Editing Fever (section)

==Types==
[[File:Fever Patterns v1.2.svg|thumb|upright=1.8|Different fever patterns observed in ''Plasmodium'' infections]]Various patterns of measured patient temperatures have been observed, some of which may be indicative of a particular [[medical diagnosis]]:
* [[Continuous fever]], where temperature remains above normal and does not fluctuate more than {{val|1|u=°C}} in 24 hours<ref>{{cite journal | vauthors = Ogoina D | title = Fever, fever patterns and diseases called 'fever' – a review | journal = Journal of Infection and Public Health | volume = 4 | issue = 3 | pages = 108–124 | date = August 2011 | pmid = 21843857 | doi = 10.1016/j.jiph.2011.05.002 | doi-access = free }}</ref> (e.g. in [[bacterial pneumonia]], [[typhoid fever]], [[infective endocarditis]], [[tuberculosis]], or [[typhus]]).<ref>Typhoid fever may show a specific fever pattern, with a slow stepwise increase and a high plateau (drops due to fever-reducing drugs are excluded).{{citation needed|date=April 2020}}</ref><ref>{{cite book |last1=Dall |first1=Lawrence |last2=Stanford |first2=James F. |editor1-last=Walker |editor1-first=H. Kenneth |editor2-last=Hall |editor2-first=W. Dallas |editor3-last=Hurst |editor3-first=J. Willis |title=Clinical Methods: The History, Physical, and Laboratory Examinations |date=1990 |publisher=Butterworths |location=Boston |isbn=0-409-90077-X |edition=3rd |url=https://www.ncbi.nlm.nih.gov/books/NBK324/ |chapter=Fever, Chills, and Night Sweats|pmid=21250166 }}</ref>
* [[Intermittent fever]] is present only for a certain period, later cycling back to normal (e.g., in [[malaria]], [[Visceral leishmaniasis|leishmaniasis]], [[pyemia]], [[sepsis]],<ref>{{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 }}{{page needed|date=January 2018}}</ref> or [[African trypanosomiasis]]).<ref>{{Cite web|date=2020-04-28|title= African Trypanosomiasis – Disease|url=https://www.cdc.gov/parasites/sleepingsickness/disease.html|access-date=2021-07-18 |website=CDC |url-status=live |archive-url=https://web.archive.org/web/20210718232904/https://www.cdc.gov/parasites/sleepingsickness/disease.html |archive-date= 2021-07-18 }}</ref>
* [[Remittent fever]], where the temperature remains above normal throughout the day and fluctuates more than {{val|1|u=°C}} in 24 hours (e.g., in [[infective endocarditis]] or [[brucellosis]]).<ref>{{cite web |url=https://www.lecturio.com/concepts/brucellosis/| title=Brucella/Brucellosis
|website=The Lecturio Medical Concept Library |access-date= 19 July 2021}}</ref>
* [[Pel–Ebstein fever]] is a cyclic fever that is rarely seen in patients with [[Hodgkin's lymphoma]].{{Citation needed|date=March 2025}}
* Undulant fever, seen in [[brucellosis]].{{Citation needed|date=March 2025}}
* [[Typhoid fever]] is a [[continuous fever]] showing a characteristic ''step-ladder pattern,'' a step-wise increase in temperature with a high plateau.<ref>{{cite web |url=https://www.lecturio.com/concepts/enteric-fever-typhoid-fever/| title=Enteric Fever (Typhoid Fever)|website=The Lecturio Medical Concept Library | date=27 August 2020|access-date= 19 July 2021}}</ref>

Among the types of intermittent fever are ones specific to cases of malaria caused by different pathogens. These are:<ref name="Ferri 2009">{{Cite book |author=Ferri FF |chapter=Chapter 332. Protozoal infections |title=Ferri's Color Atlas and Text of Clinical Medicine |year=2009 |publisher=Elsevier Health Sciences |isbn=9781416049197 |pages=1159ff |chapter-url=https://books.google.com/books?id=ZbisJsvDEegC&pg=PA1159 |url-status=live |archive-url=https://web.archive.org/web/20160603093438/https://books.google.com/books?id=ZbisJsvDEegC&pg=PA1159 |archive-date=3 June 2016 | access-date = 31 March 2020}}</ref><ref>{{cite book | vauthors = Muhammad I, Nasir, SA |title= Bedside Techniques: Methods of Clinical Examination | location = [[Multan, Pakistan]] | publisher= Saira Publishers/Salamat Iqbal Press  |date=2009 }}{{page needed|date=April 2020}}{{better source needed|date=April 2020}}</ref>
* Quotidian fever, with a 24-hour periodicity, typical of [[malaria]] caused by ''[[Plasmodium knowlesi]]'' (''P. knowlesi'');<ref>{{cite journal |last1=Singh |first1=B. |last2=Daneshvar |first2=C. |title=Human Infections and Detection of Plasmodium knowlesi |journal=Clinical Microbiology Reviews |date=1 April 2013 |volume=26 |issue=2 |pages=165–184 |doi=10.1128/CMR.00079-12|pmid=23554413 |pmc=3623376 |doi-access=free }}</ref><ref>{{cite journal |last1=Chin |first1=W. |last2=Contacos |first2=P. G. |last3=Coatney |first3=G. R. |last4=Kimball |first4=H. R. |title=A Naturally Acquired Quotidian-Type Malaria in Man Transferable to Monkeys |journal=Science |date=20 August 1965 |volume=149 |issue=3686 |page=865 |doi=10.1126/science.149.3686.865|pmid=14332847 |bibcode=1965Sci...149..865C |s2cid=27841173 }}</ref>
* [[Tertian fever]], with a 48-hour periodicity, typical of later course [[malaria]] caused by ''[[Plasmodium falciparum|P. falciparum]]'', ''[[Plasmodium vivax|P. vivax]]'', or ''[[Plasmodium ovale|P. ovale]]'';<ref name="Ferri 2009" />
* [[Quartan fever]], with a 72-hour periodicity, typical of later course [[malaria]] caused by ''[[Plasmodium malariae|P. malariae]]''.<ref name="Ferri 2009" />

In addition, there is disagreement regarding whether a specific fever pattern is associated with [[Hodgkin's lymphoma]]—the [[Pel–Ebstein fever]], with patients argued to present high temperature for one week, followed by low for the next week, and so on, where the generality of this pattern is debated.<ref>{{Cite web |date=2021-11-09 |title=Hodgkin Lymphoma: Practice Essentials, Background, Pathophysiology |url=https://emedicine.medscape.com/article/201886-clinical |website=Medscape}}</ref><ref>{{cite journal | vauthors = Hilson AJ | title = Pel-Ebstein fever | journal = The New England Journal of Medicine | volume = 333 | issue = 1 | pages = 66–67 | date = July 1995 | pmid = 7777006 | doi = 10.1056/NEJM199507063330118 }}, which cites [[Richard Asher]]'s lecture, "Making Sense" [''Lancet'' (1959) '''2''': 359].</ref>

Persistent fever that cannot be explained after repeated routine clinical inquiries is called [[fever of unknown origin]].<ref name="Harrisons20th" /><ref>{{Cite journal |last1=Magrath |first1=Melissa |last2=Pearlman |first2=Michelle |last3=Peng |first3=Lan |last4=Lee |first4=William |date=2018-06-30 |title=Granulomatous Hepatitis and Persistent Fever of Unknown Origin: A Case Report |journal=Gastroenterology, Hepatology & Digestive Disorders |volume=1 |issue=2 |pages=1–2 |doi=10.33425/2639-9334.1009 |s2cid=86786427 |issn=2639-9334|doi-access=free }}</ref> A [[neutropenic fever]], also called febrile neutropenia, is a fever in the absence of normal immune system function.<ref name="Klastersky 2014 13–26">{{Citation |last=Klastersky |first=Jean A. |title=Prevention of Febrile Neutropenia |date=2014 |url=http://dx.doi.org/10.1007/978-1-907673-70-2_2 |work=Febrile Neutropenia |pages=13–26 |place=Tarporley |publisher=Springer Healthcare Ltd. |doi=10.1007/978-1-907673-70-2_2 |isbn=978-1-907673-69-6 |access-date=2022-04-22}}</ref> Because of the lack of infection-fighting [[neutrophil]]s, a bacterial infection can spread rapidly; this fever is, therefore, usually considered to require urgent medical attention.<ref>{{Cite journal|last1=White|first1=Lindsey|last2=Ybarra|first2=Michael|date=2017-12-01|title=Neutropenic Fever|url=https://linkinghub.elsevier.com/retrieve/pii/S0889858817301284|journal=Hematology/Oncology Clinics of North America|volume=31|issue=6|pages=981–993|doi=10.1016/j.hoc.2017.08.004|pmid=29078933|via=ClinicalKey}}</ref> This kind of fever is more commonly seen in people receiving immune-suppressing [[chemotherapy]] than in apparently healthy people.<ref name="Klastersky 2014 13–26" /><ref>{{Cite book |editor=Rolston, Kenneth VI |editor2=Rubenstein, Edward B. |title=Textbook of febrile neutropenia |date=2001 |publisher=Martin Dunitz |isbn=978-1-84184-033-8 |oclc=48195937}}</ref>

=== Hyperpyrexia ===
Hyperpyrexia is an extreme elevation of [[body temperature]] which, depending upon the source, is classified as a [[core body temperature]] greater than or equal to {{convert|40|or|41|C|F|0}}; the range of hyperpyrexia includes cases considered severe (≥ 40&nbsp;°C) and extreme (≥ 42&nbsp;°C).<ref name="Harrisons20th" /><ref name="MDMA-Hyperpyrexia systematic review">{{cite journal | vauthors = Grunau BE, Wiens MO, Brubacher JR | title = Dantrolene in the treatment of MDMA-related hyperpyrexia: a systematic review | journal = Canadian Journal of Emergency Medicine | volume = 12 | issue = 5 | pages = 435–442 | date = September 2010 | pmid = 20880437 | doi = 10.1017/s1481803500012598 | quote = Dantrolene may also be associated with improved survival and reduced complications, especially in patients with extreme (≥ 42&nbsp;°C) or severe (≥ 40&nbsp;°C) hyperpyrexia | doi-access = free }}</ref><ref name="Neurobiology of hyperthermia">{{cite book | editor=Sharma HS | title=Neurobiology of Hyperthermia | date=2007 | publisher=Elsevier | isbn=978-0080549996 | pages=175–177, 485 | edition=1st | url=https://books.google.com/books?id=Vk1UTlmEwrQC&pg=485 | access-date=19 November 2016 | quote=Despite the myriad of complications associated with heat illness, an elevation of core temperature above 41.0&nbsp;°C (often referred to as fever or hyperpyrexia) is the most widely recognized symptom of this syndrome. | url-status=live | archive-url=https://web.archive.org/web/20170908174330/https://books.google.com/books?id=Vk1UTlmEwrQC&pg=485#v=onepage&q=hyperpyrexia%20core%20temperature&f=false | archive-date=8 September 2017  }}</ref> It differs from [[hyperthermia]] in that one's [[Human thermoregulation#Control system|thermoregulatory system's set point]] for body temperature is set above normal, then heat is generated to achieve it. In contrast, hyperthermia involves body temperature rising above its set point due to outside factors.<ref name="Harrisons20th" /><ref>See section in Chapter 15 therein, the section on "Fever versus hyperthermia".</ref> The high temperatures of hyperpyrexia are considered [[medical emergency|medical emergencies]], as they may indicate a serious underlying condition or lead to severe morbidity (including permanent [[brain damage]]), or to death.<ref name="EM01" /> A common cause of hyperpyrexia is an [[intracranial hemorrhage]].<ref name="Harrisons20th" /> Other causes in emergency room settings include Malignant Catatonia, [[sepsis]], [[Kawasaki syndrome]],<ref name="Marx 2006 2506">Marx (2006), p. 2506.</ref> [[neuroleptic malignant syndrome]], [[drug overdose]], [[serotonin syndrome]], and [[thyroid storm]].<ref name="EM01">{{cite journal | vauthors = McGugan EA | title = Hyperpyrexia in the emergency department | journal = Emergency Medicine | volume = 13 | issue = 1 | pages = 116–120 | date = March 2001 | pmid = 11476402 | doi = 10.1046/j.1442-2026.2001.00189.x }}</ref>