发热2011profcrkumana医学系pcywoo微.pdfVIP

Fever Prof. CR Kumana, Department of Medicine Prof. PCY Woo, Department of Microbiology Dr. J Ho, Department of Surgery Definitions • Fever (Pyrexia) – Increases core temperature setting by hypothalamus; o body thermostat set higher than normal (oral  37 C) o o – Usually 38 C over 1h, or 38.3 C – Normal diurnal rhythm (6 am , 4-6 pm ) still o maintained; upper limits of normal range 37.2-37.7 C • Hyperthermia – Body temperature , no diurnal variation, due to: – Decreased heat loss: eg. decreased ability to sweat – Increased heat production: beyond a point where the body temperature defence mechanisms can no longer cope Normal Diurnal Variation of Core (Oral) Temperature o • AM temperature 37.2 C abnormal o • PM temperature 37.7 C abnormal o • Diurnal variation =  0.5 C • 38 oC abnormally high temperature • In women: 2 week post ovulation to o menses core temp rises  0.6 C • Ward temperature chart o – Grey area between 36.8 C and o 38 C – Generally only intervene once o temperature 38 C • Fever / Pyrexia of Unknown Origin (FUO / PUO) o o – Temperature 38.3 C (100 F) – Several times over 3 weeks – No Diagnosis after Investigation in hospital for 1 week • Chills – Sensation of feeling cold • Rigors