Temperature fluctuations during the day. Normal, high and low body temperature

Without respect and consideration for biorhythms, no progress and improvement in health is possible

Real health is a properly organized mode of life. Without respect and consideration for biorhythms, no progress and improvement in health is possible. Human nature is complex, and we have not one, but several pacemakers that may or may not be synchronized (desynchronization).

I want to tell you about one important pacemaker - temperature. This is important to know, since the rhythmic organization of basic physiological functions (sleep, nutrition, physical activity, stress) affects the state of health, performance and resistance of the body to various influences.

Pacemakers: light and temperature

Adaptation of the human body to changing environmental conditions (change of time of day, seasons, solar activity, etc.) is carried out with the help of biological rhythms, or “internal clocks”. Formed in the course of evolution, the circadian rhythms of organisms are synchronized with the duration of photoperiods. Being one of the fundamental properties of living matter, biorhythms are manifested in the functioning of all body systems (nervous, endocrine, reproductive, cardiovascular, etc.).

Biorhythms are divided into circadian (daily), circannual (annual), ultradian (lasting more than a day), infradian (lasting less than a day), etc. The center of regulation of biorhythms is the hypothalamus. The circadian rhythm generator is localized in the suprachiasmatic nuclei (SCN) of the anterior hypothalamus. The suprachiasmatic nuclei receive information about illumination through the retinohypothalamic tract. The circadian pacemaker responds to various illumination parameters - wavelength, duration and time of exposure. The main external synchronizer of circadian rhythm is the light-dark cycle, but even in the absence of external light (solar) influences (bunker, submarine, cave, etc.), circadian rhythms persist, changing in duration, due to internal periodicity. Moreover, melatonin, due to its hypothermic properties, has a direct effect on the circadian rhythm of body temperature.

Although the suprachiasmatic nuclei (driven by light) certainly play a critical role in the regulation of circadian timing systems, there is evidence of other pacemakers in mammals as well. So, for example, in saimiri monkeys with damaged suprachiasmatic nuclei, the rhythms of eating, drinking and activity disappear, but the daily cycle of body temperature remains unchanged.This shows that temperature fluctuations are under the control of some other pacemaker.

The fact that the subjects exhibit spontaneous desynchronization, i.e. The discrepancy between the circadian rhythm of body temperature and the sleep-wake cycle indicates the existence of at least two drivers. There are certain sets of rhythms that are never desynchronized in such experiments and, therefore, must be subject to a common pacemaker. One such set includes sleep and wake rhythms, skin temperature, blood growth hormone concentrations, and urinary calcium levels. It is assumed (although by no means proven) that this group of rhythms is controlled by the suprachiasmatic nuclei. The second group of indicators, which vary in concert even when other bodily functions are desynchronized, are cycles of REM sleep, core body temperature, blood cortisol, and urine potassium. The pacemaker that controls these rhythms seems to be more stable than the one that controls the rhythm of sleep and wakefulness. In cases where the rhythms became free-flowing, i.e., in the absence of external timers, this group rarely deviated.

The temperature regime is adjusted during flights much later than the light regime. Even if a person is completely cut off from any external signals, such as daylight hours, weather changes, meal times, and others, it will still have diurnal temperature fluctuations. However, in this situation, the oscillations remain rhythmic, but their cycle is not exactly 24 hours. Rhythmic fluctuations in body temperature in conditions of isolation from external factors usually occur within 24 - 25 hours, and this period of time is called the circadian periodicity. That is, all daily temperature fluctuations are entirely based on endogenous biological rhythms, which are synchronized with the period of the Earth's rotation around its axis. If a person moves in space with the intersection of the hour meridians, then after arriving at a permanent place of residence for 1-2 weeks, his daily fluctuations in body temperature will be synchronized with the new local time (!).

Body temperature

Body temperature is a complex indicator of the thermal state of the body of animals, including humans. It is one of the main and oldest biomarkers. Our body temperature is easily measurable and is a very useful indicator. The problem now is that fluctuations are minimized, which leads to numerous failures. We are day and night in all seasons of the year in the same temperature comfort zone and this is not very good. Very often, the temperature rhythm begins to conflict with the light rhythm and this leads to desynchronization, which is the cause of many problems.

So, let's understand how the temperature cycle works. The main one, as always, is the hypothalamus. The endocrine glands are involved in the implementation of the hypothalamic regulation of body temperature, mainly thyroid and adrenal glands. The thyroid gland and its hormones increase thermogenesis and increase metabolism by raising the temperature. The adrenal glands produce adrenaline, which also enhances oxidative processes in tissues, in particular in muscles, increases heat generation and constricts skin vessels, reducing heat transfer.

Nerve cells of the hypothalamus have receptors that directly respond to body temperature by increasing or decreasing the secretion of TSH (thyroid-stimulating hormone), which, in turn, regulates the activity of the thyroid gland, whose hormones (T3 and T4) are responsible for the intensity of metabolism. To a lesser extent, the hormone estradiol is involved in the regulation of temperature (it plays the main role in the thermoregulation of bodies in women during the menstrual cycle), an increase in its level leads to a decrease in basal temperature.

Daily rhythms occupy a leading place among human biological rhythms. Modern authors call their totality and consistency - temporary organization, emphasizing that it plays a special role, both in the synchronization of intraorganismal processes and in the interaction of the organism with the environment. Mesor and amplitude occupy a special place among rhythm parameters. Mesor (average daily level) reflects the central line around which fluctuations in physiological function occur throughout the day. The amplitude (oscillation range) is the most flexible indicator of functional morphology and one of the first to change under the influence of various factors. The magnitude of the amplitude can serve as an indicator of the adaptation process.

The "thermostat" (hypothalamus) is located in the brain and is constantly engaged in thermoregulation. During the day, a person's body temperature fluctuates, which is a reflection of circadian rhythms. The body temperature of each person during the day fluctuates within a small range, remaining in the range from 35.5 to 37.0 ° C for a healthy person. Following the daily rhythm, the lowest body temperature is observed in the morning, around 6 o'clock, and the maximum value is reached in the evening. Like many other biorhythms, temperature follows the daily cycle of the sun, not the level of our activity. People who work at night and sleep during the day show the same temperature cycle as everyone else.

Temperature cycle

1. Morning and awakening.

The experiments of American physiologists, conducted under the guidance of Professor Zeisler, showed that sleep and awakening are closely related to body temperature. In the morning, the body temperature rises. Scientists have found that hunter-gatherer sleep and wake patterns correlate not only with the daily and night routine (which is trivial and does not need to be confirmed), but also with the ambient temperature. The last conclusion is just less obvious, but is confirmed by measurements. Awakening for both the San and the Cymans occurs when the ambient temperature is at its lowest.. Awakening is indicated by a sharp decrease in temperature of the fingers, reflecting peripheral vasoconstriction, which is accompanied by an increase in blood flow to the brain, and therefore indicates a transition from sleep to wakefulness. For San, the minimum temperature of the environment is an hour after dawn, and for Tsimans - an hour before dawn. The time of falling asleep for both of them falls on the time of a sharp decrease in the ambient temperature, and not on the onset of darkness. This explains the slightly different daily routine in these largely similar traditional societies. Probably, shifting sleep to the coldest time of the day helps to save energy costs, therefore it is more acceptable for life in traditional conditions.

Exercising and moderate physical activity in the morning contribute to a rise in body temperature and higher activity. I am also a supporter of a protein breakfast, as protein has the highest thermogenic effect compared to other nutrients. Thus, a person wakes up always on the rise of the temperature curve. Therefore, the duration of sleep depends on which phase of the temperature cycle falls asleep: the next rise in body temperature will wake you up, even if before that you did not sleep for several days.

2. Day and activity

With regard to our activity, mental and physical activity increases with an increase in body temperature. Physical activity helps keep your mind active throughout the day. So, athletes know that "warming up" increases performance, and, indeed, the optimal levels of hyperthermia, (T core of the body = 38.7 - 39.2 °), provide maximum performance in exercises for strength, speed, flexibility and agility. And when performing intermittent physical activity, an increase in body temperature to a level of 38.7-39.2 ° C is “normal” and even desirable for the effectiveness of muscle work. If a person is experiencing intense physical activity, then the optimal temperature will be elevated (for strength training). Body temperature reaches a maximum in the evening, drops at night and rises quickly upon awakening.

Research also shows that changes in habitual body temperature caused by heat or cold can have a significant impact not only on mood, but also on cognitive function. Cognition is the process that governs how we respond to our environment, as well as our ability to store memories and perform mental tasks such as arithmetic. And this ability deteriorates if the body temperature deviates from the norm. Extreme temperatures or prolonged exposure to uncomfortable weather can alter body temperature, impair homeostatic control (the body's ability to maintain its temperature). Studies have also shown that when the ambient temperature drops, the body temperature drops, and this negatively affects cognitive abilities. Scientists from the University of Kent (USA) placed the subjects in water at a temperature of 13 degrees Celsius for 30 minutes. After that, most body temperature dropped to the level of 35-36 degrees Celsius, which is slightly below the normal range of 36.5-37.2 degrees Celsius. Participants rested for 15 minutes, and then the researchers asked them to complete the Stroop Test (the name of the color is written in the box, but the color of the font in which the word is written must be indicated on the answer sheet). While seemingly simple, the test requires some cognitive effort. Participants were asked to name the font color as quickly as possible. It turned out that the test was significantly more difficult for participants placed in cold water. This study shows that low body temperature has a significant impact on attention to detail, which is considered a marker of cognition.

Decreased body temperature during the day is a common symptom of hypothyroidism. A regular drop in temperature is one of the first signs of disorders in the thyroid gland. Subclinical hypothyroidism is often accompanied by chronic fatigue, low temperature, weight gain, and weakness. Normal axillary body temperature, determined in the morning immediately after waking up to diagnose hypothyroidism, is in the range of 97.4 ─ 98.2 degrees Fahrenheit (36.3 ─ 36.8 ° C). Women should measure their body temperature during the first 5 days of their cycle and then average the values. A temperature below 36.3°C indicates an underactive thyroid gland (hypothyroidism). If the average temperature was calculated according to the method described above and it turns out to be below 36.5 ˚С, then you have a very high probability of hypothyroidism. The question is whether this disorder is primary thyroid insufficiency or whether it refers to a "malfunction" in the pituitary gland or adrenal insufficiency.

3. Evening and falling asleep

At 18-19 hours, the maximum body temperature is observed, after which it begins to decrease. It is good if going to bed coincides with a lower body temperature. The individual biorhythm of the time of the fastest drop in temperature (the extreme inflection point on the curve) corresponds to the optimal time for falling asleep. So - you can fall asleep easily and sleep faster. Therefore, all procedures related to cooling the body improve falling asleep. Light is also important, yellow low light promotes the production of melatonin, which causes drowsiness and controls body temperature.

We have already said that during the day the body temperature experiences cyclic fluctuations with an amplitude of about 1 ° C. People tend to fall asleep when their body temperature drops and wake up when it rises. 19:00 - the highest level of blood pressure and the highest body temperature. An internal signal for going to sleep is a decrease in body temperature.

Our body releases heat through our hands, face and feet when it's time to sleep. Cooling continues until approximately four in the morning. However, if something interferes with the decrease in body temperature, then the quality of sleep immediately deteriorates. The person cannot sleep, suffers from insomnia. In connection with these, the scientist advises to correctly choose bed linen, giving preference to natural fabrics. A mattress made of foam or other synthetic materials needs a natural wool mattress topper. And those who have problems falling asleep can even keep a pillow in the refrigerator during the day. You can also soak your hands under cold water for a few minutes before going to bed. After that, it is recommended to immediately go to bed.

However, many people fall asleep soundly after a warm bath, and this effect is well known to physicians. Perhaps the fact is that heating leads to the expansion of the vessels of the arms and legs, which are effective heat exchangers. When a person gets out of the bath, the dilated vessels of his limbs intensely give off heat and cool the body.

There is another explanation. In kangaroo rats, local heating of the hypothalamus increases the duration of the slow-wave sleep phase. Perhaps the fact is that the overheated hypothalamus turns on an additional brain cooling system. If this mechanism is also valid for humans, and the blood passing through the vertebral arteries from the heated body to the brain mainly enters the hypothalamus region, the same thing happens to it as in the marsupial rat: The hypothalamus turns on the cooling system, which causes sleep, more precisely, its slow-wave phase.

An interesting description of the mechanism of yawning in terms of cooling the brain. So, relatively recently, scientists began to consider the act of yawning as a system for rapid cooling of the brain, which, in addition, made it possible to explain the connection between yawning and falling asleep and hypoxia. The dependence of the frequency of yawning on the ambient temperature has been noticed for a long time. In addition, the effect of yawning on temperature-dependent attacks of epilepsy, migraine, and multiple sclerosis indicated an important role of this act in brain thermoregulation. The hypothesized link between yawning and brain cooling was proven when, in 2010, researchers injected temperature sensors into the brains of rats and found that an increase in brain temperature of just 0.1°C promptly provoked yawning attacks in rodents, followed by a decrease in brain temperature by 0 .5°С. However, these observations could not be substantiated anatomically for a long time - how does yawning remove excess heat from the brain? The act of yawning begins with the opening of the mouth and expansion of the nasopharynx, which leads to its filling with cold air through the mouth opening. Try to yawn. Did you feel a chill and a strong tension in the very center of your head?

It turned out that at the peak of yawning, the lower jaw tightens the pterygoid muscles, and they, in turn, pull back the sphenoid process, dragging behind it the back wall of the maxillary sinus. The volume of the sinuses in an adult reaches 34 cubic meters. cm, and the tension of the back walls during a yawn increases their size by another third. The resulting negative pressure in the sinuses "sucks" cold air from the nasopharynx. This air causes the evaporation of moisture on the walls of the sinus, thereby cooling the capillaries of the mucous membrane. The blood cooled in this way is then collected in the veins of the pterygoid plexus. With the end of the yawn, the jaws clench and the masticatory muscles compress the pterygoid plexus (stage 4) causing the outflow of cool blood into the sinuses of the dura mater. This blood, in turn, cools the cerebrospinal fluid, which also increases during yawning - in this act, it acts as a coolant of the central nervous system. Thus, cooling of the brain will occur immediately after the completion of the act of yawning.

4. Night and recovery

Most people sleep better in a cool room. During sleep, the body cools down, at 4.00-5.00 - the lowest body temperature. The ideal temperature in the bedroom is 18-21°C. In people with severe cases of insomnia, the daily rhythm of body temperature is disturbed: it varies slightly and without definite patterns. Either the rhythm exists, but its period is far from 24 hours. With such a rhythm, a person manages to fall asleep normally only on days when the temperature drops in the evening hours.

The temperature of the body (and the brain) obeys the circadian rhythm, and when it drops, you want to sleep. In addition, nightly cool temperatures promote nighttime fat burning, autophagy, and growth hormone production. Cooling the brain is not just associated with falling asleep, but stimulates it. Probably, this is the basis of the well-known household method of dealing with insomnia: you need to freeze well. A group of American scientists from the University of Pittsburgh located in Pennsylvania (University of Pittsburgh) managed to develop a technique that allows you to get rid of insomnia quite effectively. A special cap that cools the frontal areas of the patient's cerebral cortex can significantly improve the quality and productivity of a night's rest. In the course of the study in question here, American experts led by Dr. Eric Nofzinger (Eric Nofzinger) studied the effect of low temperature on the activity of areas of the cerebral cortex, as well as on metabolic processes in patients suffering from insomnia. At the same time, the scientists relied on data obtained in the course of previous studies, according to which the activity of metabolic processes in the frontal regions of the cerebral cortex of a healthy person decreases during sleep. At the same time, it was proved that in patients suffering from insomnia, during the night's rest, the activity of this part of the brain remains elevated.

For good sleep, it is very important to alternate slow and fast sleep, associated with alternating low and high temperatures.

Numerous experiments show that changes in brain temperature are not random. In rats, it always increases in response to external stimuli: pain, social contact with another individual, sexual arousal. Moreover, the temperature of each part of the brain in response to different stimuli rises to one specific value, as if it is striving for it.

For example, for the nucleus accumbens of the rat brain, this temperature is 38.5°C. And in the phase of slow sleep, cooling occurs by a value from several tenths of a degree to several degrees in different parts of the brain in different animals. Obviously, the temperature of the brain does not change passively, but regulates the activity of the nervous tissue. It is not for nothing that a sober-minded person is said to have a cold head. published

Body temperature is an indicator of the thermal state of the body. Thanks to it, there is a reflection of the relationship between the production of heat by the internal organs, the heat exchange between them and the outside world. At the same time, temperature indicators depend on the age of a person, time of day, the impact of the outside world, health status and other characteristics of the body. So what should be the body temperature of a person?

People are used to the fact that with changes in body temperature it is customary to talk about a violation of health. Even with a slight hesitation, a person is ready to sound the alarm. But it's not always so sad. Normal human body temperature ranges from 35.5 to 37 degrees. In this case, the average in most cases is 36.4-36.7 degrees. I would also like to note that temperature indicators can be individual for each. The normal temperature regime is considered to be when a person feels completely healthy, able-bodied and there is no failure in metabolic processes.

What is the normal body temperature in adults also depends on what nationality the person is. For example, in Japan, it is kept at 36 degrees, and in Australia, the body temperature rises to 37 degrees.

It is also worth noting that the normal human body temperature can fluctuate throughout the day. In the morning it is lower, and in the evening it rises significantly. At the same time, its fluctuation during the day can be one degree.

Human temperature is divided into several types, which include:

1. lower body temperature. Her performance falls below 35.5 degrees. This process is called hypothermia;
2. normal body temperature. Indicators can range from 35.5 to 37 degrees;
3. elevated body temperature. It rises above 37 degrees. At the same time, it is measured in the armpit;
4. subfebrile body temperature. Its limits range from 37.5 to 38 degrees;
5. febrile body temperature. The indicators are from 38 to 39 degrees;
6. high or pyretic body temperature. It rises to 41 degrees. This is the critical body temperature, which leads to disruption of metabolic processes in the brain;
7. hyperpyretic body temperature. A lethal temperature that rises above 41 degrees and leads to death.

Also, the internal temperature is classified into other types in the form:

• hypothermia. When the temperature is below 35.5 degrees;
• normal temperature. It ranges from 35.5-37 degrees;
• hyperthermia. The temperature is above 37 degrees;
• feverish state. The indicators are raised above 38 degrees, while the patient has chills, blanching of the skin, marble mesh.

Rules for measuring body temperature

All people are used to the fact that, according to the standard, temperature indicators should be measured in the armpit. To perform the procedure, you must follow a few rules.

1. The armpit should be dry.
2. Then a thermometer is taken and gently shaken to a value of 35 degrees.
3. The tip of the thermometer is located in the armpit and is pressed tightly by the hand.
4. Keep it on for five to ten minutes.
5. After that, the result is evaluated.

With a mercury thermometer, you should be extremely careful. It must not be broken, otherwise the mercury will pour out and emit harmful fumes. It is strictly forbidden to give such things to children. Instead, you can have an infrared or electronic thermometer. Such devices measure the temperature in a matter of seconds, but the values ​​\u200b\u200bfrom mercury may differ.

Not everyone thinks that the temperature can be measured not only in the armpit, but also in other places. For example, in the mouth. With this method of measurement, normal indicators will be in the range of 36-37.3 degrees.

How to measure the temperature in the mouth? There are several rules.
To measure the temperature in the mouth, you need to be in a calm state for five to seven minutes. If there are dentures, braces or plates in the oral cavity, they should be removed.

After that, the mercury thermometer must be wiped dry and placed under the tongue on either side. To get the result, you need to hold it for four to five minutes.

It is worth noting that oral temperature differs significantly from measurements in the axillary zone. Temperature measurements in the mouth can show a result higher by 0.3-0.8 degrees. If an adult doubts the indicators, then a comparison should be made between the temperature obtained in the armpit.

If the patient does not know how to measure the temperature in the mouth, then you can follow the usual technology. During the procedure, it is worth observing the execution technique. The thermometer can be placed behind the cheek or under the tongue. But clamping the device with your teeth is strictly prohibited.

Decreased body temperature

After the patient has learned what temperature he has, you need to determine its nature. If it is below 35.5 degrees, then it is customary to talk about hypothermia.

The internal temperature may be low for several reasons, which include:

• weakened immune function;
• severe hypothermia;
• recent illness;
• diseases of the endocrine system;
• the use of certain drugs;
• low hemoglobin;
• failure in the hormonal system;
• presence of internal bleeding;
• intoxication of the body;
• chronic fatigue.

If the patient's internal temperature is greatly reduced, then he will feel weak, prostration and dizziness.
To increase the temperature at home, you need to put your feet in a hot foot bath or on a heating pad. After that, put on warm socks and drink hot tea with honey, an infusion of medicinal herbs.

If the temperature indicators decrease gradually and reach 35-35.3 degrees, then we can say:

• about simple overwork, strong physical exertion, chronic lack of sleep;
• about malnutrition or adherence to a strict diet;
• about hormonal imbalance. Occurs at the stage of gestation, with menopause or menstruation in women;
• on disorders of carbohydrate metabolism due to liver diseases.

Increased body temperature

The most common phenomenon is elevated body temperature. If it keeps at levels from 37.3 to 39 degrees, then it is customary to talk about an infectious lesion. When viruses, bacteria and fungi penetrate the human body, severe intoxication occurs, which is expressed not only in an increase in body temperature, but also in a runny nose, tearing, coughing, drowsiness, and deterioration in the general condition. If the internal temperature rises above 38.5 degrees, then doctors advise taking antipyretics.

The occurrence of temperature can be observed with burns and mechanical injuries.
In rare situations, hyperthermia is observed. This condition is caused by an increase in temperature indicators above 40.3 degrees. In such a situation, you need to call an ambulance as soon as possible. When the indicators reached 41 degrees, it is customary to talk about a critical condition that threatens the patient's future life. At a temperature of 40 degrees, an irreversible process begins to occur. There is a gradual destruction of the brain and deterioration of the internal organs.

If the internal temperature is 42 degrees, then the patient dies. There are cases when the patient experienced such a condition and survived. But their number is small.

If the internal temperature rises above the hole, then the patient manifests symptoms in the form of:

1. fatigue and weakness;
2. general morbid condition;
3. dry skin and lips;
4. mild or severe chills. Depends on temperature indicators;
5. pain in the head;
6. aches in muscle structures;
7. arrhythmias;
8. decrease and complete loss of appetite;
9. increased sweating.

Each person is individual. Therefore, everyone will have their own normal body temperature. Someone with indicators of 35.5 degrees feels normal, and when it rises to 37 degrees, it is already considered sick. For others, even 38 degrees may be the limit of the norm. Therefore, it is worth focusing also on the general condition of the body.

Body temperature is an important indicator of the functioning of the body. If its value changes, this may be a consequence of either natural or pathological processes occurring in the body.

At the same time, its minimum value falls on the morning period (4-5 hours), and the maximum figure is reached at about 17 hours.

If the temperature jumps during the day (36 - 37 degrees), they are explained by the physiological state of systems and organs, when an increase in temperature values ​​\u200b\u200bis necessary to activate their work.

When the body is at rest, the body temperature drops, so jumps from 36 to 37 degrees during the day are regarded as a variant of the norm.

The human body is a heterogeneous physical environment, where areas are heated and cooled in different ways.

Contrary to popular belief, the measurement of temperature in the armpit can be the least informative, this often causes unreliable results.

In addition to the armpit, body temperature can be measured:

• in the ear canal
• in the oral cavity
• rectum.

Medicine distinguishes between several types of temperature. An elevated temperature is considered to be an indicator of 37.5 degrees, at which there are other uncomfortable manifestations.

A fever is a temperature of unknown origin, in which the only symptom is a prolonged rise in temperature from 38 degrees. The condition lasts 14 days or more.

Subfebrile temperature is considered to be up to 38.3 degrees. This is a condition of unknown origin, in which a person periodically has a fever without additional symptoms.

Specificity of physiological conditions

In addition to wakefulness and sleep, jumps in temperature indicators during the day are caused by such processes:

• overheating
• active physical activity
• digestive processes,
• psycho-emotional arousal.

In all these cases, temperature jumps from 36 to 37.38 degrees can be observed. The condition does not require correction, since the temperature rise occurs against the background of the natural physiological conditions of the body.

An exception is cases when temperature jumps from 36 to 37 degrees are accompanied by additional symptoms, namely:

1. headache,
2. discomfort in the region of the heart,
3. the appearance of a rash
4. shortness of breath
5. dyspeptic complaints.

If these symptoms are present, it is necessary to consult a doctor to exclude the development of allergic reactions, vegetovascular dystonia and endocrine disorders.

Among other things, jumps in overall body temperature during pregnancy are also due to physiological specifics. At this time, significant changes in the hormonal background occur, since progesterone is produced in large quantities, which leads to jumps in body temperature from 36 to 37 degrees.

As a rule, changes in temperature indicators are observed in the first trimester, but there are times when the condition continues throughout the pregnancy, and the reasons should be found out.

Changes in body temperature carry an additional danger in the presence of:

• catarrhal phenomena,
• dysuric signs,
• stomach ache,
• rashes on the body.

Consultation of doctors is shown to exclude diseases caused by pathogenic pathogens.

Ovulation can also change a woman's body temperature from 36 to 37 degrees. As a rule, there are the following symptoms:

1. irritability,
2. weakness,
3. headache,
4. increased appetite,
5. puffiness.

If in the first days of menstruation this unpleasant symptomatology disappears, and the temperature drops to 36 degrees, then there is no need for medical examinations.

Also, the indicator can change with menopausal syndrome, which is also due to a change in the amount of hormones. The woman does not understand why the state has changed. There are additional complaints:

• hot flashes,
• increased sweating,
• increase in blood pressure,
• malfunctions of the heart.

Such temperature fluctuations are not dangerous, but if there are other complaints and the cause is clarified, hormone replacement therapy is indicated in some cases.

Temperature jumps can be with thermoneurosis, that is, a rise in temperature to 38 degrees after stress. It is possible to draw a conclusion about the presence of this pathology by excluding more significant causes for the appearance of hyperthermia.

Sometimes it may be shown to perform an aspirin test, which involves the use of an antipyretic drug at an altitude of temperature, and subsequent monitoring of the dynamics.

If the indicators are stable, then 40 minutes after taking the remedy, he can more confidently assert the presence of termponeurosis. In this case, the treatment will consist in the appointment of restorative procedures and sedatives.

The most common causes of temperature jumps from 36 to 37 degrees in adults are:

1. heart attacks
2. purulent and infectious processes,
3. tumors,
4. inflammatory diseases,
5. autoimmune conditions
6. injury,
7. allergies,
8. endocrine pathology,
9. hypothalamic syndrome.

Abscess, tuberculosis and other infectious processes are most often the reasons why there is a change in temperature from 36 to 38 degrees. This is due to the pathogenesis of the disease.

When tuberculosis develops, fluctuations between evening and morning temperatures often reach several degrees. If we are talking about severe cases, then the temperature curve has a hectic shape.

This picture is also characteristic of purulent processes. In such a situation, the temperature rises to 38 degrees and above. When the infiltrate is opened, the indicator returns to normal in a short time.

Also, most of the other inflammatory and infectious diseases have such a symptom as sudden temperature fluctuations during the day. It is lower in the morning and higher in the evening.

The temperature may rise in the evening if chronic processes such as:

• adnexitis,
• sinusitis,
• pharyngitis,
• pyelonephritis.

Hyperthermia in these cases goes away with additional unpleasant symptoms, so you should consult a doctor to conduct an examination and prescribe therapy for a specific disease. Antibiotic treatment, which is often prescribed for inflammatory diseases, will contribute to the normalization of temperature indicators.

If hyperthermia is caused by a tumor process, then depending on its location, it proceeds in different ways. So, there may be sharp jumps in temperature or it will remain at a constant level for a long time.

To clarify the diagnosis, a comprehensive examination should be carried out, which includes:

• hardware methods,
• instrumental analysis,
• laboratory diagnostics.

Timely diagnosis will lead to effective treatment of the disease. This approach is also in hematology, where temperature jumps from 37 to 38 degrees can occur due to various forms of anemia or leukemia.

Temperature jumps can be observed due to the pathology of the endocrine system. If there is thyrotoxicosis, which occurs with hyperfunction of the thyroid gland, then the following additional symptoms should serve for consultation with an endocrinologist:

1. weight loss,
2. irritability,
3. drastic mood changes
4. tachycardia,
5. interruptions in the work of the heart.

In addition to general clinical tests, ultrasound and ECG, a study of thyroid hormones is prescribed, then a treatment regimen is created.

Principles of therapy

As you know, in order to prescribe the optimal treatment, it is necessary to identify the cause of the onset of symptoms. At elevated temperatures, the patient is examined.

When the diagnosis is confirmed, treatment should be prescribed directly based on the characteristics of the pathology. It can be:

• antibiotic therapy,
• antivirals,
• anti-inflammatory drugs,
• antihistamines,
• hormone therapy,
• strengthening measures,

An increase in temperature is a protective reaction that enables the body to effectively and quickly fight pathogens.

The appointment of antipyretics is not justified if the temperature index is up to 37 degrees. In most cases, the appointment of antipyretic drugs occurs at a temperature of more than 38 degrees.

Also shown is a plentiful warm drink, which increases sweating and promotes heat transfer. It is necessary to provide cool air in the room where the patient is located. Thus, the patient's body will have to warm the inhaled air, while giving off heat.

As a rule, due to the actions taken, the temperature drops by a degree, which means that the patient's well-being improves, especially with colds.

Conclusion

Based on the foregoing, it is worth emphasizing that temperature jumps can be seen in both physiological and pathological conditions. To confirm the safety of hyperthermia, many diseases must be excluded.

If a person has a body temperature of 37 to 38 degrees, within a few days you need to seek medical advice and undergo a medical examination. If a pathogenic agent is identified, it is urgent to start therapeutic procedures. An interesting video in this article logically completes the topic of temperature.

Thermoregulation is one of the most important abilities of our body. The temperature is maintained by the forces of the body at a certain level, reflects its ability to produce heat and exchange with the environment. During the day, the temperature level may fluctuate, but not significantly. This is due to the metabolic rate: in the morning it is minimal, and in the evening it rises by about 0.5 ° C.

The temperature of a healthy person

We know from early childhood that the normal human temperature is 36.6°C. A slight deviation in one direction or another is allowed. Depending on the human condition, microclimate, circadian rhythm and other parameters, it can range from 35.5 to 37.4°C. The average temperature level of women is slightly higher than that of men by 0.5-0.7 °C.

Body temperature can also vary among representatives of different nationalities: for example, the Japanese have an average value of 36 ° C, the Australians - about 37. In different parts of the body, the thermometer readings also differ: in the armpit they are lower than on the toes.

During the day, the temperature of the same person can vary within one degree. The lowest value is reached at 4-6 am and the highest at 4-8 pm. In women, the temperature may vary depending on the day of the cycle. For some people, 38 ° C is considered normal and is not a sign of any disease.

Normal human body temperature is kept at the same level due to the work of the hypothalamus and thyroid gland: thyroid hormones are responsible for metabolic processes. Estradiol affects the basal temperature, it decreases with an increase in its amount. The process of thermoregulation is very complex and deviations from the norm should immediately alert you. An increase or decrease in temperature indicates that there are problems in the body that must be urgently dealt with.

Extremely low temperature

It is worth worrying when the thermometer shows less than 35.2 ° C. At a temperature of about 32.2 ° C, a person feels stunned, 29.5 - loses consciousness, and 26.5 leads to death in most cases.

Hypothermia can be caused by one of the following:

• violation of the work of thermoregulatory centers in the central nervous system. This happens with brain damage of an organic nature: with tumors, injuries.
• hypothyroidism.
• paralysis, paresis, which lead to a decrease in muscle mass, and consequently, to a decrease in heat production.
• Exhausting diets, starvation lead to the fact that the body does not have enough energy to produce heat.
• hypothermia is a long stay of a person in conditions of low temperature, when the body's own regulatory mechanisms cannot cope with thermoregulation.
• dehydration: lack of fluid in the body leads to a decrease in metabolism.
• alcohol: ethanol disrupts all brain functions, including thermoregulatory ones.
• ionizing radiation: free radicals affect the metabolism, resulting in a decrease in body temperature.

A moderate decrease in temperature (up to 35.3 ° C) may be due to such reasons:

• overwork, prolonged stress, both physical and mental, chronic fatigue.
• disturbed diet, unbalanced diet, hypodynamia.
• hormonal problems, pregnancy, menopause, diseases of the thyroid gland, adrenal glands.
• violation of carbohydrate metabolism against the background of liver diseases.

subfebrile temperature

Do not underestimate a slight (37 - 37.5 ° C) increase in temperature: it may not pose any threat, or it may report serious disturbances in the functioning of the body. Therefore, it is important to find out the cause of this condition.

Subfebrile condition can lead to:

• hard hard work in a hot environment, playing sports;
• sauna, hot bath, bath, solarium;
• increased production of thyroid hormones, which leads to an acceleration of metabolism;
• viruses, colds;
• hot, spicy food;
• inflammatory diseases in a chronic form.

Serious illnesses that threaten human life also lead to prolonged subfebrile temperature. Tuberculosis, oncology in the early stages give a slight increase in temperature as one of the symptoms of the disease. Therefore, it is very important not to knock it down, but to consult a doctor to find out the reasons. Symptoms such as weakness, sweating, weight loss and inflammation of the lymph nodes should be especially alarming. An additional examination will help to identify the cause and eliminate it in time.

Febrile temperature

A temperature above 37.6 ° C indicates the presence of inflammation in the body. Thus, the body fights pathogens, and creates unfavorable conditions for their existence. Therefore, you should not immediately knock it down with medication. Up to 38.5 ° C, you can simply drink plenty of water to reduce the concentration of toxins - this is how they are excreted from the body with sweat and urine.

pyretic temperature

A temperature above 39 ° C indicates an acute inflammatory process. If the thermometer shows more than 39, doctors recommend starting an antipyretic (the most popular drug is aspirin). In this state, convulsions are possible, so you need to be more careful for those people who have concomitant diseases.

Frequent culprits of this condition are bacteria, viruses that enter the body during burns, injuries, hypothermia, by airborne droplets. The doctor can tell for sure about this, having previously taken all the tests. At a high temperature, a person feels weakness, loss of strength, headache, chills, body aches. Appetite is greatly reduced, sweating and arrhythmia are observed.

Hyperpyretic temperature

You should sound the alarm if the thermometer mark has crawled over 40.3 ° C. This condition is life-threatening and requires immediate medical attention. Critical temperature - 42 ° C: metabolism in brain tissues is disturbed, which leads to death.

General concept of fever

General characteristics of hyperthermic syndrome and types of fevers

Many diseases of infectious and non-infectious origin occur with an increase in body temperature. The feverish reaction of the body is not only a manifestation of the disease, but also one of the ways to stop it. The normal temperature when measured in the armpit is 36.4-36.8 ° C. During the day, body temperature changes. The difference between morning and evening temperatures in healthy people does not exceed 0.6 °C.

Hyperthermia - an increase in body temperature above 37 ° C - occurs when the balance between the processes of heat production and heat transfer is disturbed.

Fever is characterized not only by an increase in temperature, but also by changes in all organs and systems. Patients are concerned about headache, weakness, feeling of heat, dry mouth. With fever, metabolism increases, pulse and respiration become more frequent. With a sharp increase in body temperature, patients feel chills, a feeling of cold, trembling. At high body temperature, the skin becomes red, warm to the touch. A rapid drop in temperature is accompanied by profuse sweat.

The most common cause of fever is infection and tissue breakdown products. Fever is usually the body's response to an infection. Noninfectious fevers are rare. The degree of temperature increase can be different and largely depends on the state of the body.

Feverish reactions differ in duration, height and type of temperature curve. The duration of fever is acute (up to 2 weeks), subacute (up to 6 weeks) and chronic (more than 6 weeks).

Depending on the degree of temperature increase, subfebrile (37–38 ° C), febrile (38–39 ° C), high (39–41 ° C) and ultra-high (hyperthermic - above 41 ° C) are distinguished. Hyperthermia itself can lead to death. Depending on daily fluctuations in temperature, six main types of fever are distinguished (Fig. 12).

Persistent fever, in which the difference between morning and evening body temperature does not exceed 1 ° C. Such a fever is more common with pneumonia, typhoid fever.

Laxative (relapsing) fever is characterized by fluctuations of more than 1 ° C. It happens with tuberculosis, purulent diseases, pneumonia.

Intermittent fever is characterized by large temperature fluctuations with the correct alternation of febrile attacks and periods of normal temperature (2-3 days), typical of 3- and 4-day malaria.

Rice. 12. Types of fever: 1 - constant; 2 - laxative; 3 - intermittent; 4 - return; 5 - wavy; 6 - exhausting

Exhausting (hectic) fever is characterized by a sharp increase in body temperature (by 2-4 ° C) and its fall to normal and below. Observed in sepsis, tuberculosis.

The reverse type of fever (perverted) is characterized by a higher morning temperature than in the evening. Occurs in tuberculosis, sepsis.

Irregular fever is accompanied by varied and irregular diurnal fluctuations. It is observed in endocarditis, rheumatism, tuberculosis.

On the basis of a febrile reaction and symptoms of intoxication, one can judge the onset of the disease. So, with an acute onset, the temperature rises within 1-3 days and is accompanied by chills and symptoms of intoxication. With a gradual onset, body temperature rises slowly, over 4-7 days, the symptoms of intoxication are moderate.

Clinical characteristics of hyperthermic syndrome in infectious diseases

Fever in infectious diseases is protective. It is usually a reaction to an infection. Different infectious diseases may have different types of temperature curves, although it should be remembered that with early antibiotic therapy, temperature curves can change significantly.

Malaria

The correct alternation of febrile attacks (chills, fever, drop in temperature, accompanied by sweat) and periods of normal body temperature is characteristic of malaria. Attacks in this disease can be repeated two days on the third or three days on the fourth. The total duration of a malarial attack is 6-12 hours, with tropical malaria - up to a day or more. Then the body temperature drops sharply to normal, which is accompanied by profuse sweating. The patient feels weakness, drowsiness. His health is improving. The period of normal body temperature lasts 48–72 hours, and then again a typical malarial attack.

Typhoid fever

Fever is a constant and characteristic symptom of typhoid fever. Basically, this disease is characterized by an undulating course, in which temperature waves, as it were, roll over one another. In the middle of the last century, the German physician Wunderlich schematically described the temperature curve. It consists of a temperature rise phase (lasting about a week), a heat phase (up to 2 weeks) and a temperature drop phase (about 1 week). Currently, due to the early use of antibiotics, the temperature curve for typhoid fever has various options and is diverse. Most often, relapsing fever develops, and only in severe cases - a permanent type.

Typhus

Typically, the temperature rises within 2–3 days to 39–40 °C. The temperature rises both in the evening and in the morning. Patients have slight chills. From the 4th–5th day of illness, a constant type of fever is characteristic. Sometimes with early use of antibiotics, a relapsing type of fever is possible.

With typhus, "cuts" in the temperature curve can be observed. This usually happens on the 3-4th day of illness, when the body temperature drops by 1.5-2 ° C, and the next day, with the appearance of a rash on the skin, it rises again to high numbers. This is observed at the height of the disease.

On the 8th–10th day of illness, patients with typhus may also experience a "cut" in the temperature curve, similar to the first. But then after 3-4 days the temperature drops to normal. In uncomplicated typhus, the fever usually lasts 2-3 days.

Flu

The flu is characterized by an acute onset. Body temperature rises within a day or two to 39-40 ° C. In the first two days, the clinical picture of influenza is “obvious”: with symptoms of general intoxication and high body temperature. The fever usually lasts from 1 to 5 days, then the temperature drops critically and returns to normal. This reaction is usually accompanied by sweating.

adenovirus infection

With adenovirus infection, the temperature rises to 38-39 ° C for 2-3 days. The fever may be accompanied by chills and last for about a week.

The temperature curve is constant or remitting. The phenomena of general intoxication in adenovirus infection are usually mild.

Meningococcal infection

With meningococcal infection, body temperature can range from subfebrile to very high (up to 42 ° C). The temperature curve can be of constant, intermittent and remitting type. Against the background of antibiotic therapy, the temperature decreases by the 2-3rd day, in some patients subfebrile temperature persists for another 1-2 days.

Meningococcemia (meningococcal sepsis) begins acutely and proceeds rapidly. A characteristic feature is a hemorrhagic rash in the form of irregularly shaped stars. The elements of the rash in the same patient can be of different sizes - from small punctures to extensive hemorrhages. The rash appears 5-15 hours after the onset of the disease. Fever in meningococcemia is often intermittent. Pronounced symptoms of intoxication are characteristic: the temperature rises to 40–41 ° C, severe chills, headache, hemorrhagic rash, tachycardia, shortness of breath, cyanosis appear. Then the blood pressure drops sharply. Body temperature drops to normal or subnormal numbers. Motor excitation increases, convulsions appear. And in the absence of appropriate treatment, death occurs.

Meningitis can be not only meningococcal etiology. Meningitis, like encephalitis (inflammation of the brain), develops as a complication of any past infection. So, the most harmless at first glance viral infections, such as influenza, chicken pox, rubella, can be complicated by severe encephalitis. Usually there is a high body temperature, a sharp deterioration in the general condition, there are cerebral disorders, headache, dizziness, nausea, vomiting, impaired consciousness, general anxiety.

Depending on the damage to a particular part of the brain, various symptoms can be detected - disorders of the cranial nerves, paralysis.

Infectious mononucleosis

Infectious mononucleosis often begins acutely, rarely gradually. The rise in temperature is usually gradual. The fever may be of a constant type or with great fluctuations. The feverish period depends on the severity of the course of the disease. In mild forms, it is short (3-4 days), in severe cases - up to 20 days or more. The temperature curve can be different - constant or remitting type. The fever can also be subfebrile. The phenomena of hyperthermia (40-41 ° C) are rare. Characterized by temperature fluctuations during the day with a range of 1–2 °C and its lytic decrease.

Polio

With poliomyelitis, an acute viral disease of the central nervous system, there is also an increase in temperature. Various parts of the brain and spinal cord are affected. The disease occurs predominantly in children under 5 years of age. Early symptoms of the disease are chills, gastrointestinal disorders (diarrhea, vomiting, constipation), body temperature rises to 38–39 ° C or more. In this disease, a double-humped temperature curve is often observed: the first rise lasts 1–4 days, then the temperature decreases and remains within the normal range for 2–4 days, then it rises again. There are cases when the body temperature rises within a few hours and goes unnoticed, or the disease proceeds as a general infection without neurological symptoms.

Leptospirosis

Leptospirosis is one of the acute febrile illnesses. This is a disease of humans and animals, characterized by intoxication, undulating fever, hemorrhagic syndrome, damage to the kidneys, liver, and muscles. The disease begins acutely.

Body temperature during the day rises to high numbers (39–40 ° C) with chills. The temperature stays high for 6-9 days. A remitting type of temperature curve with fluctuations of 1.5–2.5 °C is characteristic. Then the body temperature returns to normal. In most patients, repeated waves are noted, when after 1–2 (less often 3–7) days of normal body temperature, it again rises to 38–39 ° C for 2–3 days.

Brucellosis

Fever is the most common clinical manifestation of brucellosis. The disease usually begins gradually, rarely acutely. Fever in the same patient may be different. Sometimes the disease is accompanied by a wavy temperature curve of a remitting type, typical for brucellosis, when fluctuations between morning and evening temperatures are more than 1 ° C, intermittent - a decrease in temperature from high to normal or constant - fluctuations between morning and evening temperatures do not exceed 1 ° C. Feverish waves are accompanied by profuse sweating. The number of waves of fever, their duration and intensity are different. The intervals between waves are from 3–5 days to several weeks and months. Fever may be high, long-term subfebrile, and may be normal (Fig. 13).

Rice. 13. Types of fever according to the degree of temperature rise: 1 - subfebrile (37–38 ° C); 2 - moderately elevated (38–39 °C); 3 - high (39–40 °C); 4 - excessively high (above 40 °C); 5 - hyperpyretic (above 41-42 ° C)

The disease often occurs with prolonged subfebrile condition. Characteristic is the change of a long febrile period by a fever-free interval, also of varying duration.

Despite the high temperature, the condition of the patients remains satisfactory. With brucellosis, damage to various organs and systems is noted (first of all, the musculoskeletal, urogenital, nervous systems suffer, the liver and spleen increase).

Toxoplasmosis

ornithosis

Ornithosis is a disease resulting from human infection from sick birds. The disease is accompanied by fever and atypical pneumonia.

Body temperature from the first days rises to high numbers. The feverish period lasts 9-20 days. The temperature curve can be constant or remitting. It decreases in most cases lytically. The height, duration of fever, the nature of the temperature curve depend on the severity and clinical form of the disease. With a mild course, the body temperature rises to 39 ° C and lasts 3–6 days, decreasing within 2–3 days. With moderate severity, the temperature rises above 39 ° C and remains at high numbers for 20–25 days. An increase in temperature is accompanied by chills, a decrease in profuse sweating. Ornithosis is characterized by fever, symptoms of intoxication, frequent lung damage, enlargement of the liver and spleen. The disease can be complicated by meningitis.

Tuberculosis

Tuberculosis occupies a special place among infectious diseases that occur with an increase in body temperature. Tuberculosis is a very serious disease. His clinic is diverse. Fever in patients for a long time can proceed without identified organ lesions. Most often, body temperature is kept at subfebrile numbers. The temperature curve is intermittent, usually not accompanied by chills. Sometimes fever is the only sign of illness. The tuberculous process can affect not only the lungs, but also other organs and systems (lymph nodes, bone, genitourinary systems). Debilitated patients may develop tuberculous meningitis. The disease begins gradually. Symptoms of intoxication, lethargy, drowsiness, photophobia gradually increase, body temperature is kept at subfebrile figures. In the future, the fever becomes constant, distinct meningeal signs, headache, drowsiness are found.

Sepsis

Sepsis is a severe general infectious disease that occurs as a result of insufficient local and general immunity of the body in the presence of a focus of inflammation. It develops mainly in premature infants, weakened by other diseases, survivors of trauma. It is diagnosed by a septic focus in the body and the entrance gate of infection, as well as symptoms of general intoxication. Body temperature often remains at subfebrile figures, hyperthermia is periodically possible. The temperature curve can be hectic in nature. Fever is accompanied by chills, a decrease in temperature - a sharp sweating. The liver and spleen are enlarged. Rashes on the skin are not uncommon, more often hemorrhagic.

Helminthiases

Clinical characteristics of hyperthermic syndrome in somatic diseases

Bronchopulmonary diseases

An increase in body temperature can be observed in various diseases of the lungs, heart, and other organs. So, inflammation of the bronchi (acute bronchitis) can occur in acute infectious diseases (flu, measles, whooping cough, etc.) and when the body is cooled. Body temperature in acute focal bronchitis can be subfebrile or normal, and in severe cases it can rise to 38-39 ° C. Weakness, sweating, coughing are also disturbing.

The development of focal pneumonia (pneumonia) is associated with the transition of the inflammatory process from the bronchi to the lung tissue. They can be of bacterial, viral, fungal origin. The most characteristic symptoms of focal pneumonia are cough, fever and shortness of breath. Fever in patients with bronchopneumonia is of varying duration. The temperature curve is often of a relieving type (daily temperature fluctuations of 1 ° C, with a morning minimum above 38 ° C) or of an incorrect type. Often the temperature is subfebrile, and in the elderly and senile age it may be absent altogether.

Croupous pneumonia is more often observed with hypothermia. Lobar pneumonia is characterized by a certain cyclical course. The disease begins acutely, with a tremendous chill, fever up to 39–40 °C. The chill usually lasts up to 1-3 hours. The condition is very serious. Shortness of breath, cyanosis are noted. In the stage of the height of the disease, the condition of patients worsens even more. Symptoms of intoxication are expressed, breathing is frequent, shallow, tachycardia up to 100/200 beats per minute. Against the background of severe intoxication, vascular collapse may develop, which is characterized by a drop in blood pressure, tachycardia, shortness of breath. Body temperature also drops sharply. The nervous system suffers (sleep is disturbed, there may be hallucinations, delirium). In lobar pneumonia, if antibiotic treatment is not started, the fever can last for 9-11 days and be permanent. The drop in temperature can occur critically (within 12–24 hours) or gradually, over 2–3 days. In the stage of resolution of fever usually does not happen. Body temperature returns to normal.

Rheumatism

Fever can accompany a disease such as rheumatism. It has an infectious-allergic nature. With this disease, connective tissue is damaged, mainly the cardiovascular system, joints, central nervous system and other organs suffer. The disease develops 1–2 weeks after a streptococcal infection (tonsillitis, scarlet fever, pharyngitis). Body temperature usually rises to subfebrile numbers, weakness, sweating appear. Less often, the disease begins acutely, the temperature rises to 38–39 ° C. The temperature curve is remittent in nature, accompanied by weakness, sweating. A few days later, pain in the joints appears. Rheumatism is characterized by damage to the heart muscle with the development of myocarditis. The patient is concerned about shortness of breath, pain in the heart, palpitations. There may be an increase in body temperature to subfebrile figures. The feverish period depends on the severity of the disease. Myocarditis can also develop with other infections - scarlet fever, diphtheria, rickettsiosis, viral infections. Allergic myocarditis may occur, for example, with the use of various drugs.

Septic endocarditis

Against the background of an acute severe septic condition, the development of septic endocarditis is possible - an inflammatory lesion of the endocardium with damage to the heart valves. The condition of such patients is very serious. Symptoms of intoxication are expressed. Disturbed by weakness, malaise, sweating. Initially, body temperature rises to subfebrile figures. Against the background of subfebrile temperature, irregular temperature rises to 39 ° C and above ("temperature candles") occur, chilling and profuse sweating are typical, lesions of the heart and other organs and systems are noted. Diagnosis of primary bacterial endocarditis presents particular difficulties, since at the beginning of the disease there is no lesion of the valvular apparatus, and the only manifestation of the disease is a fever of the wrong type, accompanied by chills, followed by profuse sweating and a decrease in temperature. Sometimes the rise in temperature can be observed during the day or at night. Bacterial endocarditis can develop in patients with artificial heart valves.

In some cases, there are fevers due to the development of a septic process in patients with catheters in the subclavian veins.

Diseases of the biliary system

A feverish state can occur in patients with damage to the biliary system, liver (cholangitis, liver abscess, gallbladder empyema). Fever in these diseases may be the leading symptom, especially in senile and elderly patients. The pain of such patients is usually not disturbed, there is no jaundice. The examination reveals an enlarged liver, its slight soreness.

kidney disease

An increase in temperature is noted in patients with kidney disease. This is especially true for acute pyelonephritis, which is characterized by a severe general condition, symptoms of intoxication, high fever of the wrong type, chills, dull pain in the lumbar region. With the spread of inflammation to the bladder and urethra, painful urge to urinate and pain during urination occur. A urological purulent infection (abscesses and carbuncles of the kidneys, paranephritis, nephritis) can be a source of prolonged fever. Characteristic changes in the urine in such cases may be absent or mild.

Systemic connective tissue diseases

The third place in the frequency of febrile conditions is occupied by systemic diseases of the connective tissue (collagenosis). This group includes systemic lupus erythematosus, scleroderma, nodular arteritis, dermatomyositis, rheumatoid arthritis.

Systemic lupus erythematosus is characterized by a steady progression of the process, sometimes quite long remissions. In the acute period there is always a fever of the wrong type, sometimes taking on a hectic character with chills and profuse sweat. Dystrophy, damage to the skin, joints, various organs and systems are characteristic.

It should be noted that diffuse connective tissue diseases and systemic vasculitis are relatively rarely manifested by an isolated febrile reaction. Usually they are manifested by a characteristic lesion of the skin, joints, internal organs.

Basically, fevers can occur with various vasculitis, often their localized forms (temporal arteritis, damage to large branches of the aortic arch). In the initial period of such diseases, fever appears, which is accompanied by pain in the muscles, joints, weight loss, then localized headaches appear, a thickening and thickening of the temporal artery is found. Vasculitis is more common in the elderly.

Clinical characteristics of hyperthermic syndrome in neuroendocrine pathology

An increase in body temperature is observed in various endocrine diseases. First of all, this group includes such a serious disease as diffuse toxic goiter (hyperthyroidism). The development of this disease is associated with excessive production of thyroid hormones. Numerous hormonal, metabolic, autoimmune disorders arising in the patient's body lead to damage to all organs and systems, dysfunction of other endocrine glands and various types of metabolism. First of all, the nervous, cardiovascular, digestive systems are affected. Patients experience general weakness, fatigue, palpitations, sweating, trembling of the hands, protrusion of the eyeballs, weight loss, and an increase in the thyroid gland.

The disorder of thermoregulation is manifested by an almost constant feeling of heat, intolerance to heat, thermal procedures, subfebrile body temperature. An increase in temperature to high numbers (up to 40 ° C and above) is characteristic of a complication of diffuse toxic goiter - a thyrotoxic crisis that occurs in patients with a severe form of the disease. Sharply exacerbated all the symptoms of thyrotoxicosis. There is a pronounced excitation, reaching psychosis, the pulse quickens to 150-200 beats per minute. The skin of the face is hyperemic, hot, moist, the extremities are cyanotic. Muscle weakness, trembling of the limbs develop, paralysis, paresis are expressed.

Acute purulent thyroiditis is a purulent inflammation of the thyroid gland. It can be caused by various bacteria - staphylococcus, streptococcus, pneumococcus, Escherichia coli. It occurs as a complication of purulent infection, pneumonia, scarlet fever, abscesses. The clinical picture is characterized by an acute onset, an increase in body temperature up to 39-40 ° C, chills, tachycardia, severe pain in the neck, radiating to the lower jaw, ears, aggravated by swallowing, moving the head. The skin over the enlarged and sharply painful thyroid gland is hyperemic. The duration of the disease is 1.5–2 months.

Polyneuritis - multiple lesions of peripheral nerves. Depending on the causes of the disease, infectious, allergic, toxic and other polyneuritis are distinguished. Polyneuritis is characterized by a violation of the motor and sensory functions of peripheral nerves with a primary lesion of the limbs. Infectious polyneuritis usually begins acutely, like an acute febrile process, with fever up to 38-39 ° C, pain in the extremities. Body temperature lasts for several days, then normalizes. At the forefront in the clinical picture are weakness and damage to the muscles of the arms and legs, impaired pain sensitivity.

In allergic polyneuritis, which develops after the introduction of an anti-rabies vaccine (used to prevent rabies), an increase in body temperature may also be noted. Within 3-6 days after administration, high body temperature, indomitable vomiting, headache, and impaired consciousness can be observed.

There is a constitutionally determined hypothalamopathy ("habitual fever"). This fever has a hereditary predisposition, it is more common in young women. Against the background of vegetovascular dystonia and constant subfebrile condition, there is an increase in body temperature to 38–38.5 °C. The rise in temperature is associated with physical exertion or emotional stress.

In the presence of a prolonged fever, artificial fever should be borne in mind. Some patients artificially cause an increase in body temperature in order to simulate any disease. Most often, this kind of disease occurs in young and middle-aged people, mostly females. They constantly find various diseases in themselves, are treated for a long time with various drugs. The impression that they have a serious illness is reinforced by the fact that these patients often lie in hospitals, where they are given various diagnoses and undergo therapy. When consulting these patients with a psychotherapist, hysteroid traits are revealed, which makes it possible to suspect a falsification of fever in them. The condition of such patients is usually satisfactory, feeling good. It is necessary to take the temperature in the presence of a doctor. Such patients need to be carefully examined.

The diagnosis of "artificial fever" can be suspected only after observing the patient, examining him and excluding other causes and diseases that cause an increase in body temperature.

Clinical characteristics of hyperthermic syndrome in neoplastic diseases

The leading place among febrile conditions is occupied by tumor diseases. An increase in temperature can occur with any malignant tumors. Most often, fever is observed with hypernephroma, tumors of the liver, stomach, malignant lymphomas, leukemia.

In malignant tumors, especially in small hypernephroid cancer and in lymphoproliferative diseases, severe fever may be noted. In such patients, fever (more often in the morning) is associated with the collapse of the tumor or the addition of a secondary infection.

A feature of fever in malignant diseases is the wrong type of fever, often with a maximum rise in the morning, the lack of effect from antibiotic therapy.

Often, fever is the only symptom of a malignant disease. Feverish conditions are often found in malignant tumors of the liver, stomach, intestines, lungs, prostate gland. There are cases when fever for a long time was the only symptom of malignant lymphoma with localization in the retroperitoneal lymph nodes.

The main causes of fever in cancer patients are considered to be the addition of infectious complications, tumor growth and the effect of tumor tissue on the body.

Clinical characteristics of hyperthermic syndrome when taking drugs

Among patients with prolonged fever, drug fever occurs in 5-7% of cases. It can occur on any medication, more often on the 7-9th day of treatment. Diagnosis is facilitated by the absence of an infectious or somatic disease, the appearance of a papular rash on the skin, which coincides in time with the medication. This fever is characterized by one feature: the symptoms of the underlying disease disappear during therapy, and the body temperature rises. After discontinuation of the drug, body temperature usually returns to normal after 2-3 days.

Clinical characteristics of hyperthermic syndrome in trauma and surgical diseases

Fever can be observed in various acute surgical diseases (appendicitis, peritonitis, osteomyelitis, etc.) and is associated with the penetration of microbes and their toxins into the body. A significant increase in temperature in the postoperative period may be due to the reaction of the body to the surgical injury. When muscles and tissues are injured, the temperature may increase as a result of the breakdown of muscle proteins and the formation of autoantibodies. Mechanical irritation of the centers of thermoregulation (fracture of the base of the skull) is often accompanied by an increase in temperature. With intracranial hemorrhages (in newborns), postencephalitic lesions of the brain, hyperthermia is also noted, mainly as a result of a central violation of thermoregulation.

Acute appendicitis is characterized by a sudden onset of pain, the intensity of which progresses as inflammatory changes develop in the appendix. There are also weakness, malaise, nausea, and there may be a delay in stool. Body temperature is usually elevated to 37.2-37.6 ° C, sometimes accompanied by chills. With phlegmonous appendicitis, pain in the right iliac region is constant, intense, the general condition worsens, body temperature rises to 38–38.5 ° C.

With suppuration of the appendicular infiltrate, a periappendicular abscess is formed. The condition of the patients is deteriorating. Body temperature becomes high, hectic. Sudden changes in temperature are accompanied by chills. The pain in the abdomen gets worse. A formidable complication of acute appendicitis is diffuse purulent peritonitis. Abdominal pains are diffuse. The condition of the patients is severe. There is significant tachycardia, and the pulse rate does not correspond to body temperature.

Brain injuries can be open or closed. Closed injuries include concussion, contusion and concussion with compression. The most common concussion is the main clinical manifestations of which are loss of consciousness, repeated vomiting and amnesia (loss of memory of events that preceded the disorder of consciousness). In the coming days after a concussion, there may be an increase in body temperature to subfebrile numbers. Its duration can be different and depends on the severity of the condition. Headache, dizziness, weakness, malaise, sweating are also observed.

With sun and heat stroke, general overheating of the body is not necessary. Violation of thermoregulation occurs due to exposure to direct sunlight on an uncovered head or naked body. Disturbed by weakness, dizziness, headache, nausea, sometimes vomiting and diarrhea may occur. In severe cases, excitement, delirium, convulsions, loss of consciousness are possible. High temperature, as a rule, does not happen.

Fever treatment

Treatment of fever with traditional methods

With hyperthermic syndrome, treatment is carried out in two directions: correction of the vital functions of the body and directly combating hyperthermia.

To reduce body temperature, both physical methods of cooling and medication are used.

Physical cooling methods

Physical means include methods that provide cooling of the body: it is recommended to remove clothes, wipe the skin with water at room temperature, 20–40% alcohol solution. On the wrists, a bandage moistened with cold water can be applied to the head. They also use gastric lavage through a tube with cold water (temperature 4-5 ° C), put cleansing enemas, also with cool water. In the case of infusion therapy, all solutions are administered intravenously cooled to 4 ° C. The patient can be blown with a fan to reduce body temperature.

These activities allow you to reduce body temperature by 1-2 ° C within 15-20 minutes. Body temperature should not be lowered below 37.5 ° C, since after that it continues to decrease on its own to normal numbers.

Medications

Analgin, acetylsalicylic acid, brufen are used as medications. It is most effective to use the drug intramuscularly. So, a 50% solution of analgin, 2.0 ml is used (for children - at a dose of 0.1 ml per year of life) in combination with antihistamines: 1% diphenhydramine solution, 2.5% pipolfen solution or 2 % suprastin solution.

In a more severe condition, Relanium is used to reduce the excitability of the central nervous system.

A single dose of the mixture for children is 0.1-0.15 ml / kg of body weight intramuscularly.

To maintain the function of the adrenal glands and to reduce blood pressure, corticosteroids are used - hydrocortisone (for children, 3-5 mg per 1 kg of body weight) or prednisolone (1-2 mg per 1 kg of body weight).

In the presence of respiratory disorders and heart failure, therapy should be aimed at eliminating these syndromes.

With an increase in body temperature to high numbers, children may develop a convulsive syndrome, for the relief of which Relanium is used (children under 1 year old at a dose of 0.05–0.1 ml; 1–5 years old - 0.15–0.5 ml 0, 5% solution, intramuscularly).

First aid for heat or sunstroke

It is necessary to immediately stop exposure to factors that led to sun or heat stroke. It is necessary to transfer the victim to a cool place, remove clothes, lay down, raise his head. The body and head are cooled by applying compresses with cold water or pouring cold water over them. The victim is given a sniff of ammonia, inside - soothing and heart drops (Zelenin drops, valerian, Corvalol). The patient is given a plentiful cool drink. When respiratory and cardiac activity stops, it is necessary to immediately release the upper respiratory tract from vomit and begin artificial respiration and heart massage until the first respiratory movements and cardiac activity appear (determined by pulse). The patient is urgently admitted to the hospital.

Treatment of fever with non-traditional methods

To reduce body temperature, traditional medicine recommends using infusions of various herbs. Of the medicinal plants, the following are most often used.

Linden heart-shaped (small-leaved) - lime blossom has a diaphoretic, antipyretic and bactericidal effect. 1 st. l. brew finely chopped flowers in a glass of boiling water, leave for 20 minutes, strain and drink like tea, 1 glass each.

Raspberry ordinary: 2 tbsp. l. brew dry berries in a glass of boiling water, leave for 15–20 minutes, strain, take 2–3 cups of hot infusion for 1–2 hours.

Swamp cranberries: in scientific medicine, cranberries have long been used to prepare acidic drinks prescribed for febrile patients.

Blackberry: an infusion and decoction of blackberry leaves, prepared at the rate of 10 g of leaves per 200 g of water, are consumed hot orally with honey as a diaphoretic in febrile patients.

Common pear: pear broth quenches thirst well in febrile patients, has an antiseptic effect.

Sweet orange: has long been used to treat various diseases. Patients with fever were recommended to take daily (2-3 times a day) powder from the thick peel of an orange, and orange fruits and juice quench their thirst well.

Cherry ordinary: cherry fruits, like cherry juice, well quench thirst in febrile patients.

Strawberries: Fresh berries and strawberry juice are good for fever.

For the same purpose, fruits and juice of lemon, red currant are used.

Fresh cucumber and juice from it is used for fever as an antipyretic and anti-inflammatory agent.

Peppermint: In folk medicine, mint is used internally as a diuretic, diaphoretic, anti-cold remedy.

Cultural grapes: the juice of unripe grapes is used in folk medicine as an antipyretic, as well as for sore throats.

Figs (fig tree): a decoction of figs, jam and a coffee surrogate prepared from dried figs have a diaphoretic and antipyretic effect. Decoction: 2 tbsp. l. dried berries in 1 glass of milk or water.

Rosehip (cinnamon rose): mainly used as a multivitamin remedy in the treatment of various diseases, with exhaustion of the body, as a general tonic.

Highlander bird (knotweed): prescribed as an antipyretic and anti-inflammatory agent, in particular for malaria, rheumatism.

Oats: in folk medicine, decoctions, teas, tinctures are prepared from oat straw, which are used as a diaphoretic, diuretic, antipyretic (to prepare a decoction, take 30–40 g of chopped straw per 1 liter of water, insist 2 hours).

Stinging nettle: nettle roots, together with garlic, insist on vodka for 6 days and rub the patient with this infusion and give inside 3 tablespoons a day for fever and joint pain.

Greater celandine: Inside, a decoction of celandine leaves is given for fever.

Willow: in folk medicine, willow bark is used in the form of a decoction, mainly for a feverish condition.