Fever-approach and insight for commons
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Fever is a common problem which we experience in our day to day life. Many times you get confused, what to do. For better understanding I am trying to simplify the things.
How do you know that you have fever? You feel yourself that something has changed or wrong in your body. You tell your family or friend, they touch your forehead or hand and say, “oh my god! You have fever….”They try to make themselves sure by applying thermometer in your mouth or in your axilla(under your arm firmly pressed between arm and the side of your trunk) and check the temperature reading. “If it is 100 degree Fahrenheit or more, they get confirm that you have fever.
Now the important thing you must understand that fever is an important symptoms of many different diseases. From trivial to risky. My approach here to provide you some insights which will help you in addressing fever at odd time, odd situation when you don’t have access to a qualified doctor or you cannot visit him for monetary constraints.
Following points can help you when you or your relative have fever.
Note :In current pandemic situation;if you have fever, first of all rule out COVID19 !
1.Be sure that it is really fever. Assessing fever by touch, is often misleading. Suppose you manipulated the ice container from your refrigerator or have handled ice or some cold substance with your hand and returned in bedroom to wake up your kid who is sleeping under blanket cover, you touch his forehead, “Oh god he has fever!” .You may be wrong. Or you touch someone who has just come from a hot environment and you happen to touch his body, you may be mistaken for fever.
So the best thing you should do is to confirm it by thermometer .Many of you are worried with the definition of fever. Don’t bother, just keep in your mind, if the temperature is greater than or equal to 100 degree F(Fahrenheit), it is fever. You may ask how long should I keep the thermometer in mouth or under arm, If you are using mercury thermometer, you should keep it for two minutes. For digital thermometers, there would be a beep sound to indicate. One more thing to note, you should ideally take temperature from axilla. Tip of the thermometer constantly touching the skin in axillary fold for two minutes in mercury thermometer. Take care to clean the thermometer tip with small cotton with antiseptic. Follow the standard operating procedure of the thermometer you are using.
2.If you are sure ,you have fever what should you do. Everyone knows that paracetamol 500 mg tab can relieve ones fever for adult, and for kids paracetamol 125 mg syrup or 250 mg syrup can be used. Dose adjustment for body weight is essential when you are giving that syrup for kids. The most important thing, patient who have jaundice or liver disease should not take this medicine. Pregnant and nursing mother should not take it without medical advice. Oh! Really difficult to take medicines without doctor’s advice! You have alternatives apart from medicine. Take a bath, wear light cotton clothes, sleep in air conditioned room, apply ice or do cold sponging. It is interesting to note that a type of fever which is triggered by extremely hot atmosphere cannot be resolved by medicines, the only solution is application of cold in any one of my previously explained alternatives. High temperature of your body can damage the brain. It is good to keep ice packs on forehead. How long should you do such cooling effort?
You should do cooling up to 100 degree Fahrenheit. When the reading of thermometer goes below 100,stop the cooling process.
Now work is over! your temperature reduced the work is over! No.. Not necessarily! You have to find out the reason behind your fever. Check, whether the person having fever, has any wound on skin which is causing pain or oozing pus. If it is so, thoroughly clean the wound with antiseptic, drain the pus and apply framycetin or any antiseptic ointment, cover with gauze, then apply cotton and dress it.
, try to change dressing whenever it gets dirty,wet or every alternate day. Apart from it amoxicillin dicloxacillin combination adjusted for body weight may be taken. If you are allergic to penicillin, you can take azithromycin or roxithromycin. Warning! antibiotics should be taken only under guidance of qualified medical practitioner. Is there any alternative? Yes, you can use one to two teaspoonful turmeric powder in a glass of boiled milk twice daily. Raw garlic if possible to be sandwiched in your bread can improve your healing power.
If you don’t have any wound in your body, is there any burning sensation in urine? If yes your fever might be due to urinary tract infection for which you can refer to my earlier post for urinary tract infection.
3.If you have no wound in your body and no burning sensation in urine then what else? Do you have cough with sputum coming out? If yes, Check its color, whether it is yellow or blood stained. If it is yellow, greenish or blood stained, go to your nearest clinical lab and get yourself checked, sputum for culture and sensitivity and sputum for AFB. After giving your sample you can start amoxycillin +dicloxacillin capsule 500 mg thrice daily for five to seven days for adults. For kids dose should be adjusted for body weight. warning! Antibiotics should be used under guidance of qualified medical practitioner only..
Your sputum culture and sensitivity report arrived and reports says positive results. Check for the name of antibiotics which shows the greatest number of + signs for example, it is written ++++ against levofloxacin, you can choose anyone with greater number of + for your respiratory tract infection. You should take that antibiotic at least seven days according to the prescribed daily dose according to your body weight. For example an adult weighing sixty kg can take levofloxacin 500 mg tab, one tab daily for at least 7days if he has ++++against levofloxacin in his sputum culture and sensitivity report. Or he may take roxithromycin 150 mg tab every twelve hour for seven days, if the same report says ++++ against roxithromycin. OR he may take OFLOXACIN 200 mg twelve hourly for seven days, if the report says ++++against OFLOXACIN.
The dose in children should be adjusted for their body weight. Suppose your sputum for culture and sensitivity report is negative. Check for sputum for AFB report, if it is positive, then you should go to government run hospital or primary health center, they would provide you free medicines for tuberculosis after doing some confirmatory tests from their sides. This medicine for tuberculosis should be taken for complete six months. Take care not to miss the course.
If your sputum for culture and sensitivity and sputum for AFB are negative, then you should continue amoxycillin +dicloxacillin as I have stated earlier for five days. If you see improvement in your cough, you should extend it up to seven days and if no improvement till five days of amoxycillin +dicloxacillin, then you should go for x-ray chest PA view under advice of a qualified doctor.
If your sputum for AFB is negative and your chest x- ray doesn’t show any abnormal sign and you still have fever for more than five days despite taking amoxycillin and dicloxacin for five days, you should get tested for malaria and typhoid. For malaria MP test and for typhoid Widal test.(note: if you are living in area where malaria is common, and you have fever; you should get your blood tested for malaria earliest and you should give it priority.
For malaria test the result may be positive for falciparum or vivax .Your doctor would provide you exact line of treatment .Don’t try self medication at all. For typhoid Widal test, if give you positive results, be careful to interpret it correctly, it should be positive for 1:160 dilution or greater to be significant. If you are sure of Widal positive. Adults can take Ciprofloxacin of some reputed brand 500 mg twice daily for two weeks. Their fever can be controlled by paracetamol 500 mg,cold sponging. Here it is important to note that paracetamol is just used to relieve the symptom of fever and it should not be repeated before 8 hours. Further for typhoid fever, requirement of paracetamol ends after five days of ciprofloxacin therapy. Beyond that you should complete your ciprofloxacin course of two weeks even if you have no fever after five days.
If you have fever and associated skin rash or eruptions, your fever might be due to viral infection. It is wise to consult your primary healthcare providers in such cases. In developing countries the myth is prevalent for such disease as wrath of Mata and there is no treatment for this. There are some antiviral drugs which can help you, but your doctor only can diagnose and decide about it.But you should keep one thing in your mind,you can boost your disease resisting capacity by use of vitamin-c.
If you are a welder or working in an industries where furnace being operated for metallurgy, you may experience fever with chills. Such fever is often confused with malaria. This fever is metal fume fever and can be relieved by paracetamol.,
If your little kid is wrapped in blanket for long,his body temperature may appear high on touching,so it is a better idea to confirm the fever with thermometer because kid can generate more heat due to brown fat cells containing numerous mitochondria. Whenever your kid has high body temperature that is 100 degree Fahrenheit or more, you should not cover his body with blanket. It is better to keep them in light color cotton clothes till their temperature is 100 degree F or more.High temperature can damage the kid’s brain and make them unconscious.
Twenty six years ago, when I had not joined my medical college and I had no idea about medicines, I heard a cry in my neighborhood that a two year kid got unconscious. His grandma was crying and shouting. The kid had fever. The family members had kept him in warm woolen clothes.I rushed for auto for his transportation and went along with them to a child specialist. The smart doctor just removed all woolen clothes and did cold sponging and miraculously the kid opened his eyes. Further he prescribed some medicines and advised to keep his body open for cooling.
Many kids get convulsions when they have high fever due to the bad effect of excess heat on brain. If you encounter any kid who has fever and convulsion, do cold sponging and put ice packs on forehead.
Brain is very sensitive organ, it can withstand cold but it cannot tolerate hot. If you have habit to take bath with warm water,keep in mind,never pour hot water on your head.
Thank you for patient reading…….
Now the important thing you must understand that fever is an important symptoms of many different diseases. From trivial to risky. My approach here to provide you some insights which will help you in addressing fever at odd time, odd situation when you don’t have access to a qualified doctor or you cannot visit him for monetary constraints.
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