Fever Adults -In Approach to Diagnosis and Management

Abstract

Fever is one of the most important and common presenting symptoms in family practice. However making the correct diagnoses and selecting the most effectiye therapy poses a challenge to the busy family practitioner. Fever is defined as an elevation of body temperature above the normal daif variation and is found in a number of disease states as a result of the re-setting of the hypothalamic set point by various exogenous and endogenous cytokines and pyrogens. In family practice,fever is much more likely to be a manifestation of a "common" rather than a "rare" disease and key concepts, including pyrexia of unknown origin and factitious fever, should be understood, important life threatening conditions, e.g. malaria and meningococcal disease must always be considered when confronted by a patient with acute febrile illness and ill-defined localising signs. Antipyretics and other supportive therapy should be judiciously used, since they may obscure the effect of a specific therapeutic agent on the natural course ofthe disease and the focus of management should remain the underlying condition.