Intermittent fever

[[File:Febbre.gif|thumb|right|Performance of the various types of fever

a) Fever continues

b) Fever continues to abrupt onset and remission

c) Remittent fever

d) Intermittent fever

e) Undulant fever

f) Relapsing fever]]

Intermittent fever is a type or pattern of fever in which there is an interval where temperature is elevated for several hours followed by an interval when temperature drops back to normal.{{cite book |first1=Muhammad |last1=Inayatullah |first2=Shabbir Ahmed |last2=Nasir |year=2016 |title=Bedside Techniques: Methods of Clinical Examination |publisher=Paramount Books (Pvt.) Limited |edition=4th |isbn=978-969-494-920-8 }}{{pn|date=January 2018}} This type of fever usually occurs during the course of an infectious disease.{{cite journal | vauthors = Le Moing V, Leport C | title = [Intermittent fever of infectious origin] | journal = La Revue du Praticien | publisher = Rev Prat | date=Jan 2002 | volume = 52 | issue = 2 | pages = 139–44 | pmid = 11915556| pmc = 3257674 }} Diagnosis of intermittent fever is frequently based on the clinical history but some biological tests like complete blood count and blood culture are also used. In addition radiological investigations like chest X-ray, abdominal ultrasonography can also be used in establishing diagnosis.{{cite journal |pmid=11915561 |year=2002 |last1=Vidal |first1=E |title=Prise en charge d'une fièvre intermittente chez l'adulte: Fièvres intermittentes |trans-title=Management of intermittent fever in the adult |language=fr |journal=La Revue du Praticien |volume=52 |issue=2 |pages=167–71 |last2=Liozon |first2=E |last3=Loustaud-Ratti |first3=V }}{{cite journal |pmid=11915560 |year=2002 |last1=Hachulla |first1=E |title=Fièvre intermittente symptomatique des maladies inflammatoires: Fièvres intermittentes |trans-title=Symptomatic intermittent fever of inflammatory diseases |language=fr |journal=La Revue du Praticien |volume=52 |issue=2 |pages=160–66 }}

Intermittent fever in malaria

Malaria is a common cause of intermittent fever and it has following types.{{cite journal |pmid=2682735 |jstor=23330279 |year=1989 |last1=Wittern |first1=R |title=Die Wechselfieber bei Galen |trans-title=Galen's intermittent fever |language=de |journal=History and Philosophy of the Life Sciences |volume=11 |issue=1 |pages=3–22 }}{{cite book |chapter-url={{Google books|ZbisJsvDEegC|page=1159|plainurl=yes}} |chapter=Malaria |pages=1159–61 |title=Ferri's Color Atlas and Text of Clinical Medicine |first=Fred F. |last=Ferri |year=2009 |publisher=Elsevier Health Sciences |isbn=978-1-4160-4919-7 }}

= Quotidian fever =

Bouts of fever occurring daily (24-hour periodicity) for a few hours, typical of Plasmodium falciparum.

= Tertian fever =

Fever occurs after an interval of two days (48-hour periodicity), typical of Plasmodium vivax and Plasmodium ovale.

= Quartan fever =

Fever occurs after an interval of three days (72-hour periodicity), typical of Plasmodium falciparum.

Examples

= Infectious causes of intermittent fever =

The following are examples of infectious diseases that may feature intermittent fever.{{cite journal |pmid=11915556 |year=2002 |last1=Le Moing |first1=V |title=Fièvres intermittentes d'origine infectieuse: Fièvres intermittentes |trans-title=Intermittent fever of infectious origin |language=fr |journal=La Revue du Praticien |volume=52 |issue=2 |pages=139–44 |last2=Leport |first2=C }}{{cite journal |pmid=1240348 |year=1975 |last1=Kameya |first1=K |title=Butterfly-like erythematous lesions and intermittent fever: Miliary tuberculosis |journal=Nihon Rinsho. Japanese Journal of Clinical Medicine |volume=Spec No |pages=726–27, 1040–43 |last2=Tsuchiya |first2=M |last3=Mie |first3=K }}{{cite journal |pmid=3069790 |year=1988 |last1=Gräf |first1=P |title=Intermittent fever attacks. Lyme disease without erythema chronicum migrans |journal=Der Inrnist |volume=29 |issue=11 |pages=778–80 |last2=Börner |first2=N |last3=Reichert |first3=M |last4=Weilemann |first4=L. S |last5=Meyer |first5=J |doi=10.1007/978-3-662-39609-4_126 }}

= Inflammatory causes of intermittent fever =

Adult-onset Still's disease is an inflammatory disease that may cause intermittent fever, characteristically a quotidian fever that spikes once or twice in the late afternoon to evening.{{cite journal |last1=Gerfaud-Valentin |first1=Mathieu |last2=Jamilloux |first2=Yvan |last3=Iwaz |first3=Jean |last4=Sève |first4=Pascal |date=2014 |title=Adult-onset Still's disease |journal=Autoimmunity Reviews |volume=13 |issue=7 |pages=708–722 |doi=10.1016/j.autrev.2014.01.058 |pmid=24657513 |doi-access=free }}

Management

Antipyretics like ibuprofen and paracetamol are used for fever and body aches.{{cite journal |doi=10.1001/archpedi.158.6.521 |pmid=15184213 |title=Efficacy and Safety of Acetaminophen vs Ibuprofen for Treating Children's Pain or Fever |journal=Archives of Pediatrics & Adolescent Medicine |volume=158 |issue=6 |pages=521–26 |year=2004 |last1=Perrott |first1=David A |last2=Piira |first2=Tiina |last3=Goodenough |first3=Belinda |last4=Champion |first4=G. David |doi-access= }} Antibiotics are also used for any underlying infection. For treating malaria, anti-malarial drugs like quinine, chloroquine and primaquine are given.{{cite journal |doi=10.1517/14656560902942319 |pmid=19463069 |title=Existing antimalarial agents and malaria-treatment strategies |journal=Expert Opinion on Pharmacotherapy |volume=10 |issue=8 |pages=1291–306 |year=2009 |last1=d'Alessandro |first1=Umberto |s2cid=22114286 }}

References

Category: Fever

Category:Malaria

Category:Tuberculosis