Fever - Types

Types

The cause of fever can be diagnosed from the pattern and associated features.

The pattern of fever may vary in different conditions and could assist in the diagnosis of the cause of the fever. Some of the types of fever are listed below:

Continuous fever: Fever that does not fluctuate more than 1�C in 24 hours is called continuous fever. It is seen in conditions like pneumonia, typhoid, urinary tract infections and infective endocarditis.

Remittent fever: Fever that fluctuates more than 1�C in 24 hours is referred to as remittent fever. Causes include typhoid and infectious mononucleosis.

Intermittent fever: Fever that is present only for some time in the day is called intermittent fever. Malaria caused by Plasmodium vivax results in fever every third day and that caused by Plasmodium malariae results in fever every fourth day.

Hectic or septic fever: Fever variation between the highest and lowest temperatures is very large and more than 5�C. This type of fever is seen in septicemia or infection of the blood

Pel Ebstein fever: The febrile and afebrile periods alternate and follow a definite pattern. For example, in Hodgkin's disease and other lymphomas, fever for 3 to 10 days is followed by a fever-free period of 3 to 10 days, with the same cycle repeating.

Low-grade fever: The fever does not exceed 37.8�C and is present daily especially in the evenings. Tuberculosis causes low-grade fever.

Fever with rigors: Rigor is the shaking or excessive shivering that accompanies fever. Fever accompanied with rigors are seen in conditions like malaria, kala azar, filariasis, urinary tract infections, inflammation of gall bladder, septicemia, infective endocarditis or inflammation of the inner layer of the heart, abscesses and pneumonia.

Fever with herpes labialis: Fever sometimes results in activation of herpes simplex virus. This results in small fluid-filled boils at the angles of the mouth. Fever with herpes labialis is seen in pneumonia, malaria, meningitis and severe infection with streptococci.

Fever with rash: Fever with rash is often seen in viral infections like chicken pox, small pox, measles and rubella or German measles. Other conditions like typhus and allergy also result in fever with rash.

Fever with membrane in throat: Febrile conditions that could result in the formation of a membrane in the throat include diphtheria, infectious mononucleosis, agranulocytosis (a condition where white blood cell count is low), fungal infection and Vincent's angina or trench mouth.

Fever with delirium or altered consciousness: Delirium with fever could occur in conditions like encephalitis or infection of the brain, typhoid, meningitis, pneumonia or severe liver disease.

References:

1. Harrison�s Principles of Internal Medicine
2. Nelson�s Textbook of Pediatrics
3. PJ Mehta�s Practical Medicine