Intermittent fever explained

Intermittent fever is a type or pattern of fever in which there is an interval where temperature is elevated for several hours followed by an interval when temperature drops back to normal.^[1] This type of fever usually occurs during the course of an infectious disease.^[2] Diagnosis of intermittent fever is frequently based on the clinical history but some biological tests like complete blood count and blood culture are also used. In addition radiological investigations like chest X-ray, abdominal ultrasonography can also be used in establishing diagnosis.^{[3] [4]}

Intermittent fever in malaria

Malaria is a common cause of intermittent fever and it has following types.^{[5] [6]}

Quotidian fever

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

Tertian fever

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

Quartan fever

See main article: Quartan fever. Fever occurs after an interval of three days (72-hour periodicity), typical of Plasmodium falciparum.

Examples

Infectious causes of intermittent fever

The following are examples of infectious diseases that may feature intermittent fever.^{[7] [8] [9]}

• Malaria
• Tuberculosis
• Sepsis
• Kala azar
• Borreliosis (Lyme disease)
• Rat-bite fever
• Epstein-barr virus
• Chronic meningococcemia.

Inflammatory causes of intermittent fever

Adult-onset Still's disease is an inflammatory disease that may cause intermittent fever, characteristically a quotidian fever that spikes once or twice in the late afternoon to evening.^[10]

Management

Antipyretics like ibuprofen and paracetamol are used for fever and body aches.^[11] Antibiotics are also used for any underlying infection. For treating malaria, anti-malarial drugs like quinine, chloroquine and primaquine are given.^[12]

See also

• Continuous fever
• Relapsing fever
• Undulant fever
• Remittent fever
• Neutropenic fever
• Cyclic fever; called Pel–Ebstein fever in Hodgkin's lymphoma

Notes and References

1. Book: Muhammad . Inayatullah . Shabbir Ahmed . Nasir . 2016 . Bedside Techniques: Methods of Clinical Examination . Paramount Books (Pvt.) Limited . 4th . 978-969-494-920-8 .
2. Le Moing V, Leport C . [Intermittent fever of infectious origin] . La Revue du Praticien . Rev Prat . Jan 2002 . 52 . 2 . 139–44 . 11915556. 3257674 .
3. 11915561 . 2002 . Vidal . E . Prise en charge d'une fièvre intermittente chez l'adulte: Fièvres intermittentes . Management of intermittent fever in the adult . fr . La Revue du Praticien . 52 . 2 . 167–71 . Liozon . E . Loustaud-Ratti . V .
4. 11915560 . 2002 . Hachulla . E . Fièvre intermittente symptomatique des maladies inflammatoires: Fièvres intermittentes . Symptomatic intermittent fever of inflammatory diseases . fr . La Revue du Praticien . 52 . 2 . 160–66 .
5. 2682735 . 23330279 . 1989 . Wittern . R . Die Wechselfieber bei Galen . Galen's intermittent fever . de . History and Philosophy of the Life Sciences . 11 . 1 . 3–22 .
6. Book: Ferri, Fred F. . . Malaria . 1159–61 . Ferri's Color Atlas and Text of Clinical Medicine . 2009 . Elsevier Health Sciences . 978-1-4160-4919-7 .
7. 11915556 . 2002 . Le Moing . V . Fièvres intermittentes d'origine infectieuse: Fièvres intermittentes . Intermittent fever of infectious origin . fr . La Revue du Praticien . 52 . 2 . 139–44 . Leport . C .
8. 1240348 . 1975 . Kameya . K . Butterfly-like erythematous lesions and intermittent fever: Miliary tuberculosis . Nihon Rinsho. Japanese Journal of Clinical Medicine . Spec No . 726–27, 1040–43 . Tsuchiya . M . Mie . K .
9. 3069790 . 1988 . Gräf . P . Intermittent fever attacks. Lyme disease without erythema chronicum migrans . Der Inrnist . 29 . 11 . 778–80 . Börner . N . Reichert . M . Weilemann . L. S . Meyer . J . 10.1007/978-3-662-39609-4_126 .
10. Gerfaud-Valentin . Mathieu . Jamilloux . Yvan . Iwaz . Jean . Sève . Pascal . 2014 . Adult-onset Still's disease . Autoimmunity Reviews . 13 . 7 . 708–722 . 10.1016/j.autrev.2014.01.058 . 24657513 . free .
11. 10.1001/archpedi.158.6.521 . 15184213 . Efficacy and Safety of Acetaminophen vs Ibuprofen for Treating Children's Pain or Fever . Archives of Pediatrics & Adolescent Medicine . 158 . 6 . 521–26 . 2004 . Perrott . David A . Piira . Tiina . Goodenough . Belinda . Champion . G. David .
12. 10.1517/14656560902942319 . 19463069 . Existing antimalarial agents and malaria-treatment strategies . Expert Opinion on Pharmacotherapy . 10 . 8 . 1291–306 . 2009 . d'Alessandro . Umberto . 22114286 .