Fever and chills
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Causes and Mechanisms of Fever and Chills
Fever with chills is a common response of the body to various external triggers, especially infections. These triggers, known as exogenous pyrogens, stimulate immune cells like monocytes and macrophages to release cytokines such as interleukin-1 and tumor necrosis factor. These cytokines, called endogenous pyrogens, act on the hypothalamus in the brain to raise the body’s core temperature by increasing heat production and reducing heat loss. This process also activates both non-specific and specific immune responses, including T- and B-cell activation, to help fight off infections. Pyogenic (pus-forming) infections are the most frequent cause of abrupt fever with chills, but other conditions can also produce similar symptoms 1.
Clinical Presentation and Diagnosis of Fever and Chills
Fever and chills often present suddenly and are accompanied by other symptoms like malaise and body aches. These symptoms are common in both viral and bacterial infections. The presence of chills, especially shaking chills, is strongly associated with the invasion of the bloodstream by bacteria, although the chill itself usually occurs some time after the bacteria enter the blood. The timing and pattern of fever and chills, along with a thorough patient history and physical examination, are crucial for identifying the underlying cause. In some cases, such as when vital functions are compromised or there are signs of severe infection, immediate hospitalization is necessary 1235.
Fever and Chills in Specific Diseases
Fever and chills are hallmark symptoms in many infectious diseases. For example, in COVID-19, fever is a very common symptom in adults, with about 79% experiencing it, and chills are present in about 14% of adult cases. In children with COVID-19, fever is less common, affecting about 46%. Most fevers in COVID-19 are of low to medium grade, with high-grade fevers being less frequent 4. In rickettsial infections, such as rickettsialpox, fever and chills can also be accompanied by a rash and other systemic symptoms, highlighting the importance of considering a wide range of infectious causes 7.
Social and Cultural Perspectives on Fever and Chills
Cultural beliefs about fever and chills can influence how people understand and treat these symptoms. In some communities, there is a strong distinction between “chills” and “fevers,” and these folk models can shape expectations for medical treatment. Physicians may sometimes adapt their explanations and treatments to align with these beliefs, even when they are not scientifically justified, to help patients make sense of their illness 6.
Management and Treatment Considerations
The primary goal in treating fever and chills is to address the underlying cause, usually an infection. Antipyretic (fever-reducing) medications can be used, but their risks and benefits should be carefully considered for each patient. In cases where the infection is severe or the patient’s condition is unstable, prompt medical intervention and hospitalization may be required 15.
Conclusion
Fever and chills are common symptoms that signal the body’s response to infection or other inflammatory processes. They are most often caused by bacterial or viral infections, but can also occur in other conditions. Accurate diagnosis relies on clinical evaluation, and treatment should focus on the underlying cause. Understanding both the biological mechanisms and the cultural context of these symptoms can improve patient care and outcomes 1234567.
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