in the armpit - 37.2 ° C;
oral or rectal - 37.8 ° C.

An increase in temperature is a protective and adaptive reaction of the body to a disease. It can be caused by various pathological processes. As a rule, fever is one of a number of symptoms of the disease. But in some cases, she is the only or leading clinical sign, in connection with which there are difficulties in establishing its etiology.

The most common causes of fever of unknown origin:

infectious and inflammatory diseases (40% of cases) - tuberculosis, viral infections, helminthiasis, endocarditis, pyelonephritis, abscesses, osteomyelitis;
cancer (20%) - leukemia, lung or stomach cancer with metastases, lymphoma, hypernephroma;
systemic connective tissue pathologies (20%) - rheumatism, arthritis, lupus, allergic vasculitis, Crohn's disease;
other diseases (10%) - hereditary, metabolic, psychogenic.

In 10% of cases, the cause of LNG cannot be identified. As a rule, this occurs with an atypical course of a common disease or with the development of a non-standard reaction to pharmacological agents.

A drug fever may appear 2-3 days after taking the drug. The groups of medicines that most often cause hyperthermia:

antibiotics;
non-steroidal anti-inflammatory drugs;
laxatives with phenolphthalein;
drugs to improve the functioning of the cardiovascular system;
phenobarbital, haloperidol and other drugs that affect the central nervous system;
cytostatics.

Fever of unknown origin in children most often occurs against the background of infectious pathologies and diseases of the connective tissue.

Symptoms

The main signs of fever of unknown origin:

body temperature is higher than normal;
duration - for adults - more than 3 weeks, for children - more than 8 days;
inability to make a diagnosis after a routine examination.

In many cases, there are pathological symptoms caused by impaired thermoregulation and intoxication - chills, sweating, a feeling of lack of air, pain in the heart.

Depending on the characteristics of the patient's condition, several types of LNG are distinguished.

By the nature of the flow:

classical (occurs with diseases known to science);
nosocomial (appears in people who are in the intensive unit of the hospital for more than 2 days);
neutropenic (the number of neutrophils in the blood is below 500 per 1 μl);
HIV-associated (combined with diseases characteristic of HIV-infected people).

Based on the level of temperature rise (° C):

subfebrile (37.2-37.9);
febrile (38-38.9);
pyretic (39-40.9);
hyperpyretic (above 41).

By type of temperature change:

constant (daily changes do not exceed 1 ° С);
weakening (fluctuations during the day are 1-2 ° C);
intermittent (periods of normal and elevated temperature lasting 1-3 days alternating);
hectic (sudden changes in temperature);
wavy (daily the temperature gradually decreases and then rises);
perverted (temperature is higher in the morning than in the evening);
wrong (no patterns).

Prolonged fever of unknown origin can last longer than 45 days and is classified as chronic.

Diagnostics

Diagnostic search algorithm in case of fever of unknown origin:

collecting anamnesis - establishing symptoms, clarifying the time of occurrence of hyperthermia, clarifying the list of medications taken, identifying family (hereditary) diseases;
physical examination - auscultation and percussion chest, palpation internal organs, inspection oral cavity, eyes and ears, reflex test;
basic laboratory and instrumental research;
application of additional methods.

Diagnostic standards for unexplained fever include the following basic laboratory tests:

clinical analyzes of blood, urine, feces;
coagulogram;
blood biochemistry;
tuberculin test;
aspirin test (with an infectious nature of the temperature, it normalizes after taking antipyretics).

Basic instrumental methods:

radiography of the lungs;
ECG, EchoCG;
Ultrasound of the genitourinary system and kidneys;
CT or MRI of the brain.

Additional diagnostic methods:

microbiological analysis of urine, blood, nasopharyngeal smear - makes it possible to identify the causative agent of the infection;
HIV test;
determination of titers of viral antibodies in the blood - allows you to identify the Epstein-Barr virus, toxoplasmosis;
bone marrow puncture;
CT scan abdominal cavity;
fibrogastroduodenoscopy;
allergy tests and so on.

Differential diagnosis of fever of unknown origin is based on consideration of the following diseases:

bacterial - sinusitis, pneumonia, tuberculosis, brucellosis, osteomyelitis, mastoiditis, abscess, salmonellosis, tularemia, leptospirosis;
viral - hepatitis, cytomegalovirus infection, AIDS, mononucleosis;
fungal - coccidioidomycosis;
mixed - malaria, lues, Lyme disease, mountain fever;
tumor - leukemia, lymphoma, neuroblastoma;
associated with damage to connective tissue - rheumatic fever, lupus,;
others - inflammatory pathologies of the gastrointestinal tract, thyroiditis, side effects medicines.

Treatment

If the patient is stable, treatment of fever of unknown origin is not carried out. In severe cases, a trial therapy is carried out, the essence of which depends on the alleged disease:

tuberculosis - anti-tuberculosis drugs;
deep vein thrombophlebitis, pulmonary embolism - heparin;
osteomyelitis, infectious pathologies - antibiotics;
viral infections - immunostimulants, interferon;
thyroiditis, Still's disease, rheumatic fever - glucocorticoids.

If drug hyperthermia is suspected, the patient's medication should be discontinued.

Forecast

The prognosis of LNG depends on the underlying disease.

Prophylaxis

Prevention of fever of unknown origin:

reasonable intake of medicines;
adequate treatment of somatic pathologies.

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Fever of unknown origin(LNG) - an increase in body temperature> 38.3 ° C for> 3 weeks in the absence of identification of the cause after a 1-week intensive diagnostic search.

Code by international classification diseases ICD-10:

Causes

Etiology
. Infectious diseases ... Any infection can be accompanied by a fever, but difficulties in diagnosis are more often caused by sporadic, uncharacteristic for the area or atypical diseases. Anamnesis, including epidemiological, is important.

.. Bacterial infections ... Abscesses of the abdominal cavity (subphrenic, retroperitoneal, pelvic), the likelihood of which increases with a history of trauma, surgery, gynecological or laparoscopic manipulations ... Tuberculosis is one of the frequent reasons LNG. Diagnosis is difficult in cases of extrapulmonary tuberculosis with negative tuberculin tests. An important role in diagnostics is assigned to the search for lymph nodes and their biopsy ... Infective endocarditis is difficult to diagnose in cases of absence of heart murmurs or negative bacteriological blood culture (more often due to previous antibacterial therapy) ... Empyema gallbladder or cholangitis in elderly patients can occur without local tension symptoms in the right upper quadrant of the abdomen ... Osteomyelitis can be suspected in the presence of local bone tenderness, but radiological changes can be detected only after a few weeks ... Meningeal or, especially, gonococcal sepsis may be suspected of having a characteristic rash; confirmed by bacteriological blood culture data ... When identifying hospital LNG, the structure of hospital infections in a specific medical institution should be taken into account; the most common etiological agents are Pseudomonas aeruginosa and staphylococci.

.. Viral infections... AIDS fever in 80% is due to concomitant infection, in 20% - to lymphomas ... Infection caused by the herpes virus, CMV, Epstein-Barr is difficult to diagnose in the elderly (erased clinical manifestations); serological confirmation of infection is important.

.. Fungal infections(candidiasis, fusarium, actinomycosis, histoplasmosis) are most likely in AIDS patients and with neutropenia.

. Neoplasms.

.. Hodgken and non-Hodgken lymphomas: diagnosis is difficult with retroperitoneal localization of lymph nodes .. Hemoblastosis .. Solid tumors (most typical - with liver metastases or obstruction by a tumor of the urinary tract).

. Systemic connective tissue diseases.

.. SLE: the diagnosis is facilitated by the detection of ANAT. Still's syndrome has no serological markers; accompanied by the appearance of a salmon-colored rash at the height of fever (see. Rheumatoid arthritis). Among systemic vasculitis, polyarteritis nodosa and giant cell arteritis are the most common.

. Granulomatous diseases.

.. Sarcoidosis ( diagnosis is difficult with isolated liver damage or dubious changes in the lungs; a liver biopsy or CT scan is important to clarify the state of the bronchopulmonary lymph nodes) .. Crohn's disease is a diagnostic difficulty in the absence of diarrhea; endoscopy and biopsy data are important.

. Fever of medicinal origin(vaccines, antibiotics, various drugs): usually there are no skin manifestations of allergy or eosinophilia; the abolition of drugs leads to the normalization of body temperature within a few days.

. Endocrine pathology.

.. Acute thyroiditis and thyrotoxicosis.. Adrenal insufficiency (rare). Recurrent PE.

Pathogenesis. Exogenous pyrogens induce the production of cytokines (IL - 1, IL - 6,  - IFN, TNF - ). The effect of cytokines on the thermoregulatory centers of the hypothalamus leads to an increase in body temperature.

Classification. The "classic" variant of LNG (difficult-to-diagnose variants of diseases traditionally associated with fever). Hospital LNG. LNG with neutropenia. HIV - associated (mycobacteriosis, CMV - infection, cryptococcosis, histoplasmosis).

Symptoms (signs)

Clinical picture... Increased body temperature. The type and nature of the fever is usually not very informative. Common symptoms associated with an increase in body temperature are headache, general malaise, muscle pain.
Diagnostic tactics
. Anamnesis.. In the anamnesis, not only complaints of the current moment are important, but also those that have already disappeared .. All previous illnesses should be identified, including operations, trauma and mental abnormalities .. Details such as family history, vaccination and admission data may also be significant. medications, professional history, clarification of the travel route, data on the sexual partner, the presence of animals in the environment. Physical research. At the earliest stage of diagnosis, artificial causes of fever (administration of pyrogens, manipulation with a thermometer) should be excluded. Identification of the type of fever (intermittent, remitting, constant) allows one to suspect malaria by the characteristic frequency of fever (on the 3rd or 4th day), but for other diseases it gives little information. Physical examination should be carried out carefully and regularly, focusing on the appearance or change in the nature of the rash, heart murmurs, lymph nodes, neurological manifestations, fundus symptoms.

Diagnostics

Laboratory data
... KLA .. Changes in leukocytes: leukocytosis (with purulent infections - a shift of the leukocyte formula to the left, with viral infections - lymphocytosis), leukopenia and neutropenia (the content of neutrophils in the peripheral blood<1,0109/л.. Анемия.. Тромбоцитопения или тромбоцитоз.. Увеличение СОЭ.
... OAM. It should be borne in mind that persistent leukocyturia with repeated negative results of bacteriological urine culture should alert against renal tuberculosis.
... Biochemical blood tests .. Increase in the concentration of CRP .. With an increase in the concentration of ALT, AST, it is necessary to conduct a targeted study for liver pathology .. D - fibrinogen dimers - in case of suspected pulmonary embolism.
... Bacteriological blood culture. Several cultures of venous blood (no more than 6) are performed for possible bacteremia or septicemia.
... Bacteriological culture of urine, if kidney tuberculosis is suspected - inoculation on selective media for mycobacteria.
... Bacteriological culture of sputum or feces - in the presence of appropriate clinical manifestations.
... Bacterioscopy: study of a "thick drop" of blood on the plasmodium of malaria.
... Immunological methods. Comprehensive examination of a patient for tuberculosis. In anergic or acute infection, a tuberculin skin test is almost always negative (it should be repeated after 2 weeks).
... Serological studies are carried out for infections caused by Epstein-Barr viruses, hepatitis, CMV, causative agents of syphilis, lymoborreliosis, Q - fever, amebiasis, coccidioidomycosis. Testing for HIV infection is mandatory! ... Examination of thyroid function in case of suspected thyroiditis. Determination of RF and ANAT for suspected systemic connective tissue diseases.

Instrumental data
... X-ray of the chest, abdominal cavity, sinuses (according to clinical indications). CT / MRI of the abdomen and pelvis if an abscess or mass is suspected. Scanning bones with Tc99 in the early diagnosis of osteomyelitis is more sensitive than the X-ray method. Ultrasound of the abdominal cavity and pelvic organs (in combination with biopsy according to indications) with suspicion of mass formation, obstructive kidney disease or pathology of the gallbladder and biliary tract. Echocardiography for suspected heart valve lesions, atrial myxoma, pericardial effusion. Colonoscopy for suspected Crohn's disease. ECG: there may be signs of overload of the right heart in pulmonary embolism. Puncture of the bone marrow with suspected hemoblastosis, to identify the causes of neutropenia. Liver biopsy for suspected granulomatous hepatitis. Temporal artery biopsy for suspected giant cell arteritis. Biopsy of lymph nodes, altered areas of muscles and / or skin.

Features in children. The most common causes of LNG are infectious processes, systemic connective tissue diseases.

Features in the elderly. The most likely causes are cancer, infections (including tuberculosis), systemic diseases of the connective tissue (especially polymyalgia rheumatica and temporal artery arteritis). Signs and symptoms are less pronounced. Comorbidities and the use of various drugs can mask the fever. The mortality rate is higher than in other age groups.

Features in pregnant women. An increase in body temperature increases the risk of developing defects in the development of the neural tube of the fetus, causing premature birth.

Treatment

TREATMENT
General tactics. It is necessary to establish the cause of the fever using all possible methods; until the cause is established, symptomatic treatment. Caution should be made against "empirical therapy" of HA, which can be harmful in the infectious nature of fever.
Mode. Hospitalization of the patient, limitation of contacts until the exclusion of infectious pathology. Patients with neutropenia are placed in boxes.
Diet. When the body temperature rises, the amount of fluid consumed increases. Patients with neutropenia are prohibited from transferring flowers (source of Pseudomonas aeruginosa), bananas (source of fusaria), lemons (source of candida) to the ward.

Drug treatment
Treatment is prescribed depending on the underlying disease. If the cause of the fever is not established (in 20%), the following drugs can be prescribed.
... Antipyretic drugs: paracetamol or NSAIDs (indomethacin 150 mg / day or naproxen 0.4 g / day).
... The tactics of empirical therapy for LNG against the background of neutropenia .. Stage I: start with penicillin, which has activity against Pseudomonas aeruginosa, (azlocillin, 2-4 g 3-4 r / day) in combination with gentamicin, 1.5-2 mg / kg every 8 hours or with ceftazidime 2 g IV every 8 or 12 hours. Stage II: if the fever persists on the 3rd day, add an antibiotic acting on the gram-positive flora (cefazolin 1 g IV every 6-8 hours if ceftazidime has not been previously prescribed) .. Stage III: if the fever persists for another 3 days, add amphotericin B 0.7 mg / kg / day or flunicazole 200-400 mg / day IV. If the fever is eliminated, an effective the antibiotic regimen is continued until the number of neutrophils is restored to normal.

Course and forecast. Depends on etiology and age. The one-year survival rate is 91% for those under 35, 82% for those aged 35-64, and 67% for those over 64.
Abbreviations. LNG - fever of unknown origin.

ICD-10. R50 Fever of unknown origin

Subfebrile condition (ICD-10 code - R50) is a slight increase in body temperature, which lasts at least for several weeks. The temperature rises in the range of 37-37.9 degrees. When microbes enter the human body, it responds with an increase in temperature and various symptoms, depending on the progressive disease.

Especially often people can face this kind of problem in winter, during the period of intensification of infections. Microorganisms try to get into the human body, but unsuccessfully, starting from the immune barrier. And this kind of collision can provoke a slight increase in temperature, in other words, a prolonged subfebrile condition.

The temperature in infectious diseases is observed for a maximum of 7-10 days in the patient. If the indicators are delayed for a long period of time, it is necessary to consult a doctor, because only he can establish the presence of serious infectious or non-infectious diseases occurring in the body.

After contacting a specialist about a prolonged temperature rise, compared with the clinical manifestations of the disease, the most effective treatment will be prescribed. If the temperature drops, it means that the treatment is selected correctly, and the subfebrile fever passes. If the temperature does not drop, then it is necessary to correct the patient's treatment.

Prolonged subfebrile condition is a slightly elevated body temperature that lasts for months and sometimes years. It is observed in people of different ages, from one-year-old children to old people. In women, this problem occurs three times more often than in men, and the peak of exacerbation occurs at the age of twenty to forty years.

Subfebrile condition in children proceeds in a similar way, however, it may not have clinical manifestations.

Etiology

A prolonged increase in temperature is of various etiology:

changes in hormonal levels during pregnancy;
lack of physical activity;
weakened immunity;
thermoneurosis;
the presence of infections in the body;
cancers;
the presence of diseases of an autoimmune nature;
Availability ;
Availability ;
Availability ;
inflammatory processes in the body;
endocrine system diseases;
long-term medication intake;
bowel disease;
psychogenic factor;

The most common cause of low-grade fever is the course of the inflammatory process in the body, caused by a number of infectious diseases:

With hyperthermia of this kind, there are additional complaints about the state of health, but when taking antipyretic drugs it becomes much easier.

Subfebrile condition of an infectious nature is manifested with an exacerbation of the following chronic pathologies in the body:

inflammation of the uterine appendages;
non-healing ulcers in the elderly, in people with.

Post-infectious subfebrile condition can persist for a month after the disease is cured.

Fever with toxoplasmosis, which can be contracted from cats, is also a common problem. Some foods (meat, eggs) that have not been heat treated can also become a source of contamination.

The presence of malignant neoplasms in the body also causes subfebrile conditions due to the entry into the blood of endogenous pyrogens - proteins that provoke an increase in the temperature of the human body.

Due to the body with sluggish hepatitis B, C, a feverish state is also noted.

Situations of an increase in the temperature regime of the body were noted when taking a certain group of drugs:

thyroxine preparations;
antibiotics;
antipsychotics;
antihistamines;
antidepressants;
antiparkinsonian;
narcotic painkillers.

Subfebrile condition with VSD can manifest itself in a child, a teenager, and in adults due to a hereditary factor or injuries sustained during childbirth.

Classification

Depending on the change in the temperature curve, the following forms of the disease are distinguished:

intermittent fever (alternating decrease and increase in body temperature by more than 1 degree over several days);
relapsing fever (temperature fluctuations of more than 1 degree over 24 hours);
persistent fever (an increase in temperature for a long period of time and by less than a degree);
wave-like fever (alternation of persistent and remitting fever with a normal temperature).

Subfebrile condition of unknown genesis can be divided into the following types:

classic - a form of the disease that is difficult to diagnose;
hospital - manifests itself within a day from the moment of hospitalization;
an increase in temperature due to a decrease in the content of enzymes in the blood that are responsible for the immune system;
- associated fevers (, mycobacteriosis).

It is necessary to carry out treatment under the supervision of doctors who can diagnose the disease and prescribe the most effective treatment.

Symptoms

Prolonged subfebrile condition is characterized by the following symptoms:

lack of appetite;
weakness;
disruption of the gastrointestinal tract;
redness of the skin;
rapid breathing;
increased sweating;
unbalanced emotional state.

However, the main symptom is the presence of an elevated temperature for a long time period.

Diagnostics

Timely visit to a qualified specialist reduces the risk of possible complications of the problem.

During the appointment, the doctor must:

analyze the clinical picture of the patient;
find out the patient's complaints;
check with the patient about the presence of chronic diseases;
find out whether surgical interventions were performed on which organs;
conduct a general examination of the patient (examination of the skin, mucous membranes, lymph nodes);
to carry out auscultation of the heart muscle, lungs.

Also, without fail to establish the cause of the temperature, patients are assigned to undergo such studies as:

general blood analysis;
general urine analysis;
blood chemistry;
sputum examination;
tuberculin test;
serological blood test;
radiography;
ultrasound diagnostics;
CT scan;
echocardiography.

Consultations of specialists in different directions will be required (to confirm or deny the fact of the presence of certain diseases), namely:

neurologist;
hematologist;
oncologist;
infectious disease specialist;
rheumatologist;
phthisiatrician.

If the doctor does not receive enough research results, an additional examination and analysis of the amidopyrine sample is carried out, that is, the simultaneous measurement of the temperature in both armpits and in the rectum.

Treatment

Treatment is aimed at eliminating the underlying factor that provoked subfebrile condition.

compliance with the outpatient regime;
drinking plenty of fluids;
avoid hypothermia of the body;
do not drink cold drinks;
observe moderate physical activity;
adherence to proper nutrition.

Also, with a significant increase in temperature, the clinician prescribes anti-inflammatory drugs, such as:

Antigrippin;
TeraFlu;
Maximum;
Fervex.

The patients will benefit from spending time in the fresh air, hydrotherapy, physiotherapy. According to indications, if subfebrile temperature manifests itself on a nervous basis, sedatives can be prescribed.