Peer Reviewed
Feature Article Emergency medicine

Fever in adults: keys to rational management

Paul Preisz, David Wise
Abstract
It is often assumed that a patient presenting with a fever should be treated, regardless of the presence or absence of any other symptoms. However, the evidence that antifever treatments lead to an improvement in morbidity or mortality – or even patient comfort – is somewhat lacking.
Key Points
  • Fever is often misunderstood by patients and healthcare workers. The fever response to infection may be an evolutionary adaptation that could actually be beneficial.
  • Normal core body temperature is 370.8oC, and varies with circadian rhythm, the menstrual cycle, and the method of measurement. This variation must be taken into account when interpreting a measured temperature.
  • A fever greater than 40oC should prompt the clinician to exclude a specific hyperpyrexial syndrome.
  • A fever associated with a specific underlying illness is managed by treating that illness.
  • Treatment of a fever per se is indicated if the hypermetabolic demands imposed on the patient by the fever are excessive.
  • Pharmacological antifever measures should be used before physical measures; the latter can then be added, if necessary.
  • There is no evidence definitively supporting the use of paracetamol combined with an NSAID to reduce fever. Either paracetamol or an NSAID can be used alone.
Get full access
Subscribe for full access to all articles
Buy this article

Single article purchases are temporarily unavailable due to site maintenance.

If you would like to purchase an article during this time, please email us at [email protected] with the article details and we'll assist you directly. We'll also let you know when online purchasing is available again.

Thank you for your patience and understanding.

Already a subscriber?