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| Meta Title | Fever - Wikipedia |
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| Boilerpipe Text | Fever
Other names
Pyrexia, febrile response, febrile
[
1
]
Person with fever
Specialty
Infectious disease
,
pediatrics
Symptoms
Initially
:
shivering
, feeling
cold
,
chills
[
2
]
Later
:
flushed
,
sweating
[
3
]
Complications
Febrile seizure
[
4
]
Causes
Virus
,
bacteria
, increase in the body's temperature
set point
[
5
]
[
6
]
Diagnostic method
Temperature higher than the normal range of 37.2 and 38.3 °C (99.0 and 100.9 °F)
[
1
]
[
7
]
[
8
]
Differential diagnosis
Hyperthermia
[
1
]
Treatment
Based on underlying cause, not required for fever itself
[
2
]
[
9
]
Medication
Antipyretics
(
ibuprofen
,
paracetamol
[acetaminophen])
[
9
]
[
10
]
Frequency
Common
[
2
]
[
11
]
Fever
or
pyrexia
in humans is a symptom of an anti-infection defense mechanism that appears with
body temperature
exceeding the normal range caused by an increase in the body's temperature
set point
in the
hypothalamus
.
[
5
]
[
6
]
[
7
]
[
12
]
There is no single agreed-upon upper limit for normal temperature: sources use values ranging between 37.2 and 38.3 °C (99.0 and 100.9 °F) in humans.
[
1
]
[
7
]
[
8
]
The increase in set point triggers increased
muscle contractions
and causes a feeling of
cold
or
chills
.
[
2
]
This results in greater heat production and efforts to conserve heat.
[
3
]
When the set point temperature returns to normal, a person feels hot, becomes
flushed
, and may begin to
sweat
.
[
3
]
Rarely a fever may trigger a
febrile seizure
, with this being more common in young children.
[
4
]
Fevers do not typically go higher than 41 to 42 °C (106 to 108 °F).
[
6
]
A fever can be caused by many
medical conditions
ranging from non-serious to
life-threatening
.
[
13
]
This includes
viral
,
bacterial
, and
parasitic infections
—such as
influenza
, the
common cold
,
meningitis
,
urinary tract infections
,
appendicitis
,
Lassa fever
,
COVID-19
, and
malaria
.
[
13
]
[
14
]
Non-infectious causes include
vasculitis
,
deep vein thrombosis
,
connective tissue disease
, side effects of medication or vaccination, and
cancer
.
[
13
]
[
15
]
It differs from
hyperthermia
, in that hyperthermia is an increase in body temperature over the temperature set point, due to either too much heat production or not enough
heat loss
.
[
1
]
Treatment to reduce fever is generally not required.
[
2
]
[
9
]
Treatment of associated pain and inflammation, however, may be useful and help a person rest.
[
9
]
Medications such as
ibuprofen
or
paracetamol
(acetaminophen) may help with this as well as lower temperature.
[
9
]
[
10
]
Children younger than three months require medical attention, as might people with serious medical problems such as a
compromised immune system
or people with other symptoms.
[
16
]
Hyperthermia
requires treatment.
[
2
]
Fever is one of the most common
medical signs
.
[
2
]
It is part of about 30% of healthcare visits by children
[
2
]
and occurs in up to 75% of adults who are seriously sick.
[
11
]
While fever evolved as a defense mechanism,
treating a fever
does not appear to improve or worsen outcomes.
[
17
]
[
18
]
[
19
]
Fever is often viewed with greater concern by parents and healthcare professionals than is usually deserved, a phenomenon known as "fever phobia".
[
2
]
[
20
]
Associated symptoms
[
edit
]
A fever is usually accompanied by
sickness behavior
, which consists of
lethargy
,
depression
,
loss of appetite
,
sleepiness
,
hyperalgesia
,
dehydration
,
[
21
]
[
22
]
and the inability to concentrate. Sleeping with a fever can often cause intense or confusing
nightmares
, commonly called "
fever dreams
".
[
23
]
Mild to severe
delirium
(which can also cause
hallucinations
) may also present itself during high fevers.
[
24
]
Differential diagnosis
[
edit
]
Hyperthermia
is an elevation of body temperature over the temperature set point, due to either too much heat production or not enough
heat loss
.
[
1
]
[
7
]
Hyperthermia is thus not considered fever.
[
7
]
: 103
[
25
]
Hyperthermia should not be confused with
hyperpyrexia
(which is a very high fever).
[
7
]
: 102
Clinically, it is important to distinguish between fever and hyperthermia as hyperthermia may quickly lead to death and does not respond to antipyretic medications. The distinction may however be difficult to make in an emergency setting, and is often established by identifying possible causes.
[
7
]
: 103
Temperature is regulated in the
hypothalamus
. The trigger of a fever, called a pyrogen, results in the release of
prostaglandin E2
(PGE2). PGE2 in turn acts on the hypothalamus, which creates a systemic response in the body, causing heat-generating effects to match a new higher temperature set point. There are four receptors in which PGE2 can bind (EP1-4), with a previous study showing the EP3 subtype is what mediates the fever response.
[
26
]
Hence, the hypothalamus can be seen as working like a
thermostat
.
[
7
]
When the set point is raised, the body increases its temperature through both active generation of heat and retention of heat. Peripheral
vasoconstriction
both reduces heat loss through the skin and causes the person to feel cold.
Norepinephrine
increases
thermogenesis
in
brown adipose tissue
, and muscle contraction through shivering raises the
metabolic rate
.
[
27
]
If these measures are insufficient to make the blood temperature in the brain match the new set point in the hypothalamus, the brain orchestrates heat effector mechanisms via the
autonomic nervous system
or primary motor center for shivering. These may be:
[
28
]
[
29
]
[
30
]
Increased heat production by increased
muscle tone
,
shivering
(muscle movements to produce heat) and release of hormones like
epinephrine
; and
Prevention of heat loss, e.g., through
vasoconstriction
.
When the hypothalamic set point moves back to baseline—either spontaneously or via medication—normal functions such as sweating, and the reverse of the foregoing processes (e.g., vasodilation, end of shivering, and nonshivering heat production) are used to cool the body to the new, lower setting.
[
citation needed
]
This contrasts with
hyperthermia
, in which the normal setting remains, and the body overheats through undesirable retention of excess heat or over-production of heat. Hyperthermia is usually the result of an excessively hot environment (
heat stroke
) or an adverse reaction to drugs. Fever can be differentiated from hyperthermia by the circumstances surrounding it and its response to
anti-pyretic
medications.
[
7
]
[
verification needed
]
In infants, the autonomic nervous system may also activate
brown adipose tissue
to produce heat (non-shivering thermogenesis).
[
31
]
Increased heart rate and vasoconstriction contribute to increased
blood pressure
in fever.
[
32
]
A pyrogen is a substance that induces fever.
[
33
]
In the presence of an infectious agent, such as bacteria, viruses, viroids,
etc
., the immune response of the body is to inhibit their growth and eliminate them. The most common pyrogens are endotoxins, which are
lipopolysaccharides
(LPS) produced by
Gram-negative bacteria
such as
E. coli
.
But pyrogens include non-endotoxic substances (derived from microorganisms other than gram-negative-bacteria or from chemical substances) as well.
[
34
]
The types of pyrogens include internal (endogenous) and external (exogenous) to the body.
[
35
]
The "pyrogenicity" of given pyrogens varies: in extreme cases, bacterial pyrogens can act as
superantigens
and cause rapid and dangerous fevers.
[
36
]
Endogenous pyrogens are
cytokines
released from
monocytes
(which are part of the
immune system
).
[
37
]
In general, they stimulate chemical responses, often in the presence of an
antigen
, leading to a fever. Whilst they can be a product of external factors like exogenous pyrogens, they can also be induced by internal factors like
damage associated molecular patterns
such as cases like
rheumatoid arthritis
or lupus.
[
38
]
Major endogenous pyrogens are
interleukin 1
(α and β)
[
39
]
: 1237–1248
and
interleukin 6
(IL-6).
[
40
]
Minor endogenous pyrogens include
interleukin-8
,
tumor necrosis factor-β
,
macrophage inflammatory protein
-α and macrophage inflammatory protein-β as well as
interferon-α
,
interferon-β
, and
interferon-γ
.
[
39
]
: 1237–1248
Tumor necrosis factor-α
(TNF) also acts as a pyrogen, mediated by
interleukin 1
(IL-1) release.
[
41
]
These cytokine factors are released into general circulation, where they migrate to the brain's
circumventricular organs
where they are more easily absorbed than in areas protected by the
blood–brain barrier
.
[
42
]
The cytokines then bind to
endothelial receptors
on vessel walls to receptors on
microglial cells
, resulting in activation of the
arachidonic acid pathway
.
[
43
]
Of these, IL-1β, TNF, and IL-6 are able to raise the temperature setpoint of an organism and cause fever. These proteins produce a
cyclooxygenase
which induces the hypothalamic production of PGE2 which then stimulates the release of neurotransmitters such as
cyclic adenosine monophosphate
and increases body temperature.
[
44
]
Exogenous pyrogens are external to the body and are of microbial origin. In general, these pyrogens, including bacterial cell wall products, may act on Toll-like receptors in the hypothalamus and elevate the thermoregulatory setpoint.
[
45
]
An example of a class of exogenous pyrogens are bacterial
lipopolysaccharides
(LPS) present in the cell wall of
gram-negative bacteria
. According to one mechanism of pyrogen action, an immune system protein,
lipopolysaccharide-binding protein
(LBP), binds to LPS, and the LBP–LPS complex then binds to a
CD14
receptor on a
macrophage
. The LBP-LPS binding to CD14 results in cellular synthesis and release of various endogenous
cytokines
, e.g., interleukin 1 (IL-1), interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNFα). A further downstream event is activation of the
arachidonic acid pathway
.
[
46
]
Neural circuit mechanism with PGE2 action
[
edit
]
PGE2 release comes from the
arachidonic acid
pathway. This pathway (as it relates to fever), is mediated by the
enzymes
phospholipase A2
(PLA2),
cyclooxygenase-2
(COX-2), and
prostaglandin E2 synthase
. These enzymes ultimately mediate the synthesis and release of PGE2.
[
47
]
PGE2 is the ultimate mediator of the febrile response. The setpoint temperature of the body will remain elevated until PGE2 is no longer present. PGE2 acts on neurons in the
preoptic area
(POA) through the
prostaglandin E receptor 3
(EP3).
[
48
]
[
49
]
[
50
]
[
51
]
EP3-expressing neurons in the POA innervate the
dorsomedial hypothalamus
(DMH),
[
52
]
[
53
]
the rostral
raphe
pallidus nucleus in the
medulla oblongata
(rRPa),
[
49
]
[
53
]
and the
paraventricular nucleus
(PVN) of the
hypothalamus
.
[
54
]
Under normal conditions, EP3-expressing neurons in the POA are important
thermoregulatory
neurons, which provide continuous inhibitory signals with the transmitter
GABA
to control
sympathetic
output neurons in the DMH and rRPa, thereby performing bidirectional regulation of basal body temperature.
[
51
]
During infection, PGE2 produced in the brain inhibits the activity of EP3-expressing neurons in the POA to attenuate the inhibition of sympathetic output, and thereby activates the sympathetic output system, which evokes non-shivering thermogenesis to produce body heat and skin vasoconstriction to decrease heat loss from the body surface, leading to fever.
[
51
]
It is presumed that the innervation from the POA to the PVN mediates the neuroendocrine effects of fever through the pathway involving
pituitary gland
and various
endocrine organs
.
A range for
normal temperatures
has been found.
[
8
]
Central temperatures, such as rectal temperatures, are more accurate than peripheral temperatures.
[
60
]
Fever is generally agreed to be present if the elevated temperature
[
61
]
is caused by a raised set point and:
Temperature in the
anus
(rectum/rectal) is at or over 37.5–38.3 °C (99.5–100.9 °F).
[
1
]
[
8
]
An
ear
(tympanic) or
forehead
(temporal) temperature may also be used.
[
62
]
[
63
]
Temperature in the mouth (oral) is at or over 37.2 °C (99.0 °F) in the morning or over 37.7 °C (99.9 °F) in the afternoon
[
7
]
[
64
]
Temperature under the arm (axillary) is usually about 0.6 °C (1.1 °F) below core body temperature.
[
65
]
In adults, the
normal range
of temperatures in healthy individuals is 36.32–37.76 °C (97.4–100.0 °F) (rectal), 35.76–37.52 °C (96.4–99.5 °F) (
ear
), 35.61–37.61 °C (96.1–99.7 °F) (urine), 35.73–37.41 °C (96.3–99.3 °F) (oral), and 35.01–36.93 °C (95.0–98.5 °F) (axillary), with no significant gender differences.
[
66
]
Normal body temperatures vary depending on many factors, including age, sex, time of day, ambient temperature, activity level, and more.
[
67
]
[
68
]
Normal daily temperature variation has been described as 0.5 °C (0.9 °F).
[
7
]
: 4012
A raised temperature is not always a fever.
[
67
]
For example, the temperature rises in healthy people when they exercise, but this is not considered a fever, as the set point is normal.
[
67
]
On the other hand, a "normal" temperature may be a fever, if it is unusually high for that person; for example,
medically frail
elderly people have a decreased ability to generate body heat, so a "normal" temperature of 37.3 °C (99.1 °F) may represent a clinically significant fever.
[
67
]
[
69
]
Associated conditions
[
edit
]
Fever is a common
symptom
of many medical conditions:
Infectious disease
, e.g.,
COVID-19
,
[
14
]
dengue
,
Ebola
,
gastroenteritis
,
HIV
,
influenza
,
Lyme disease
,
rocky mountain spotted fever
,
secondary syphilis
,
malaria
,
mononucleosis
, as well as infections of the skin, e.g.,
abscesses
and
boils
.
[
70
]
[
71
]
[
72
]
[
73
]
[
74
]
[
75
]
Immunological
diseases, e.g.,
relapsing polychondritis
,
[
76
]
autoimmune hepatitis
,
granulomatosis with polyangiitis
,
Horton disease
,
inflammatory bowel diseases
,
Kawasaki disease
,
lupus erythematosus
,
sarcoidosis
,
Still's disease
,
rheumatoid arthritis
,
lymphoproliferative disorders
and
psoriasis
;
[
citation needed
]
Tissue destruction, as a result of
cerebral bleeding
,
crush syndrome
,
hemolysis
,
infarction
,
rhabdomyolysis
,
surgery
, etc.;
[
77
]
[
78
]
Cancers
, particularly blood cancers such as
leukemia
and
lymphomas
;
[
79
]
Metabolic disorders
, e.g.,
gout
, and
porphyria
;
[
80
]
Inherited metabolic disorder, e.g.,
Fabry disease
.
[
7
]
Adult and pediatric manifestations for the same disease may differ; for instance, in
COVID-19
, one metastudy describes 92.8% of adults versus 43.9% of children presenting with fever.
[
14
]
In addition, fever can result from a reaction to an incompatible blood product.
[
81
]
Different fever patterns observed in
Plasmodium
infections
Various patterns of measured patient temperatures have been observed, some of which may be indicative of a particular
medical diagnosis
:
Continuous fever
, where temperature remains above normal and does not fluctuate more than
1 °C
in 24 hours
[
82
]
(e.g. in
bacterial pneumonia
,
typhoid fever
,
infective endocarditis
,
tuberculosis
, or
typhus
).
[
83
]
[
84
]
Intermittent fever
is present only for a certain period, later cycling back to normal (e.g., in
malaria
,
leishmaniasis
,
pyemia
,
sepsis
,
[
85
]
or
African trypanosomiasis
).
[
86
]
Remittent fever
, where the temperature remains above normal throughout the day and fluctuates more than
1 °C
in 24 hours (e.g., in
infective endocarditis
or
brucellosis
).
[
87
]
Pel–Ebstein fever
is a cyclic fever that is rarely seen in patients with
Hodgkin's lymphoma
.
[
citation needed
]
Undulant fever, seen in
brucellosis
.
[
citation needed
]
Typhoid fever
is a
continuous fever
showing a characteristic
step-ladder pattern,
a step-wise increase in temperature with a high plateau.
[
88
]
Among the types of intermittent fever are ones specific to cases of malaria caused by different pathogens. These are:
[
89
]
[
90
]
Quotidian fever, with a 24-hour periodicity, typical of
malaria
caused by
Plasmodium knowlesi
(
P. knowlesi
);
[
91
]
[
92
]
Tertian fever
, with a 48-hour periodicity, typical of later course
malaria
caused by
P. falciparum
,
P. vivax
, or
P. ovale
;
[
89
]
Quartan fever
, with a 72-hour periodicity, typical of later course
malaria
caused by
P. malariae
.
[
89
]
In addition, there is disagreement regarding whether a specific fever pattern is associated with
Hodgkin's lymphoma
—the
Pel–Ebstein fever
, with patients argued to present high temperature for one week, followed by low for the next week, and so on, where the generality of this pattern is debated.
[
93
]
[
94
]
Persistent fever that cannot be explained after repeated routine clinical inquiries is called
fever of unknown origin
.
[
7
]
[
95
]
A
neutropenic fever
, also called febrile neutropenia, is a fever in the absence of normal immune system function.
[
96
]
Because of the lack of infection-fighting
neutrophils
, a bacterial infection can spread rapidly; this fever is, therefore, usually considered to require urgent medical attention.
[
97
]
This kind of fever is more commonly seen in people receiving immune-suppressing
chemotherapy
than in apparently healthy people.
[
96
]
[
98
]
Hyperpyrexia is an extreme elevation of
body temperature
which, depending upon the source, is classified as a
core body temperature
greater than or equal to 40 or 41 °C (104 or 106 °F); the range of hyperpyrexia includes cases considered severe (≥ 40 °C) and extreme (≥ 42 °C).
[
7
]
[
99
]
[
100
]
It differs from
hyperthermia
in that one's
thermoregulatory system's set point
for body temperature is set above normal, then heat is generated to achieve it. In contrast, hyperthermia involves body temperature rising above its set point due to outside factors.
[
7
]
[
101
]
The high temperatures of hyperpyrexia are considered
medical emergencies
, as they may indicate a serious underlying condition or lead to severe morbidity (including permanent
brain damage
), or to death.
[
102
]
A common cause of hyperpyrexia is an
intracranial hemorrhage
.
[
7
]
Other causes in emergency room settings include
malignant catatonia
,
sepsis
,
Kawasaki syndrome
,
[
103
]
neuroleptic malignant syndrome
,
drug overdose
,
serotonin syndrome
, and
thyroid storm
.
[
102
]
Hyperthermia: Characterized on the left. Normal body temperature (thermoregulatory set point) is shown in green, while the hyperthermic temperature is shown in red. As can be seen, hyperthermia can be conceptualized as an increase above the thermoregulatory set point.
Hypothermia: Characterized in the center: Normal body temperature is shown in green, while the hypothermic temperature is shown in blue. As can be seen, hypothermia can be conceptualized as a decrease below the thermoregulatory set point.
Fever: Characterized on the right: Normal body temperature is shown in green. It reads "New Normal" because the thermoregulatory set point has risen. This has caused what was the normal body temperature (in blue) to be considered hypothermic.
Fever is thought to contribute to host defense,
[
17
]
as the reproduction of
pathogens
with strict temperature requirements can be hindered, and the rates of some important immunological reactions are increased by temperature.
[
104
]
Fever has been described in teaching texts as assisting the healing process in various ways, including:
increased mobility of
leukocytes
;
[
105
]
: 1044
enhanced leukocyte
phagocytosis
;
[
105
]
: 1030
decreased
endotoxin
effects;
[
105
]
: 1029
and
increased
proliferation
of
T cells
.
[
105
]
: 1030
[
106
]
: 212
Advantages and disadvantages
[
edit
]
A fever response to an infectious disease is generally regarded as protective, whereas fever in non-infections may be maladaptive.
[
107
]
[
108
]
Studies have not been consistent on whether treating fever generally worsens or improves mortality risk.
[
109
]
Benefits or harms may depend on the type of infection, health status of the patient and other factors.
[
107
]
Studies using
warm-blooded
vertebrates
suggest that they recover more rapidly from infections or critical illness due to fever.
[
110
]
In
sepsis
, fever is associated with reduced mortality.
[
111
]
[
citation needed
]
Fever does not necessarily need to be treated,
[
112
]
and most people with a fever recover without specific medical attention.
[
113
]
Although it is unpleasant, fever rarely rises to a dangerous level even if untreated.
[
114
]
Damage to the brain generally does not occur until temperatures reach 40.0 °C (104.0 °F), and it is rare for an untreated fever to exceed 40.6 °C (105.1 °F).
[
115
]
Treating fever in people with
sepsis
does not affect outcomes.
[
116
]
Small trials have shown no benefit of treating fevers of 38.5 °C (101.3 °F) or higher of critically ill patients in ICUs, and one trial was terminated early because patients receiving aggressive fever treatment were dying more often.
[
19
]
According to the NIH, the two assumptions which are generally used to argue in favor of treating fevers have not been experimentally validated. These are that (1) a fever is noxious, and (2) suppression of a fever will reduce its noxious effect. Most of the other studies supporting the association of fever with poorer outcomes have been observational in nature. In theory, these critically ill patients and those faced with additional physiologic stress may benefit from fever reduction, but the evidence on both sides of the argument appears to be mostly equivocal.
[
19
]
Conservative measures
[
edit
]
Limited evidence supports sponging or bathing feverish children with tepid water.
[
117
]
The use of a
fan
or air conditioning may somewhat reduce the temperature and increase comfort. If the temperature reaches the extremely high level of
hyperpyrexia
, aggressive cooling is required (generally produced mechanically via
conduction
by applying numerous ice packs across most of the body or direct submersion in
ice water
).
[
102
]
In general, people are advised to keep adequately hydrated.
[
118
]
Whether increased fluid intake improves symptoms or shortens respiratory illnesses such as the
common cold
is not known.
[
119
]
Medications that lower fevers are called
antipyretics
.
[
120
]
The antipyretic
ibuprofen
is effective in reducing fevers in children.
[
121
]
It is more effective than
acetaminophen
(paracetamol) in children.
[
121
]
Ibuprofen and acetaminophen may safely be used together in children with fevers.
[
122
]
[
123
]
The efficacy of acetaminophen by itself in children with fevers has been questioned.
[
124
]
Ibuprofen is also superior to
aspirin
in children with fevers.
[
125
]
Additionally,
aspirin
is not recommended in those under the age of 18 due to the risk of
Reye's syndrome
.
[
126
]
Using both paracetamol and ibuprofen at the same time or alternating between the two is more effective at decreasing fever than using only paracetamol or ibuprofen.
[
127
]
It is not clear if it increases child comfort.
[
127
]
Response or nonresponse to medications does not predict whether or not a child has a serious illness.
[
128
]
With respect to the effect of antipyretics on the risk of death in those with infection, studies have found mixed results, as of 2019.
[
129
]
Fever is one of the most common
medical signs
.
[
2
]
It is part of about 30% of healthcare visits by children,
[
2
]
and occurs in up to 75% of adults who are seriously sick.
[
11
]
About 5% of people who go to an emergency room have a fever.
[
130
]
A number of types of fever were known as early as 460 BC to 370 BC when
Hippocrates
was practicing medicine including that due to
malaria
(tertian or every 2 days and quartan or every 3 days).
[
131
]
It also became clear around this time that fever was a symptom of disease rather than a disease in and of itself.
[
131
]
Infections presenting with fever were a major source of mortality in humans for about 200,000 years. Until the late nineteenth century, approximately half of all humans died from infections before the age of fifteen.
[
132
]
An older term,
febricula
(a
diminutive
form of the
Latin
word for fever), was once used to refer to a low-grade fever lasting only a few days. This term fell out of use in the early 20th century, and the symptoms it referred to are now thought to have been caused mainly by various minor
viral
respiratory infections
.
[
133
]
Society and culture
[
edit
]
Febris
Febris
(
fever
in
Latin
) is the goddess of fever in
Roman mythology
. People with fevers would visit her temples.
Tertiana and Quartana are the goddesses of tertian and quartan fevers of malaria in Roman mythology.
[
134
]
Jvarasura
(
fever-demon
in
Hindi
) is the personification of fever and disease in
Hindu
and
Buddhist mythology
.
Fever is often viewed with greater concern by parents and healthcare professionals than might be deserved, a phenomenon known as fever phobia,
[
2
]
[
135
]
which is based in both caregiver's and parents' misconceptions about fever in children. Among them, many parents incorrectly believe that fever is a
disease
rather than a
medical sign
, that even low fevers are harmful, and that any temperature even briefly or slightly above the oversimplified "normal" number marked on a thermometer is a clinically significant fever.
[
135
]
They are also afraid of harmless side effects like
febrile seizures
and dramatically overestimate the likelihood of permanent damage from typical fevers.
[
135
]
The underlying problem, according to professor of pediatrics Barton D. Schmitt, is that "as parents we tend to suspect that our children's brains may melt."
[
136
]
As a result of these misconceptions parents are anxious, give the child fever-reducing medicine when the temperature is technically normal or only slightly elevated, and interfere with the child's sleep to give the child more medicine.
[
135
]
Fever is an important metric for the
diagnosis
of
disease in domestic animals
. The body temperature of animals, which is taken rectally, is different from one species to another. For example, a
horse
is said to have a fever above
101 °F
(
38.3 °C
).
[
137
]
In species that allow the body to have a wide range of "normal" temperatures, such as
camels
,
[
138
]
whose body temperature varies as the environmental temperature varies,
[
139
]
the body temperature which constitutes a febrile state differs depending on the environmental temperature.
[
140
]
Fever can also be behaviorally induced by invertebrates that do not have immune-system based fever. For instance, some species of grasshopper will thermoregulate to achieve body temperatures that are 2–5 °C higher than normal in order to inhibit the growth of fungal pathogens such as
Beauveria bassiana
and
Metarhizium acridum
.
[
141
]
Honeybee colonies are also able to induce a fever in response to a fungal parasite
Ascosphaera apis
.
[
141
]
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13402948
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^
Leese A (March 1917).
"
'Tips' on camels, for veterinary surgeons on active service"
.
The British Veterinary Journal
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73
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^
Tefera M (July 2004). "Observations on the clinical examination of the camel (Camelus dromedarius) in the field".
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Wikimedia Commons has media related to
Fever
.
Fever and Taking Your Child's Temperature
US National Institute of Health factsheet
Drugs most commonly associated with the adverse event Pyrexia (Fever) as reported the FDA
Archived
9 March 2012 at the
Wayback Machine
Fever
at MedlinePlus
Why are We So Afraid of Fevers?
at
The New York Times |
| Markdown | [Jump to content](https://en.wikipedia.org/wiki/Fever#bodyContent)
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## Contents
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- [(Top)](https://en.wikipedia.org/wiki/Fever)
- [1 Associated symptoms](https://en.wikipedia.org/wiki/Fever#Associated_symptoms)
- [2 Differential diagnosis](https://en.wikipedia.org/wiki/Fever#Differential_diagnosis)
Toggle Differential diagnosis subsection
- [2\.1 Hyperthermia](https://en.wikipedia.org/wiki/Fever#Hyperthermia)
- [3 Mechanism](https://en.wikipedia.org/wiki/Fever#Mechanism)
Toggle Mechanism subsection
- [3\.1 Hypothalamus](https://en.wikipedia.org/wiki/Fever#Hypothalamus)
- [3\.2 Pyrogens](https://en.wikipedia.org/wiki/Fever#Pyrogens)
- [3\.2.1 Endogenous](https://en.wikipedia.org/wiki/Fever#Endogenous)
- [3\.2.2 Exogenous](https://en.wikipedia.org/wiki/Fever#Exogenous)
- [3\.3 Neural circuit mechanism with PGE2 action](https://en.wikipedia.org/wiki/Fever#Neural_circuit_mechanism_with_PGE2_action)
- [4 Diagnosis](https://en.wikipedia.org/wiki/Fever#Diagnosis)
Toggle Diagnosis subsection
- [4\.1 Associated conditions](https://en.wikipedia.org/wiki/Fever#Associated_conditions)
- [5 Types](https://en.wikipedia.org/wiki/Fever#Types)
Toggle Types subsection
- [5\.1 Hyperpyrexia](https://en.wikipedia.org/wiki/Fever#Hyperpyrexia)
- [6 Function](https://en.wikipedia.org/wiki/Fever#Function)
Toggle Function subsection
- [6\.1 Immune function](https://en.wikipedia.org/wiki/Fever#Immune_function)
- [6\.2 Advantages and disadvantages](https://en.wikipedia.org/wiki/Fever#Advantages_and_disadvantages)
- [7 Management](https://en.wikipedia.org/wiki/Fever#Management)
Toggle Management subsection
- [7\.1 Conservative measures](https://en.wikipedia.org/wiki/Fever#Conservative_measures)
- [7\.2 Medications](https://en.wikipedia.org/wiki/Fever#Medications)
- [8 Epidemiology](https://en.wikipedia.org/wiki/Fever#Epidemiology)
- [9 History](https://en.wikipedia.org/wiki/Fever#History)
- [10 Society and culture](https://en.wikipedia.org/wiki/Fever#Society_and_culture)
Toggle Society and culture subsection
- [10\.1 Mythology](https://en.wikipedia.org/wiki/Fever#Mythology)
- [10\.2 Pediatrics](https://en.wikipedia.org/wiki/Fever#Pediatrics)
- [11 Other animals](https://en.wikipedia.org/wiki/Fever#Other_animals)
- [12 References](https://en.wikipedia.org/wiki/Fever#References)
- [13 External links](https://en.wikipedia.org/wiki/Fever#External_links)
Toggle the table of contents
# Fever
123 languages
- [Afrikaans](https://af.wikipedia.org/wiki/Koors "Koors – Afrikaans")
- [አማርኛ](https://am.wikipedia.org/wiki/%E1%89%B5%E1%8A%A9%E1%88%B3%E1%89%B5 "ትኩሳት – Amharic")
- [العربية](https://ar.wikipedia.org/wiki/%D8%AD%D9%85%D9%89 "حمى – Arabic")
- [ܐܪܡܝܐ](https://arc.wikipedia.org/wiki/%DC%90%DC%AB%DC%AC%DC%90_\(%DC%90%DC%A3%DC%9D%DC%98%DC%AC%DC%90\) "ܐܫܬܐ (ܐܣܝܘܬܐ) – Aramaic")
- [مصرى](https://arz.wikipedia.org/wiki/%D8%AD%D9%85%D9%89 "حمى – Egyptian Arabic")
- [অসমীয়া](https://as.wikipedia.org/wiki/%E0%A6%9C%E0%A7%8D%E0%A6%AC%E0%A7%B0 "জ্বৰ – Assamese")
- [Asturianu](https://ast.wikipedia.org/wiki/Fiebre "Fiebre – Asturian")
- [Azərbaycanca](https://az.wikipedia.org/wiki/Q%C4%B1zd%C4%B1rma "Qızdırma – Azerbaijani")
- [Bikol Central](https://bcl.wikipedia.org/wiki/Kalintura "Kalintura – Central Bikol")
- [Беларуская (тарашкевіца)](https://be-tarask.wikipedia.org/wiki/%D0%9B%D1%96%D1%85%D0%B0%D0%BC%D0%B0%D0%BD%D0%BA%D0%B0 "Ліхаманка – Belarusian (Taraškievica orthography)")
- [Беларуская](https://be.wikipedia.org/wiki/%D0%9B%D1%96%D1%85%D0%B0%D0%BC%D0%B0%D0%BD%D0%BA%D0%B0 "Ліхаманка – Belarusian")
- [Български](https://bg.wikipedia.org/wiki/%D0%A2%D1%80%D0%B5%D1%81%D0%BA%D0%B0_\(%D0%BC%D0%B5%D0%B4%D0%B8%D1%86%D0%B8%D0%BD%D0%B0\) "Треска (медицина) – Bulgarian")
- [ပအိုဝ်ႏဘာႏသာႏ](https://blk.wikipedia.org/wiki/%E1%80%91%E1%80%AC%EA%A9%BB%E1%80%86%E1%80%B1%E1%80%AC%E1%80%B7%E1%80%9B%E1%80%B1%E1%80%AC%E1%82%8F%E1%80%82%E1%80%AB%E1%82%8F "ထာꩻဆော့ရောႏဂါႏ – Pa'O")
- [বাংলা](https://bn.wikipedia.org/wiki/%E0%A6%9C%E0%A7%8D%E0%A6%AC%E0%A6%B0 "জ্বর – Bangla")
- [བོད་ཡིག](https://bo.wikipedia.org/wiki/%E0%BD%9A%E0%BD%91%E0%BC%8B%E0%BD%86%E0%BD%BA%E0%BD%93%E0%BC%8B "ཚད་ཆེན་ – Tibetan")
- [Brezhoneg](https://br.wikipedia.org/wiki/Terzhienn "Terzhienn – Breton")
- [Bosanski](https://bs.wikipedia.org/wiki/Groznica "Groznica – Bosnian")
- [Català](https://ca.wikipedia.org/wiki/Febre "Febre – Catalan")
- [کوردی](https://ckb.wikipedia.org/wiki/%D8%AA%D8%A7_\(%D9%86%DB%8C%D8%B4%D8%A7%D9%86%DB%95%DB%8C_%D9%86%DB%95%D8%AE%DB%86%D8%B4%DB%8C\) "تا (نیشانەی نەخۆشی) – Central Kurdish")
- [Čeština](https://cs.wikipedia.org/wiki/Hore%C4%8Dka "Horečka – Czech")
- [Cymraeg](https://cy.wikipedia.org/wiki/Y_dwymyn "Y dwymyn – Welsh")
- [Dansk](https://da.wikipedia.org/wiki/Feber "Feber – Danish")
- [Deutsch](https://de.wikipedia.org/wiki/Fieber "Fieber – German")
- [Ελληνικά](https://el.wikipedia.org/wiki/%CE%A0%CF%85%CF%81%CE%B5%CF%84%CF%8C%CF%82 "Πυρετός – Greek")
- [Esperanto](https://eo.wikipedia.org/wiki/Febro "Febro – Esperanto")
- [Español](https://es.wikipedia.org/wiki/Fiebre "Fiebre – Spanish")
- [Eesti](https://et.wikipedia.org/wiki/Palavik "Palavik – Estonian")
- [Euskara](https://eu.wikipedia.org/wiki/Sukar "Sukar – Basque")
- [فارسی](https://fa.wikipedia.org/wiki/%D8%AA%D8%A8 "تب – Persian")
- [Suomi](https://fi.wikipedia.org/wiki/Kuume "Kuume – Finnish")
- [Français](https://fr.wikipedia.org/wiki/Fi%C3%A8vre "Fièvre – French")
- [Gaeilge](https://ga.wikipedia.org/wiki/Fiabhras "Fiabhras – Irish")
- [Galego](https://gl.wikipedia.org/wiki/Febre "Febre – Galician")
- [Avañe'ẽ](https://gn.wikipedia.org/wiki/Ak%C3%A3nundu "Akãnundu – Guarani")
- [ગુજરાતી](https://gu.wikipedia.org/wiki/%E0%AA%A4%E0%AA%BE%E0%AA%B5 "તાવ – Gujarati")
- [Hausa](https://ha.wikipedia.org/wiki/Zazza%C9%93i "Zazzaɓi – Hausa")
- [עברית](https://he.wikipedia.org/wiki/%D7%97%D7%95%D7%9D_\(%D7%AA%D7%A1%D7%9E%D7%99%D7%9F\) "חום (תסמין) – Hebrew")
- [हिन्दी](https://hi.wikipedia.org/wiki/%E0%A4%9C%E0%A5%8D%E0%A4%B5%E0%A4%B0 "ज्वर – Hindi")
- [Hrvatski](https://hr.wikipedia.org/wiki/Groznica "Groznica – Croatian")
- [Kreyòl ayisyen](https://ht.wikipedia.org/wiki/Lafy%C3%A8v "Lafyèv – Haitian Creole")
- [Magyar](https://hu.wikipedia.org/wiki/L%C3%A1z_\(%C3%A9lettan\) "Láz (élettan) – Hungarian")
- [Հայերեն](https://hy.wikipedia.org/wiki/%D5%8F%D5%A5%D5%B6%D5%A4 "Տենդ – Armenian")
- [Արեւմտահայերէն](https://hyw.wikipedia.org/wiki/%D5%8F%D5%A5%D5%B6%D5%A4 "Տենդ – Western Armenian")
- [Interlingua](https://ia.wikipedia.org/wiki/Febre "Febre – Interlingua")
- [Bahasa Indonesia](https://id.wikipedia.org/wiki/Demam "Demam – Indonesian")
- [Ido](https://io.wikipedia.org/wiki/Febro "Febro – Ido")
- [Íslenska](https://is.wikipedia.org/wiki/Hiti_\(sj%C3%BAkd%C3%B3ms%C3%A1stand\) "Hiti (sjúkdómsástand) – Icelandic")
- [Italiano](https://it.wikipedia.org/wiki/Febbre "Febbre – Italian")
- [日本語](https://ja.wikipedia.org/wiki/%E7%99%BA%E7%86%B1 "発熱 – Japanese")
- [ქართული](https://ka.wikipedia.org/wiki/%E1%83%AA%E1%83%AE%E1%83%94%E1%83%9A%E1%83%94%E1%83%91%E1%83%90 "ცხელება – Georgian")
- [Taqbaylit](https://kab.wikipedia.org/wiki/Tawla "Tawla – Kabyle")
- [Қазақша](https://kk.wikipedia.org/wiki/%D2%9A%D1%8B%D0%B7%D0%B1%D0%B0 "Қызба – Kazakh")
- [ಕನ್ನಡ](https://kn.wikipedia.org/wiki/%E0%B2%9C%E0%B3%8D%E0%B2%B5%E0%B2%B0 "ಜ್ವರ – Kannada")
- [한국어](https://ko.wikipedia.org/wiki/%EB%B0%9C%EC%97%B4 "발열 – Korean")
- [کٲشُر](https://ks.wikipedia.org/wiki/%D8%AA%D9%8E%D9%BE%DA%BE "تَپھ – Kashmiri")
- [Kurdî](https://ku.wikipedia.org/wiki/Ta_\(biyoloj%C3%AE\) "Ta (biyolojî) – Kurdish")
- [Кыргызча](https://ky.wikipedia.org/wiki/%D0%9A%D0%B0%D0%BB%D1%82%D1%8B%D1%80%D0%B0%D1%82%D0%BC%D0%B0 "Калтыратма – Kyrgyz")
- [Latina](https://la.wikipedia.org/wiki/Febris "Febris – Latin")
- [Lombard](https://lmo.wikipedia.org/wiki/Fever "Fever – Lombard")
- [Lingála](https://ln.wikipedia.org/wiki/F%C9%9B%CC%81f%C9%9Bl%C9%9B "Fɛ́fɛlɛ – Lingala")
- [ລາວ](https://lo.wikipedia.org/wiki/%E0%BB%84%E0%BA%82%E0%BB%89 "ໄຂ້ – Lao")
- [Lietuvių](https://lt.wikipedia.org/wiki/Kar%C5%A1%C4%8Diavimas "Karščiavimas – Lithuanian")
- [Latviešu](https://lv.wikipedia.org/wiki/Drudzis "Drudzis – Latvian")
- [Minangkabau](https://min.wikipedia.org/wiki/Damam "Damam – Minangkabau")
- [Македонски](https://mk.wikipedia.org/wiki/%D0%A2%D1%80%D0%B5%D1%81%D0%BA%D0%B0_\(%D1%81%D0%BE%D1%81%D1%82%D0%BE%D1%98%D0%B1%D0%B0\) "Треска (состојба) – Macedonian")
- [മലയാളം](https://ml.wikipedia.org/wiki/%E0%B4%AA%E0%B4%A8%E0%B4%BF "പനി – Malayalam")
- [मराठी](https://mr.wikipedia.org/wiki/%E0%A4%A4%E0%A4%BE%E0%A4%AA "ताप – Marathi")
- [Bahasa Melayu](https://ms.wikipedia.org/wiki/Demam "Demam – Malay")
- [မြန်မာဘာသာ](https://my.wikipedia.org/wiki/%E1%80%96%E1%80%BB%E1%80%AC%E1%80%B8%E1%80%94%E1%80%AC%E1%80%81%E1%80%BC%E1%80%84%E1%80%BA%E1%80%B8 "ဖျားနာခြင်း – Burmese")
- [नेपाली](https://ne.wikipedia.org/wiki/%E0%A4%9C%E0%A5%8D%E0%A4%B5%E0%A4%B0%E0%A5%8B "ज्वरो – Nepali")
- [नेपाल भाषा](https://new.wikipedia.org/wiki/%E0%A4%9C%E0%A5%8D%E0%A4%B5%E0%A4%B0 "ज्वर – Newari")
- [Li Niha](https://nia.wikipedia.org/wiki/Mofa%27aukhu "Mofa'aukhu – Nias")
- [Nederlands](https://nl.wikipedia.org/wiki/Koorts "Koorts – Dutch")
- [Norsk nynorsk](https://nn.wikipedia.org/wiki/Feber "Feber – Norwegian Nynorsk")
- [Norsk bokmål](https://no.wikipedia.org/wiki/Feber "Feber – Norwegian Bokmål")
- [Occitan](https://oc.wikipedia.org/wiki/F%C3%A8bre "Fèbre – Occitan")
- [ଓଡ଼ିଆ](https://or.wikipedia.org/wiki/%E0%AC%9C%E0%AD%8D%E0%AD%B1%E0%AC%B0 "ଜ୍ୱର – Odia")
- [ਪੰਜਾਬੀ](https://pa.wikipedia.org/wiki/%E0%A8%A4%E0%A8%BE%E0%A8%AA_\(%E0%A8%AC%E0%A8%BF%E0%A8%AE%E0%A8%BE%E0%A8%B0%E0%A9%80\) "ਤਾਪ (ਬਿਮਾਰੀ) – Punjabi")
- [Polski](https://pl.wikipedia.org/wiki/Gor%C4%85czka "Gorączka – Polish")
- [پنجابی](https://pnb.wikipedia.org/wiki/%D8%AA%D8%A7%D9%BE "تاپ – Western Punjabi")
- [پښتو](https://ps.wikipedia.org/wiki/%D8%AA%D8%A8%D9%87 "تبه – Pashto")
- [Português](https://pt.wikipedia.org/wiki/Febre "Febre – Portuguese")
- [Runa Simi](https://qu.wikipedia.org/wiki/Ruphariy "Ruphariy – Quechua")
- [Română](https://ro.wikipedia.org/wiki/Febr%C4%83 "Febră – Romanian")
- [Armãneashti](https://roa-rup.wikipedia.org/wiki/Heavr%C3%A2 "Heavrâ – Aromanian")
- [Русский](https://ru.wikipedia.org/wiki/%D0%9B%D0%B8%D1%85%D0%BE%D1%80%D0%B0%D0%B4%D0%BA%D0%B0 "Лихорадка – Russian")
- [संस्कृतम्](https://sa.wikipedia.org/wiki/%E0%A4%9C%E0%A5%8D%E0%A4%B5%E0%A4%B0%E0%A4%83 "ज्वरः – Sanskrit")
- [ᱥᱟᱱᱛᱟᱲᱤ](https://sat.wikipedia.org/wiki/%E1%B1%A8%E1%B1%A9%E1%B1%A3%E1%B1%9F%E1%B1%B9 "ᱨᱩᱣᱟᱹ – Santali")
- [Sicilianu](https://scn.wikipedia.org/wiki/Frevi "Frevi – Sicilian")
- [سنڌي](https://sd.wikipedia.org/wiki/%D8%AA%D9%BE "تپ – Sindhi")
- [Srpskohrvatski / српскохрватски](https://sh.wikipedia.org/wiki/Groznica "Groznica – Serbo-Croatian")
- [සිංහල](https://si.wikipedia.org/wiki/%E0%B6%8B%E0%B6%AB "උණ – Sinhala")
- [Simple English](https://simple.wikipedia.org/wiki/Fever "Fever – Simple English")
- [Slovenčina](https://sk.wikipedia.org/wiki/Hor%C3%BA%C4%8Dka "Horúčka – Slovak")
- [Slovenščina](https://sl.wikipedia.org/wiki/Vro%C4%8Dina "Vročina – Slovenian")
- [Shqip](https://sq.wikipedia.org/wiki/Ethet "Ethet – Albanian")
- [Српски / srpski](https://sr.wikipedia.org/wiki/Groznica "Groznica – Serbian")
- [Sesotho](https://st.wikipedia.org/wiki/Feberu "Feberu – Southern Sotho")
- [Sunda](https://su.wikipedia.org/wiki/Muriang "Muriang – Sundanese")
- [Svenska](https://sv.wikipedia.org/wiki/Feber "Feber – Swedish")
- [Kiswahili](https://sw.wikipedia.org/wiki/Homa "Homa – Swahili")
- [தமிழ்](https://ta.wikipedia.org/wiki/%E0%AE%95%E0%AE%BE%E0%AE%AF%E0%AF%8D%E0%AE%9A%E0%AF%8D%E0%AE%9A%E0%AE%B2%E0%AF%8D "காய்ச்சல் – Tamil")
- [ತುಳು](https://tcy.wikipedia.org/wiki/%E0%B2%9C%E0%B2%B0%E0%B3%8A "ಜರೊ – Tulu")
- [తెలుగు](https://te.wikipedia.org/wiki/%E0%B0%9C%E0%B1%8D%E0%B0%B5%E0%B0%B0%E0%B0%82 "జ్వరం – Telugu")
- [Тоҷикӣ](https://tg.wikipedia.org/wiki/%D0%A2%D0%B0%D0%B1 "Таб – Tajik")
- [ไทย](https://th.wikipedia.org/wiki/%E0%B9%84%E0%B8%82%E0%B9%89 "ไข้ – Thai")
- [Tagalog](https://tl.wikipedia.org/wiki/Lagnat "Lagnat – Tagalog")
- [Türkçe](https://tr.wikipedia.org/wiki/Ate%C5%9F_\(t%C4%B1p\) "Ateş (tıp) – Turkish")
- [ئۇيغۇرچە / Uyghurche](https://ug.wikipedia.org/wiki/%D9%82%D9%89%D8%B2%D9%89%D8%AA%D9%85%D8%A7 "قىزىتما – Uyghur")
- [Українська](https://uk.wikipedia.org/wiki/%D0%93%D0%B0%D1%80%D1%8F%D1%87%D0%BA%D0%B0 "Гарячка – Ukrainian")
- [اردو](https://ur.wikipedia.org/wiki/%D8%A8%D8%AE%D8%A7%D8%B1 "بخار – Urdu")
- [Oʻzbekcha / ўзбекча](https://uz.wikipedia.org/wiki/Isitma "Isitma – Uzbek")
- [Vèneto](https://vec.wikipedia.org/wiki/Fevra "Fevra – Venetian")
- [Tiếng Việt](https://vi.wikipedia.org/wiki/S%E1%BB%91t "Sốt – Vietnamese")
- [Walon](https://wa.wikipedia.org/wiki/Five "Five – Walloon")
- [Winaray](https://war.wikipedia.org/wiki/Hiranat "Hiranat – Waray")
- [吴语](https://wuu.wikipedia.org/wiki/%E5%AF%92%E7%83%AD "寒热 – Wu")
- [ייִדיש](https://yi.wikipedia.org/wiki/%D7%A4%D7%99%D7%91%D7%A2%D7%A8 "פיבער – Yiddish")
- [Yorùbá](https://yo.wikipedia.org/wiki/Ib%C3%A0 "Ibà – Yoruba")
- [Vahcuengh](https://za.wikipedia.org/wiki/Fatndat "Fatndat – Zhuang")
- [閩南語 / Bân-lâm-gí](https://zh-min-nan.wikipedia.org/wiki/Hoat-sio "Hoat-sio – Minnan")
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From Wikipedia, the free encyclopedia
Raised body temperature caused by disease
Not to be confused with [Hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia"). For other uses, see [Fever (disambiguation)](https://en.wikipedia.org/wiki/Fever_\(disambiguation\) "Fever (disambiguation)").
Medical condition
| Fever | |
|---|---|
| Other names | Pyrexia, febrile response, febrile[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1) |
| [](https://en.wikipedia.org/wiki/File:Symptoms-fever.jpg) | |
| Person with fever | |
| [Specialty](https://en.wikipedia.org/wiki/Medical_specialty "Medical specialty") | [Infectious disease](https://en.wikipedia.org/wiki/Infectious_disease_\(medical_specialty\) "Infectious disease (medical specialty)"), [pediatrics](https://en.wikipedia.org/wiki/Pediatrics "Pediatrics") |
| [Symptoms](https://en.wikipedia.org/wiki/Signs_and_symptoms "Signs and symptoms") | **Initially**: [shivering](https://en.wikipedia.org/wiki/Shivering "Shivering"), feeling [cold](https://en.wikipedia.org/wiki/Cold "Cold"), [chills](https://en.wikipedia.org/wiki/Chills "Chills")[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2) **Later**: [flushed](https://en.wikipedia.org/wiki/Flushed "Flushed"), [sweating](https://en.wikipedia.org/wiki/Sweat "Sweat")[\[3\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sue2014-3) |
| [Complications](https://en.wikipedia.org/wiki/Complication_\(medicine\) "Complication (medicine)") | [Febrile seizure](https://en.wikipedia.org/wiki/Febrile_seizure "Febrile seizure")[\[4\]](https://en.wikipedia.org/wiki/Fever#cite_note-CDC2010-4) |
| [Causes](https://en.wikipedia.org/wiki/Cause_\(medicine\) "Cause (medicine)") | [Virus](https://en.wikipedia.org/wiki/Virus "Virus"), [bacteria](https://en.wikipedia.org/wiki/Bacteria "Bacteria"), increase in the body's temperature [set point](https://en.wikipedia.org/wiki/Human_body_temperature#Fever "Human body temperature")[\[5\]](https://en.wikipedia.org/wiki/Fever#cite_note-Kl2015-5)[\[6\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012p375-6) |
| [Diagnostic method](https://en.wikipedia.org/wiki/Medical_diagnosis "Medical diagnosis") | Temperature higher than the normal range of 37.2 and 38.3 °C (99.0 and 100.9 °F)[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1)[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[8\]](https://en.wikipedia.org/wiki/Fever#cite_note-CC09-8) |
| [Differential diagnosis](https://en.wikipedia.org/wiki/Differential_diagnosis "Differential diagnosis") | [Hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia")[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1) |
| Treatment | Based on underlying cause, not required for fever itself[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2)[\[9\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ric2015-9) |
| [Medication](https://en.wikipedia.org/wiki/Medication "Medication") | [Antipyretics](https://en.wikipedia.org/wiki/Antipyretic "Antipyretic") ([ibuprofen](https://en.wikipedia.org/wiki/Ibuprofen "Ibuprofen"), [paracetamol](https://en.wikipedia.org/wiki/Paracetamol "Paracetamol") \[acetaminophen\])[\[9\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ric2015-9)[\[10\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012-10) |
| Frequency | Common[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2)[\[11\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ki2013-11) |
**Fever** or **pyrexia** in humans is a symptom of an anti-infection defense mechanism that appears with [body temperature](https://en.wikipedia.org/wiki/Human_body_temperature "Human body temperature") exceeding the normal range caused by an increase in the body's temperature [set point](https://en.wikipedia.org/wiki/Human_body_temperature#Fever "Human body temperature") in the [hypothalamus](https://en.wikipedia.org/wiki/Hypothalamus "Hypothalamus").[\[5\]](https://en.wikipedia.org/wiki/Fever#cite_note-Kl2015-5)[\[6\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012p375-6)[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[12\]](https://en.wikipedia.org/wiki/Fever#cite_note-12) There is no single agreed-upon upper limit for normal temperature: sources use values ranging between 37.2 and 38.3 °C (99.0 and 100.9 °F) in humans.[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1)[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[8\]](https://en.wikipedia.org/wiki/Fever#cite_note-CC09-8)
The increase in set point triggers increased [muscle contractions](https://en.wikipedia.org/wiki/Muscle_tone "Muscle tone") and causes a feeling of [cold](https://en.wikipedia.org/wiki/Cold "Cold") or [chills](https://en.wikipedia.org/wiki/Chills "Chills").[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2) This results in greater heat production and efforts to conserve heat.[\[3\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sue2014-3) When the set point temperature returns to normal, a person feels hot, becomes [flushed](https://en.wikipedia.org/wiki/Flushing_\(physiology\) "Flushing (physiology)"), and may begin to [sweat](https://en.wikipedia.org/wiki/Perspiration "Perspiration").[\[3\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sue2014-3) Rarely a fever may trigger a [febrile seizure](https://en.wikipedia.org/wiki/Febrile_seizure "Febrile seizure"), with this being more common in young children.[\[4\]](https://en.wikipedia.org/wiki/Fever#cite_note-CDC2010-4) Fevers do not typically go higher than 41 to 42 °C (106 to 108 °F).[\[6\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012p375-6)
A fever can be caused by many [medical conditions](https://en.wikipedia.org/wiki/Medical_conditions "Medical conditions") ranging from non-serious to [life-threatening](https://en.wikipedia.org/wiki/Life-threatening "Life-threatening").[\[13\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012p5-13) This includes [viral](https://en.wikipedia.org/wiki/Viral_infection "Viral infection"), [bacterial](https://en.wikipedia.org/wiki/Bacterial_infection "Bacterial infection"), and [parasitic infections](https://en.wikipedia.org/wiki/Parasitic_infections "Parasitic infections")—such as [influenza](https://en.wikipedia.org/wiki/Influenza "Influenza"), the [common cold](https://en.wikipedia.org/wiki/Common_cold "Common cold"), [meningitis](https://en.wikipedia.org/wiki/Meningitis "Meningitis"), [urinary tract infections](https://en.wikipedia.org/wiki/Urinary_tract_infections "Urinary tract infections"), [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis"), [Lassa fever](https://en.wikipedia.org/wiki/Lassa_fever "Lassa fever"), [COVID-19](https://en.wikipedia.org/wiki/COVID-19 "COVID-19"), and [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria").[\[13\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012p5-13)[\[14\]](https://en.wikipedia.org/wiki/Fever#cite_note-Rod2020-14) Non-infectious causes include [vasculitis](https://en.wikipedia.org/wiki/Vasculitis "Vasculitis"), [deep vein thrombosis](https://en.wikipedia.org/wiki/Deep_vein_thrombosis "Deep vein thrombosis"), [connective tissue disease](https://en.wikipedia.org/wiki/Connective_tissue_disease "Connective tissue disease"), side effects of medication or vaccination, and [cancer](https://en.wikipedia.org/wiki/Cancer "Cancer").[\[13\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012p5-13)[\[15\]](https://en.wikipedia.org/wiki/Fever#cite_note-15) It differs from [hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia"), in that hyperthermia is an increase in body temperature over the temperature set point, due to either too much heat production or not enough [heat loss](https://en.wikipedia.org/wiki/Thermoregulation "Thermoregulation").[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1)
Treatment to reduce fever is generally not required.[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2)[\[9\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ric2015-9) Treatment of associated pain and inflammation, however, may be useful and help a person rest.[\[9\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ric2015-9) Medications such as [ibuprofen](https://en.wikipedia.org/wiki/Ibuprofen "Ibuprofen") or [paracetamol](https://en.wikipedia.org/wiki/Paracetamol "Paracetamol") (acetaminophen) may help with this as well as lower temperature.[\[9\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ric2015-9)[\[10\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012-10) Children younger than three months require medical attention, as might people with serious medical problems such as a [compromised immune system](https://en.wikipedia.org/wiki/Compromised_immune_system "Compromised immune system") or people with other symptoms.[\[16\]](https://en.wikipedia.org/wiki/Fever#cite_note-16) [Hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia") requires treatment.[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2)
Fever is one of the most common [medical signs](https://en.wikipedia.org/wiki/Medical_signs "Medical signs").[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2) It is part of about 30% of healthcare visits by children[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2) and occurs in up to 75% of adults who are seriously sick.[\[11\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ki2013-11) While fever evolved as a defense mechanism, [treating a fever](https://en.wikipedia.org/wiki/Antipyretic "Antipyretic") does not appear to improve or worsen outcomes.[\[17\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sch2006-17)[\[18\]](https://en.wikipedia.org/wiki/Fever#cite_note-Antipyretic_therapy_in_febrile_crit-18)[\[19\]](https://en.wikipedia.org/wiki/Fever#cite_note-:0-19) Fever is often viewed with greater concern by parents and healthcare professionals than is usually deserved, a phenomenon known as "fever phobia".[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2)[\[20\]](https://en.wikipedia.org/wiki/Fever#cite_note-20)
## Associated symptoms
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=1 "Edit section: Associated symptoms")\]
A fever is usually accompanied by [sickness behavior](https://en.wikipedia.org/wiki/Sickness_behavior "Sickness behavior"), which consists of [lethargy](https://en.wikipedia.org/wiki/Lethargy "Lethargy"), [depression](https://en.wikipedia.org/wiki/Depression_\(mood\) "Depression (mood)"), [loss of appetite](https://en.wikipedia.org/wiki/Anorexia_\(symptom\) "Anorexia (symptom)"), [sleepiness](https://en.wikipedia.org/wiki/Sleepiness "Sleepiness"), [hyperalgesia](https://en.wikipedia.org/wiki/Hyperalgesia "Hyperalgesia"), [dehydration](https://en.wikipedia.org/wiki/Dehydration "Dehydration"),[\[21\]](https://en.wikipedia.org/wiki/Fever#cite_note-21)[\[22\]](https://en.wikipedia.org/wiki/Fever#cite_note-22) and the inability to concentrate. Sleeping with a fever can often cause intense or confusing [nightmares](https://en.wikipedia.org/wiki/Nightmare "Nightmare"), commonly called "[fever dreams](https://en.wikipedia.org/wiki/Fever_dream "Fever dream")".[\[23\]](https://en.wikipedia.org/wiki/Fever#cite_note-23) Mild to severe [delirium](https://en.wikipedia.org/wiki/Delirium "Delirium") (which can also cause [hallucinations](https://en.wikipedia.org/wiki/Hallucinations "Hallucinations")) may also present itself during high fevers.[\[24\]](https://en.wikipedia.org/wiki/Fever#cite_note-24)
## Differential diagnosis
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=2 "Edit section: Differential diagnosis")\]
### Hyperthermia
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=3 "Edit section: Hyperthermia")\]
[Hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia") is an elevation of body temperature over the temperature set point, due to either too much heat production or not enough [heat loss](https://en.wikipedia.org/wiki/Thermoregulation "Thermoregulation").[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1)[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7) Hyperthermia is thus not considered fever.[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7): 103 [\[25\]](https://en.wikipedia.org/wiki/Fever#cite_note-25) Hyperthermia should not be confused with [hyperpyrexia](https://en.wikipedia.org/wiki/Hyperpyrexia "Hyperpyrexia") (which is a very high fever).[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7): 102
Clinically, it is important to distinguish between fever and hyperthermia as hyperthermia may quickly lead to death and does not respond to antipyretic medications. The distinction may however be difficult to make in an emergency setting, and is often established by identifying possible causes.[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7): 103
## Mechanism
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=4 "Edit section: Mechanism")\]
See also: [Thermoregulation in humans](https://en.wikipedia.org/wiki/Thermoregulation_in_humans "Thermoregulation in humans")
### Hypothalamus
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=5 "Edit section: Hypothalamus")\]
Temperature is regulated in the [hypothalamus](https://en.wikipedia.org/wiki/Hypothalamus "Hypothalamus"). The trigger of a fever, called a pyrogen, results in the release of [prostaglandin E2](https://en.wikipedia.org/wiki/Prostaglandin_E2 "Prostaglandin E2") (PGE2). PGE2 in turn acts on the hypothalamus, which creates a systemic response in the body, causing heat-generating effects to match a new higher temperature set point. There are four receptors in which PGE2 can bind (EP1-4), with a previous study showing the EP3 subtype is what mediates the fever response.[\[26\]](https://en.wikipedia.org/wiki/Fever#cite_note-26) Hence, the hypothalamus can be seen as working like a [thermostat](https://en.wikipedia.org/wiki/Thermostat "Thermostat").[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7) When the set point is raised, the body increases its temperature through both active generation of heat and retention of heat. Peripheral [vasoconstriction](https://en.wikipedia.org/wiki/Vasoconstriction "Vasoconstriction") both reduces heat loss through the skin and causes the person to feel cold. [Norepinephrine](https://en.wikipedia.org/wiki/Norepinephrine "Norepinephrine") increases [thermogenesis](https://en.wikipedia.org/wiki/Thermogenesis "Thermogenesis") in [brown adipose tissue](https://en.wikipedia.org/wiki/Brown_adipose_tissue "Brown adipose tissue"), and muscle contraction through shivering raises the [metabolic rate](https://en.wikipedia.org/wiki/Basal_metabolic_rate "Basal metabolic rate").[\[27\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid25976513-27)
If these measures are insufficient to make the blood temperature in the brain match the new set point in the hypothalamus, the brain orchestrates heat effector mechanisms via the [autonomic nervous system](https://en.wikipedia.org/wiki/Autonomic_nervous_system "Autonomic nervous system") or primary motor center for shivering. These may be:[\[28\]](https://en.wikipedia.org/wiki/Fever#cite_note-28)[\[29\]](https://en.wikipedia.org/wiki/Fever#cite_note-29)[\[30\]](https://en.wikipedia.org/wiki/Fever#cite_note-30)
- Increased heat production by increased [muscle tone](https://en.wikipedia.org/wiki/Muscle_tone "Muscle tone"), [shivering](https://en.wikipedia.org/wiki/Shivering "Shivering") (muscle movements to produce heat) and release of hormones like [epinephrine](https://en.wikipedia.org/wiki/Epinephrine "Epinephrine"); and
- Prevention of heat loss, e.g., through [vasoconstriction](https://en.wikipedia.org/wiki/Vasoconstriction "Vasoconstriction").
When the hypothalamic set point moves back to baseline—either spontaneously or via medication—normal functions such as sweating, and the reverse of the foregoing processes (e.g., vasodilation, end of shivering, and nonshivering heat production) are used to cool the body to the new, lower setting.\[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
This contrasts with [hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia"), in which the normal setting remains, and the body overheats through undesirable retention of excess heat or over-production of heat. Hyperthermia is usually the result of an excessively hot environment ([heat stroke](https://en.wikipedia.org/wiki/Heat_stroke "Heat stroke")) or an adverse reaction to drugs. Fever can be differentiated from hyperthermia by the circumstances surrounding it and its response to [anti-pyretic](https://en.wikipedia.org/wiki/Anti-pyretic "Anti-pyretic") medications.[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)\[*[verification needed](https://en.wikipedia.org/wiki/Wikipedia:Verifiability "Wikipedia:Verifiability")*\]
In infants, the autonomic nervous system may also activate [brown adipose tissue](https://en.wikipedia.org/wiki/Brown_adipose_tissue "Brown adipose tissue") to produce heat (non-shivering thermogenesis).[\[31\]](https://en.wikipedia.org/wiki/Fever#cite_note-31)
Increased heart rate and vasoconstriction contribute to increased [blood pressure](https://en.wikipedia.org/wiki/Blood_pressure "Blood pressure") in fever.[\[32\]](https://en.wikipedia.org/wiki/Fever#cite_note-32)
### Pyrogens
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=6 "Edit section: Pyrogens")\]
A pyrogen is a substance that induces fever.[\[33\]](https://en.wikipedia.org/wiki/Fever#cite_note-33) In the presence of an infectious agent, such as bacteria, viruses, viroids, *etc*., the immune response of the body is to inhibit their growth and eliminate them. The most common pyrogens are endotoxins, which are [lipopolysaccharides](https://en.wikipedia.org/wiki/Lipopolysaccharide "Lipopolysaccharide") (LPS) produced by [Gram-negative bacteria](https://en.wikipedia.org/wiki/Gram-negative_bacteria "Gram-negative bacteria") such as *[E. coli](https://en.wikipedia.org/wiki/Escherichia_coli "Escherichia coli").* But pyrogens include non-endotoxic substances (derived from microorganisms other than gram-negative-bacteria or from chemical substances) as well.[\[34\]](https://en.wikipedia.org/wiki/Fever#cite_note-34) The types of pyrogens include internal (endogenous) and external (exogenous) to the body.[\[35\]](https://en.wikipedia.org/wiki/Fever#cite_note-35)
The "pyrogenicity" of given pyrogens varies: in extreme cases, bacterial pyrogens can act as [superantigens](https://en.wikipedia.org/wiki/Superantigens "Superantigens") and cause rapid and dangerous fevers.[\[36\]](https://en.wikipedia.org/wiki/Fever#cite_note-36)
#### Endogenous
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=7 "Edit section: Endogenous")\]
Endogenous pyrogens are [cytokines](https://en.wikipedia.org/wiki/Cytokine "Cytokine") released from [monocytes](https://en.wikipedia.org/wiki/Monocyte "Monocyte") (which are part of the [immune system](https://en.wikipedia.org/wiki/Immune_system "Immune system")).[\[37\]](https://en.wikipedia.org/wiki/Fever#cite_note-37) In general, they stimulate chemical responses, often in the presence of an [antigen](https://en.wikipedia.org/wiki/Antigen "Antigen"), leading to a fever. Whilst they can be a product of external factors like exogenous pyrogens, they can also be induced by internal factors like [damage associated molecular patterns](https://en.wikipedia.org/wiki/Damage_associated_molecular_pattern "Damage associated molecular pattern") such as cases like [rheumatoid arthritis](https://en.wikipedia.org/wiki/Rheumatoid_arthritis "Rheumatoid arthritis") or lupus.[\[38\]](https://en.wikipedia.org/wiki/Fever#cite_note-38)
Major endogenous pyrogens are [interleukin 1](https://en.wikipedia.org/wiki/Interleukin_1 "Interleukin 1") (α and β)[\[39\]](https://en.wikipedia.org/wiki/Fever#cite_note-boron-58-39): 1237–1248 and [interleukin 6](https://en.wikipedia.org/wiki/Interleukin_6 "Interleukin 6") (IL-6).[\[40\]](https://en.wikipedia.org/wiki/Fever#cite_note-40) Minor endogenous pyrogens include [interleukin-8](https://en.wikipedia.org/wiki/Interleukin-8 "Interleukin-8"), [tumor necrosis factor-β](https://en.wikipedia.org/wiki/Lymphotoxin_alpha "Lymphotoxin alpha"), [macrophage inflammatory protein](https://en.wikipedia.org/wiki/Macrophage_inflammatory_protein "Macrophage inflammatory protein")\-α and macrophage inflammatory protein-β as well as [interferon-α](https://en.wikipedia.org/wiki/Interferon-%CE%B1 "Interferon-α"), [interferon-β](https://en.wikipedia.org/wiki/IFN-%CE%B2 "IFN-β"), and [interferon-γ](https://en.wikipedia.org/wiki/Interferon-gamma "Interferon-gamma").[\[39\]](https://en.wikipedia.org/wiki/Fever#cite_note-boron-58-39): 1237–1248 [Tumor necrosis factor-α](https://en.wikipedia.org/wiki/Tumor_necrosis_factor-%CE%B1 "Tumor necrosis factor-α") (TNF) also acts as a pyrogen, mediated by [interleukin 1](https://en.wikipedia.org/wiki/Interleukin_1 "Interleukin 1") (IL-1) release.[\[41\]](https://en.wikipedia.org/wiki/Fever#cite_note-41) These cytokine factors are released into general circulation, where they migrate to the brain's [circumventricular organs](https://en.wikipedia.org/wiki/Circumventricular_organ "Circumventricular organ") where they are more easily absorbed than in areas protected by the [blood–brain barrier](https://en.wikipedia.org/wiki/Blood%E2%80%93brain_barrier "Blood–brain barrier").[\[42\]](https://en.wikipedia.org/wiki/Fever#cite_note-42) The cytokines then bind to [endothelial receptors](https://en.wikipedia.org/wiki/Endothelium "Endothelium") on vessel walls to receptors on [microglial cells](https://en.wikipedia.org/wiki/Microglial_cell "Microglial cell"), resulting in activation of the [arachidonic acid pathway](https://en.wikipedia.org/wiki/Arachidonic_acid_pathway "Arachidonic acid pathway").[\[43\]](https://en.wikipedia.org/wiki/Fever#cite_note-43)
Of these, IL-1β, TNF, and IL-6 are able to raise the temperature setpoint of an organism and cause fever. These proteins produce a [cyclooxygenase](https://en.wikipedia.org/wiki/Cyclooxygenase "Cyclooxygenase") which induces the hypothalamic production of PGE2 which then stimulates the release of neurotransmitters such as [cyclic adenosine monophosphate](https://en.wikipedia.org/wiki/Cyclic_adenosine_monophosphate "Cyclic adenosine monophosphate") and increases body temperature.[\[44\]](https://en.wikipedia.org/wiki/Fever#cite_note-44)
#### Exogenous
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=8 "Edit section: Exogenous")\]
Exogenous pyrogens are external to the body and are of microbial origin. In general, these pyrogens, including bacterial cell wall products, may act on Toll-like receptors in the hypothalamus and elevate the thermoregulatory setpoint.[\[45\]](https://en.wikipedia.org/wiki/Fever#cite_note-45)
An example of a class of exogenous pyrogens are bacterial [lipopolysaccharides](https://en.wikipedia.org/wiki/Lipopolysaccharide "Lipopolysaccharide") (LPS) present in the cell wall of [gram-negative bacteria](https://en.wikipedia.org/wiki/Gram-negative_bacteria "Gram-negative bacteria"). According to one mechanism of pyrogen action, an immune system protein, [lipopolysaccharide-binding protein](https://en.wikipedia.org/wiki/Lipopolysaccharide-binding_protein "Lipopolysaccharide-binding protein") (LBP), binds to LPS, and the LBP–LPS complex then binds to a [CD14](https://en.wikipedia.org/wiki/CD14 "CD14") receptor on a [macrophage](https://en.wikipedia.org/wiki/Macrophage "Macrophage"). The LBP-LPS binding to CD14 results in cellular synthesis and release of various endogenous [cytokines](https://en.wikipedia.org/wiki/Cytokine "Cytokine"), e.g., interleukin 1 (IL-1), interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNFα). A further downstream event is activation of the [arachidonic acid pathway](https://en.wikipedia.org/wiki/Arachidonic_acid_pathway "Arachidonic acid pathway").[\[46\]](https://en.wikipedia.org/wiki/Fever#cite_note-46)
### Neural circuit mechanism with PGE2 action
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=9 "Edit section: Neural circuit mechanism with PGE2 action")\]
PGE2 release comes from the [arachidonic acid](https://en.wikipedia.org/wiki/Arachidonic_acid "Arachidonic acid") pathway. This pathway (as it relates to fever), is mediated by the [enzymes](https://en.wikipedia.org/wiki/Enzyme "Enzyme") [phospholipase A2](https://en.wikipedia.org/wiki/Phospholipase "Phospholipase") (PLA2), [cyclooxygenase-2](https://en.wikipedia.org/wiki/Cyclooxygenase "Cyclooxygenase") (COX-2), and [prostaglandin E2 synthase](https://en.wikipedia.org/wiki/Prostaglandin_E2_synthase "Prostaglandin E2 synthase"). These enzymes ultimately mediate the synthesis and release of PGE2.[\[47\]](https://en.wikipedia.org/wiki/Fever#cite_note-47)
PGE2 is the ultimate mediator of the febrile response. The setpoint temperature of the body will remain elevated until PGE2 is no longer present. PGE2 acts on neurons in the [preoptic area](https://en.wikipedia.org/wiki/Preoptic_area "Preoptic area") (POA) through the [prostaglandin E receptor 3](https://en.wikipedia.org/wiki/Prostaglandin_E_receptor_3 "Prostaglandin E receptor 3") (EP3).[\[48\]](https://en.wikipedia.org/wiki/Fever#cite_note-48)[\[49\]](https://en.wikipedia.org/wiki/Fever#cite_note-:1-49)[\[50\]](https://en.wikipedia.org/wiki/Fever#cite_note-50)[\[51\]](https://en.wikipedia.org/wiki/Fever#cite_note-:2-51) EP3-expressing neurons in the POA innervate the [dorsomedial hypothalamus](https://en.wikipedia.org/wiki/Dorsomedial_hypothalamus "Dorsomedial hypothalamus") (DMH),[\[52\]](https://en.wikipedia.org/wiki/Fever#cite_note-52)[\[53\]](https://en.wikipedia.org/wiki/Fever#cite_note-:3-53) the rostral [raphe](https://en.wikipedia.org/wiki/Raphe "Raphe") pallidus nucleus in the [medulla oblongata](https://en.wikipedia.org/wiki/Medulla_oblongata "Medulla oblongata") (rRPa),[\[49\]](https://en.wikipedia.org/wiki/Fever#cite_note-:1-49)[\[53\]](https://en.wikipedia.org/wiki/Fever#cite_note-:3-53) and the [paraventricular nucleus](https://en.wikipedia.org/wiki/Paraventricular_nucleus "Paraventricular nucleus") (PVN) of the [hypothalamus](https://en.wikipedia.org/wiki/Hypothalamus "Hypothalamus").[\[54\]](https://en.wikipedia.org/wiki/Fever#cite_note-54) Under normal conditions, EP3-expressing neurons in the POA are important [thermoregulatory](https://en.wikipedia.org/wiki/Thermoregulation "Thermoregulation") neurons, which provide continuous inhibitory signals with the transmitter [GABA](https://en.wikipedia.org/wiki/GABA "GABA") to control [sympathetic](https://en.wikipedia.org/wiki/Sympathetic_nervous_system "Sympathetic nervous system") output neurons in the DMH and rRPa, thereby performing bidirectional regulation of basal body temperature.[\[51\]](https://en.wikipedia.org/wiki/Fever#cite_note-:2-51) During infection, PGE2 produced in the brain inhibits the activity of EP3-expressing neurons in the POA to attenuate the inhibition of sympathetic output, and thereby activates the sympathetic output system, which evokes non-shivering thermogenesis to produce body heat and skin vasoconstriction to decrease heat loss from the body surface, leading to fever.[\[51\]](https://en.wikipedia.org/wiki/Fever#cite_note-:2-51) It is presumed that the innervation from the POA to the PVN mediates the neuroendocrine effects of fever through the pathway involving [pituitary gland](https://en.wikipedia.org/wiki/Pituitary_gland "Pituitary gland") and various [endocrine organs](https://en.wikipedia.org/wiki/Endocrine_organs "Endocrine organs").
## Diagnosis
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=10 "Edit section: Diagnosis")\]
| | |
|---|---|
| Temperature classification | |
| | |
| | [Core](https://en.wikipedia.org/wiki/Core_temperature#Core_temperature "Core temperature") (rectal, esophageal, etc.) |
| [Hypothermia](https://en.wikipedia.org/wiki/Hypothermia "Hypothermia") | \<35.0 °C (95.0 °F)[\[55\]](https://en.wikipedia.org/wiki/Fever#cite_note-Rosen-55) |
| [Normal](https://en.wikipedia.org/wiki/Human_body_temperature "Human body temperature") | 36\.5–37.5 °C (97.7–99.5 °F)[\[56\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid18788094-56)[\[57\]](https://en.wikipedia.org/wiki/Fever#cite_note-57) |
| [Fever]() | \>37.5 or 38.3 °C (99.5 or 100.9 °F)[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1)[\[8\]](https://en.wikipedia.org/wiki/Fever#cite_note-CC09-8) |
| [Hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia") | \>37.5 or 38.3 °C (99.5 or 100.9 °F)[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1)[\[8\]](https://en.wikipedia.org/wiki/Fever#cite_note-CC09-8) |
| [Hyperpyrexia](https://en.wikipedia.org/wiki/Fever#Hyperpyrexia) | \>40.0 or 41.0 °C (104.0 or 105.8 °F)[\[58\]](https://en.wikipedia.org/wiki/Fever#cite_note-58)[\[59\]](https://en.wikipedia.org/wiki/Fever#cite_note-59) |
| Note: The difference between fever and hyperthermia is the underlying mechanism. Different sources have different cut-offs for fever, hyperthermia and hyperpyrexia. | |
| [v](https://en.wikipedia.org/wiki/Template:HumanTemperature "Template:HumanTemperature") [t](https://en.wikipedia.org/wiki/Template_talk:HumanTemperature "Template talk:HumanTemperature") [e](https://en.wikipedia.org/wiki/Special:EditPage/Template:HumanTemperature "Special:EditPage/Template:HumanTemperature") | |
A range for [normal temperatures](https://en.wikipedia.org/wiki/Normal_human_body_temperature "Normal human body temperature") has been found.[\[8\]](https://en.wikipedia.org/wiki/Fever#cite_note-CC09-8) Central temperatures, such as rectal temperatures, are more accurate than peripheral temperatures.[\[60\]](https://en.wikipedia.org/wiki/Fever#cite_note-Niven2015-60) Fever is generally agreed to be present if the elevated temperature[\[61\]](https://en.wikipedia.org/wiki/Fever#cite_note-61) is caused by a raised set point and:
- Temperature in the [anus](https://en.wikipedia.org/wiki/Human_anus "Human anus") (rectum/rectal) is at or over 37.5–38.3 °C (99.5–100.9 °F).[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1)[\[8\]](https://en.wikipedia.org/wiki/Fever#cite_note-CC09-8) An [ear](https://en.wikipedia.org/wiki/Ear "Ear") (tympanic) or [forehead](https://en.wikipedia.org/wiki/Forehead "Forehead") (temporal) temperature may also be used.[\[62\]](https://en.wikipedia.org/wiki/Fever#cite_note-62)[\[63\]](https://en.wikipedia.org/wiki/Fever#cite_note-63)
- Temperature in the mouth (oral) is at or over 37.2 °C (99.0 °F) in the morning or over 37.7 °C (99.9 °F) in the afternoon[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[64\]](https://en.wikipedia.org/wiki/Fever#cite_note-Reiew09-64)
- Temperature under the arm (axillary) is usually about 0.6 °C (1.1 °F) below core body temperature.[\[65\]](https://en.wikipedia.org/wiki/Fever#cite_note-Pecoraro_Petri_Costantino_Squizzato_pp._1071%E2%80%931083-65)
In adults, the [normal range](https://en.wikipedia.org/wiki/Normal_human_body_temperature "Normal human body temperature") of temperatures in healthy individuals is 36.32–37.76 °C (97.4–100.0 °F) (rectal), 35.76–37.52 °C (96.4–99.5 °F) ([ear](https://en.wikipedia.org/wiki/Tympanic_membrane "Tympanic membrane")), 35.61–37.61 °C (96.1–99.7 °F) (urine), 35.73–37.41 °C (96.3–99.3 °F) (oral), and 35.01–36.93 °C (95.0–98.5 °F) (axillary), with no significant gender differences.[\[66\]](https://en.wikipedia.org/wiki/Fever#cite_note-geneva2019-66)
Normal body temperatures vary depending on many factors, including age, sex, time of day, ambient temperature, activity level, and more.[\[67\]](https://en.wikipedia.org/wiki/Fever#cite_note-Garami-67)[\[68\]](https://en.wikipedia.org/wiki/Fever#cite_note-68) Normal daily temperature variation has been described as 0.5 °C (0.9 °F).[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7): 4012 A raised temperature is not always a fever.[\[67\]](https://en.wikipedia.org/wiki/Fever#cite_note-Garami-67) For example, the temperature rises in healthy people when they exercise, but this is not considered a fever, as the set point is normal.[\[67\]](https://en.wikipedia.org/wiki/Fever#cite_note-Garami-67) On the other hand, a "normal" temperature may be a fever, if it is unusually high for that person; for example, [medically frail](https://en.wikipedia.org/wiki/Medically_frail "Medically frail") elderly people have a decreased ability to generate body heat, so a "normal" temperature of 37.3 °C (99.1 °F) may represent a clinically significant fever.[\[67\]](https://en.wikipedia.org/wiki/Fever#cite_note-Garami-67)[\[69\]](https://en.wikipedia.org/wiki/Fever#cite_note-69)
### Associated conditions
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=11 "Edit section: Associated conditions")\]
Fever is a common [symptom](https://en.wikipedia.org/wiki/Symptom "Symptom") of many medical conditions:
- [Infectious disease](https://en.wikipedia.org/wiki/Infectious_disease "Infectious disease"), e.g., [COVID-19](https://en.wikipedia.org/wiki/COVID-19 "COVID-19"),[\[14\]](https://en.wikipedia.org/wiki/Fever#cite_note-Rod2020-14) [dengue](https://en.wikipedia.org/wiki/Dengue "Dengue"), [Ebola](https://en.wikipedia.org/wiki/Ebola_virus_disease "Ebola virus disease"), [gastroenteritis](https://en.wikipedia.org/wiki/Gastroenteritis "Gastroenteritis"), [HIV](https://en.wikipedia.org/wiki/HIV "HIV"), [influenza](https://en.wikipedia.org/wiki/Influenza "Influenza"), [Lyme disease](https://en.wikipedia.org/wiki/Lyme_disease "Lyme disease"), [rocky mountain spotted fever](https://en.wikipedia.org/wiki/Rocky_mountain_spotted_fever "Rocky mountain spotted fever"), [secondary syphilis](https://en.wikipedia.org/wiki/Syphilis#Secondary "Syphilis"), [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria"), [mononucleosis](https://en.wikipedia.org/wiki/Infectious_mononucleosis "Infectious mononucleosis"), as well as infections of the skin, e.g., [abscesses](https://en.wikipedia.org/wiki/Abscess "Abscess") and [boils](https://en.wikipedia.org/wiki/Boils "Boils").[\[70\]](https://en.wikipedia.org/wiki/Fever#cite_note-70)[\[71\]](https://en.wikipedia.org/wiki/Fever#cite_note-71)[\[72\]](https://en.wikipedia.org/wiki/Fever#cite_note-72)[\[73\]](https://en.wikipedia.org/wiki/Fever#cite_note-73)[\[74\]](https://en.wikipedia.org/wiki/Fever#cite_note-74)[\[75\]](https://en.wikipedia.org/wiki/Fever#cite_note-75)
- [Immunological](https://en.wikipedia.org/wiki/Immunology "Immunology") diseases, e.g., [relapsing polychondritis](https://en.wikipedia.org/wiki/Relapsing_polychondritis "Relapsing polychondritis"),[\[76\]](https://en.wikipedia.org/wiki/Fever#cite_note-Puechal_2014-76) [autoimmune hepatitis](https://en.wikipedia.org/wiki/Autoimmune_hepatitis "Autoimmune hepatitis"), [granulomatosis with polyangiitis](https://en.wikipedia.org/wiki/Granulomatosis_with_polyangiitis "Granulomatosis with polyangiitis"), [Horton disease](https://en.wikipedia.org/wiki/Horton_disease "Horton disease"), [inflammatory bowel diseases](https://en.wikipedia.org/wiki/Inflammatory_bowel_disease "Inflammatory bowel disease"), [Kawasaki disease](https://en.wikipedia.org/wiki/Kawasaki_disease "Kawasaki disease"), [lupus erythematosus](https://en.wikipedia.org/wiki/Lupus_erythematosus "Lupus erythematosus"), [sarcoidosis](https://en.wikipedia.org/wiki/Sarcoidosis "Sarcoidosis"), [Still's disease](https://en.wikipedia.org/wiki/Adult-onset_Still%27s_disease "Adult-onset Still's disease"), [rheumatoid arthritis](https://en.wikipedia.org/wiki/Rheumatoid_arthritis "Rheumatoid arthritis"), [lymphoproliferative disorders](https://en.wikipedia.org/wiki/Lymphoproliferative_disorders "Lymphoproliferative disorders") and [psoriasis](https://en.wikipedia.org/wiki/Psoriasis "Psoriasis");\[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
- Tissue destruction, as a result of [cerebral bleeding](https://en.wikipedia.org/wiki/Cerebral_hemorrhage "Cerebral hemorrhage"), [crush syndrome](https://en.wikipedia.org/wiki/Crush_syndrome "Crush syndrome"), [hemolysis](https://en.wikipedia.org/wiki/Hemolysis "Hemolysis"), [infarction](https://en.wikipedia.org/wiki/Infarction "Infarction"), [rhabdomyolysis](https://en.wikipedia.org/wiki/Rhabdomyolysis "Rhabdomyolysis"), [surgery](https://en.wikipedia.org/wiki/Surgery "Surgery"), etc.;[\[77\]](https://en.wikipedia.org/wiki/Fever#cite_note-77)[\[78\]](https://en.wikipedia.org/wiki/Fever#cite_note-78)
- [Cancers](https://en.wikipedia.org/wiki/Cancer "Cancer"), particularly blood cancers such as [leukemia](https://en.wikipedia.org/wiki/Leukemia "Leukemia") and [lymphomas](https://en.wikipedia.org/wiki/Lymphoma "Lymphoma");[\[79\]](https://en.wikipedia.org/wiki/Fever#cite_note-79)
- [Metabolic disorders](https://en.wikipedia.org/wiki/Metabolic_disorder "Metabolic disorder"), e.g., [gout](https://en.wikipedia.org/wiki/Gout "Gout"), and [porphyria](https://en.wikipedia.org/wiki/Porphyria "Porphyria");[\[80\]](https://en.wikipedia.org/wiki/Fever#cite_note-80)
- Inherited metabolic disorder, e.g., [Fabry disease](https://en.wikipedia.org/wiki/Fabry_disease "Fabry disease").[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)
Adult and pediatric manifestations for the same disease may differ; for instance, in [COVID-19](https://en.wikipedia.org/wiki/COVID-19 "COVID-19"), one metastudy describes 92.8% of adults versus 43.9% of children presenting with fever.[\[14\]](https://en.wikipedia.org/wiki/Fever#cite_note-Rod2020-14)
In addition, fever can result from a reaction to an incompatible blood product.[\[81\]](https://en.wikipedia.org/wiki/Fever#cite_note-81)
## Types
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=12 "Edit section: Types")\]
[](https://en.wikipedia.org/wiki/File:Fever_Patterns_v1.2.svg)
Different fever patterns observed in *Plasmodium* infections
Various patterns of measured patient temperatures have been observed, some of which may be indicative of a particular [medical diagnosis](https://en.wikipedia.org/wiki/Medical_diagnosis "Medical diagnosis"):
- [Continuous fever](https://en.wikipedia.org/wiki/Continuous_fever "Continuous fever"), where temperature remains above normal and does not fluctuate more than 1 °C in 24 hours[\[82\]](https://en.wikipedia.org/wiki/Fever#cite_note-82) (e.g. in [bacterial pneumonia](https://en.wikipedia.org/wiki/Bacterial_pneumonia "Bacterial pneumonia"), [typhoid fever](https://en.wikipedia.org/wiki/Typhoid_fever "Typhoid fever"), [infective endocarditis](https://en.wikipedia.org/wiki/Infective_endocarditis "Infective endocarditis"), [tuberculosis](https://en.wikipedia.org/wiki/Tuberculosis "Tuberculosis"), or [typhus](https://en.wikipedia.org/wiki/Typhus "Typhus")).[\[83\]](https://en.wikipedia.org/wiki/Fever#cite_note-83)[\[84\]](https://en.wikipedia.org/wiki/Fever#cite_note-84)
- [Intermittent fever](https://en.wikipedia.org/wiki/Intermittent_fever "Intermittent fever") is present only for a certain period, later cycling back to normal (e.g., in [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria"), [leishmaniasis](https://en.wikipedia.org/wiki/Visceral_leishmaniasis "Visceral leishmaniasis"), [pyemia](https://en.wikipedia.org/wiki/Pyemia "Pyemia"), [sepsis](https://en.wikipedia.org/wiki/Sepsis "Sepsis"),[\[85\]](https://en.wikipedia.org/wiki/Fever#cite_note-85) or [African trypanosomiasis](https://en.wikipedia.org/wiki/African_trypanosomiasis "African trypanosomiasis")).[\[86\]](https://en.wikipedia.org/wiki/Fever#cite_note-86)
- [Remittent fever](https://en.wikipedia.org/wiki/Remittent_fever "Remittent fever"), where the temperature remains above normal throughout the day and fluctuates more than 1 °C in 24 hours (e.g., in [infective endocarditis](https://en.wikipedia.org/wiki/Infective_endocarditis "Infective endocarditis") or [brucellosis](https://en.wikipedia.org/wiki/Brucellosis "Brucellosis")).[\[87\]](https://en.wikipedia.org/wiki/Fever#cite_note-87)
- [Pel–Ebstein fever](https://en.wikipedia.org/wiki/Pel%E2%80%93Ebstein_fever "Pel–Ebstein fever") is a cyclic fever that is rarely seen in patients with [Hodgkin's lymphoma](https://en.wikipedia.org/wiki/Hodgkin%27s_lymphoma "Hodgkin's lymphoma").\[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
- Undulant fever, seen in [brucellosis](https://en.wikipedia.org/wiki/Brucellosis "Brucellosis").\[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
- [Typhoid fever](https://en.wikipedia.org/wiki/Typhoid_fever "Typhoid fever") is a [continuous fever](https://en.wikipedia.org/wiki/Continuous_fever "Continuous fever") showing a characteristic *step-ladder pattern,* a step-wise increase in temperature with a high plateau.[\[88\]](https://en.wikipedia.org/wiki/Fever#cite_note-88)
Among the types of intermittent fever are ones specific to cases of malaria caused by different pathogens. These are:[\[89\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ferri_2009-89)[\[90\]](https://en.wikipedia.org/wiki/Fever#cite_note-90)
- Quotidian fever, with a 24-hour periodicity, typical of [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria") caused by *[Plasmodium knowlesi](https://en.wikipedia.org/wiki/Plasmodium_knowlesi "Plasmodium knowlesi")* (*P. knowlesi*);[\[91\]](https://en.wikipedia.org/wiki/Fever#cite_note-91)[\[92\]](https://en.wikipedia.org/wiki/Fever#cite_note-92)
- [Tertian fever](https://en.wikipedia.org/wiki/Tertian_fever "Tertian fever"), with a 48-hour periodicity, typical of later course [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria") caused by *[P. falciparum](https://en.wikipedia.org/wiki/Plasmodium_falciparum "Plasmodium falciparum")*, *[P. vivax](https://en.wikipedia.org/wiki/Plasmodium_vivax "Plasmodium vivax")*, or *[P. ovale](https://en.wikipedia.org/wiki/Plasmodium_ovale "Plasmodium ovale")*;[\[89\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ferri_2009-89)
- [Quartan fever](https://en.wikipedia.org/wiki/Quartan_fever "Quartan fever"), with a 72-hour periodicity, typical of later course [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria") caused by *[P. malariae](https://en.wikipedia.org/wiki/Plasmodium_malariae "Plasmodium malariae")*.[\[89\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ferri_2009-89)
In addition, there is disagreement regarding whether a specific fever pattern is associated with [Hodgkin's lymphoma](https://en.wikipedia.org/wiki/Hodgkin%27s_lymphoma "Hodgkin's lymphoma")—the [Pel–Ebstein fever](https://en.wikipedia.org/wiki/Pel%E2%80%93Ebstein_fever "Pel–Ebstein fever"), with patients argued to present high temperature for one week, followed by low for the next week, and so on, where the generality of this pattern is debated.[\[93\]](https://en.wikipedia.org/wiki/Fever#cite_note-93)[\[94\]](https://en.wikipedia.org/wiki/Fever#cite_note-94)
Persistent fever that cannot be explained after repeated routine clinical inquiries is called [fever of unknown origin](https://en.wikipedia.org/wiki/Fever_of_unknown_origin "Fever of unknown origin").[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[95\]](https://en.wikipedia.org/wiki/Fever#cite_note-95) A [neutropenic fever](https://en.wikipedia.org/wiki/Neutropenic_fever "Neutropenic fever"), also called febrile neutropenia, is a fever in the absence of normal immune system function.[\[96\]](https://en.wikipedia.org/wiki/Fever#cite_note-Klastersky_2014_13%E2%80%9326-96) Because of the lack of infection-fighting [neutrophils](https://en.wikipedia.org/wiki/Neutrophil "Neutrophil"), a bacterial infection can spread rapidly; this fever is, therefore, usually considered to require urgent medical attention.[\[97\]](https://en.wikipedia.org/wiki/Fever#cite_note-97) This kind of fever is more commonly seen in people receiving immune-suppressing [chemotherapy](https://en.wikipedia.org/wiki/Chemotherapy "Chemotherapy") than in apparently healthy people.[\[96\]](https://en.wikipedia.org/wiki/Fever#cite_note-Klastersky_2014_13%E2%80%9326-96)[\[98\]](https://en.wikipedia.org/wiki/Fever#cite_note-98)
### Hyperpyrexia
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=13 "Edit section: Hyperpyrexia")\]
Hyperpyrexia is an extreme elevation of [body temperature](https://en.wikipedia.org/wiki/Body_temperature "Body temperature") which, depending upon the source, is classified as a [core body temperature](https://en.wikipedia.org/wiki/Core_body_temperature "Core body temperature") greater than or equal to 40 or 41 °C (104 or 106 °F); the range of hyperpyrexia includes cases considered severe (≥ 40 °C) and extreme (≥ 42 °C).[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[99\]](https://en.wikipedia.org/wiki/Fever#cite_note-MDMA-Hyperpyrexia_systematic_review-99)[\[100\]](https://en.wikipedia.org/wiki/Fever#cite_note-Neurobiology_of_hyperthermia-100) It differs from [hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia") in that one's [thermoregulatory system's set point](https://en.wikipedia.org/wiki/Human_thermoregulation#Control_system "Human thermoregulation") for body temperature is set above normal, then heat is generated to achieve it. In contrast, hyperthermia involves body temperature rising above its set point due to outside factors.[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[101\]](https://en.wikipedia.org/wiki/Fever#cite_note-101) The high temperatures of hyperpyrexia are considered [medical emergencies](https://en.wikipedia.org/wiki/Medical_emergency "Medical emergency"), as they may indicate a serious underlying condition or lead to severe morbidity (including permanent [brain damage](https://en.wikipedia.org/wiki/Brain_damage "Brain damage")), or to death.[\[102\]](https://en.wikipedia.org/wiki/Fever#cite_note-EM01-102) A common cause of hyperpyrexia is an [intracranial hemorrhage](https://en.wikipedia.org/wiki/Intracranial_hemorrhage "Intracranial hemorrhage").[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7) Other causes in emergency room settings include [malignant catatonia](https://en.wikipedia.org/wiki/Catatonia "Catatonia"), [sepsis](https://en.wikipedia.org/wiki/Sepsis "Sepsis"), [Kawasaki syndrome](https://en.wikipedia.org/wiki/Kawasaki_syndrome "Kawasaki syndrome"),[\[103\]](https://en.wikipedia.org/wiki/Fever#cite_note-Marx_2006_2506-103) [neuroleptic malignant syndrome](https://en.wikipedia.org/wiki/Neuroleptic_malignant_syndrome "Neuroleptic malignant syndrome"), [drug overdose](https://en.wikipedia.org/wiki/Drug_overdose "Drug overdose"), [serotonin syndrome](https://en.wikipedia.org/wiki/Serotonin_syndrome "Serotonin syndrome"), and [thyroid storm](https://en.wikipedia.org/wiki/Thyroid_storm "Thyroid storm").[\[102\]](https://en.wikipedia.org/wiki/Fever#cite_note-EM01-102)
## Function
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=14 "Edit section: Function")\]
[](https://en.wikipedia.org/wiki/File:Fever-conceptual.svg)
Hyperthermia: Characterized on the left. Normal body temperature (thermoregulatory set point) is shown in green, while the hyperthermic temperature is shown in red. As can be seen, hyperthermia can be conceptualized as an increase above the thermoregulatory set point.
Hypothermia: Characterized in the center: Normal body temperature is shown in green, while the hypothermic temperature is shown in blue. As can be seen, hypothermia can be conceptualized as a decrease below the thermoregulatory set point.
Fever: Characterized on the right: Normal body temperature is shown in green. It reads "New Normal" because the thermoregulatory set point has risen. This has caused what was the normal body temperature (in blue) to be considered hypothermic.
### Immune function
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=15 "Edit section: Immune function")\]
Fever is thought to contribute to host defense,[\[17\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sch2006-17) as the reproduction of [pathogens](https://en.wikipedia.org/wiki/Pathogen "Pathogen") with strict temperature requirements can be hindered, and the rates of some important immunological reactions are increased by temperature.[\[104\]](https://en.wikipedia.org/wiki/Fever#cite_note-Fischler-104) Fever has been described in teaching texts as assisting the healing process in various ways, including:
- increased mobility of [leukocytes](https://en.wikipedia.org/wiki/Leukocytes "Leukocytes");[\[105\]](https://en.wikipedia.org/wiki/Fever#cite_note-Craven2003-105): 1044
- enhanced leukocyte [phagocytosis](https://en.wikipedia.org/wiki/Phagocytosis "Phagocytosis");[\[105\]](https://en.wikipedia.org/wiki/Fever#cite_note-Craven2003-105): 1030
- decreased [endotoxin](https://en.wikipedia.org/wiki/Endotoxin "Endotoxin") effects;[\[105\]](https://en.wikipedia.org/wiki/Fever#cite_note-Craven2003-105): 1029 and
- increased [proliferation](https://en.wikipedia.org/wiki/Cell_proliferation "Cell proliferation") of [T cells](https://en.wikipedia.org/wiki/T_cells "T cells").[\[105\]](https://en.wikipedia.org/wiki/Fever#cite_note-Craven2003-105): 1030 [\[106\]](https://en.wikipedia.org/wiki/Fever#cite_note-LewisDirksenHeitkemper2005-106): 212
### Advantages and disadvantages
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=16 "Edit section: Advantages and disadvantages")\]
A fever response to an infectious disease is generally regarded as protective, whereas fever in non-infections may be maladaptive.[\[107\]](https://en.wikipedia.org/wiki/Fever#cite_note-kiek-107)[\[108\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid9917881-108) Studies have not been consistent on whether treating fever generally worsens or improves mortality risk.[\[109\]](https://en.wikipedia.org/wiki/Fever#cite_note-SepticReview2017-109) Benefits or harms may depend on the type of infection, health status of the patient and other factors.[\[107\]](https://en.wikipedia.org/wiki/Fever#cite_note-kiek-107) Studies using [warm-blooded](https://en.wikipedia.org/wiki/Warm-blooded "Warm-blooded") [vertebrates](https://en.wikipedia.org/wiki/Vertebrates "Vertebrates") suggest that they recover more rapidly from infections or critical illness due to fever.[\[110\]](https://en.wikipedia.org/wiki/Fever#cite_note-VUB-110) In [sepsis](https://en.wikipedia.org/wiki/Sepsis "Sepsis"), fever is associated with reduced mortality.[\[111\]](https://en.wikipedia.org/wiki/Fever#cite_note-111)\[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
## Management
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=17 "Edit section: Management")\]
Fever does not necessarily need to be treated,[\[112\]](https://en.wikipedia.org/wiki/Fever#cite_note-112) and most people with a fever recover without specific medical attention.[\[113\]](https://en.wikipedia.org/wiki/Fever#cite_note-CDC_symptoms-113) Although it is unpleasant, fever rarely rises to a dangerous level even if untreated.[\[114\]](https://en.wikipedia.org/wiki/Fever#cite_note-114) Damage to the brain generally does not occur until temperatures reach 40.0 °C (104.0 °F), and it is rare for an untreated fever to exceed 40.6 °C (105.1 °F).[\[115\]](https://en.wikipedia.org/wiki/Fever#cite_note-revben-115) Treating fever in people with [sepsis](https://en.wikipedia.org/wiki/Sepsis "Sepsis") does not affect outcomes.[\[116\]](https://en.wikipedia.org/wiki/Fever#cite_note-116) Small trials have shown no benefit of treating fevers of 38.5 °C (101.3 °F) or higher of critically ill patients in ICUs, and one trial was terminated early because patients receiving aggressive fever treatment were dying more often.[\[19\]](https://en.wikipedia.org/wiki/Fever#cite_note-:0-19)
According to the NIH, the two assumptions which are generally used to argue in favor of treating fevers have not been experimentally validated. These are that (1) a fever is noxious, and (2) suppression of a fever will reduce its noxious effect. Most of the other studies supporting the association of fever with poorer outcomes have been observational in nature. In theory, these critically ill patients and those faced with additional physiologic stress may benefit from fever reduction, but the evidence on both sides of the argument appears to be mostly equivocal.[\[19\]](https://en.wikipedia.org/wiki/Fever#cite_note-:0-19)
### Conservative measures
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=18 "Edit section: Conservative measures")\]
Limited evidence supports sponging or bathing feverish children with tepid water.[\[117\]](https://en.wikipedia.org/wiki/Fever#cite_note-117) The use of a [fan](https://en.wikipedia.org/wiki/Mechanical_fan "Mechanical fan") or air conditioning may somewhat reduce the temperature and increase comfort. If the temperature reaches the extremely high level of [hyperpyrexia](https://en.wikipedia.org/wiki/Hyperpyrexia "Hyperpyrexia"), aggressive cooling is required (generally produced mechanically via [conduction](https://en.wikipedia.org/wiki/Conduction_\(heat\) "Conduction (heat)") by applying numerous ice packs across most of the body or direct submersion in [ice water](https://en.wikipedia.org/wiki/Ice_bath "Ice bath")).[\[102\]](https://en.wikipedia.org/wiki/Fever#cite_note-EM01-102) In general, people are advised to keep adequately hydrated.[\[118\]](https://en.wikipedia.org/wiki/Fever#cite_note-118) Whether increased fluid intake improves symptoms or shortens respiratory illnesses such as the [common cold](https://en.wikipedia.org/wiki/Common_cold "Common cold") is not known.[\[119\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid21328268-119)
### Medications
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=19 "Edit section: Medications")\]
Medications that lower fevers are called *[antipyretics](https://en.wikipedia.org/wiki/Antipyretic "Antipyretic")*.[\[120\]](https://en.wikipedia.org/wiki/Fever#cite_note-120) The antipyretic [ibuprofen](https://en.wikipedia.org/wiki/Ibuprofen "Ibuprofen") is effective in reducing fevers in children.[\[121\]](https://en.wikipedia.org/wiki/Fever#cite_note-Per2004-121) It is more effective than [acetaminophen](https://en.wikipedia.org/wiki/Acetaminophen "Acetaminophen") (paracetamol) in children.[\[121\]](https://en.wikipedia.org/wiki/Fever#cite_note-Per2004-121) Ibuprofen and acetaminophen may safely be used together in children with fevers.[\[122\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid19454182-122)[\[123\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid19606950-123) The efficacy of acetaminophen by itself in children with fevers has been questioned.[\[124\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid12076499-124) Ibuprofen is also superior to [aspirin](https://en.wikipedia.org/wiki/Aspirin "Aspirin") in children with fevers.[\[125\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid9049576-125) Additionally, [aspirin](https://en.wikipedia.org/wiki/Aspirin "Aspirin") is not recommended in those under the age of 18 due to the risk of [Reye's syndrome](https://en.wikipedia.org/wiki/Reye%27s_syndrome "Reye's syndrome").[\[126\]](https://en.wikipedia.org/wiki/Fever#cite_note-126)
Using both paracetamol and ibuprofen at the same time or alternating between the two is more effective at decreasing fever than using only paracetamol or ibuprofen.[\[127\]](https://en.wikipedia.org/wiki/Fever#cite_note-Wong2013-127) It is not clear if it increases child comfort.[\[127\]](https://en.wikipedia.org/wiki/Fever#cite_note-Wong2013-127) Response or nonresponse to medications does not predict whether or not a child has a serious illness.[\[128\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid23846358-128)
With respect to the effect of antipyretics on the risk of death in those with infection, studies have found mixed results, as of 2019.[\[129\]](https://en.wikipedia.org/wiki/Fever#cite_note-129)
## Epidemiology
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=20 "Edit section: Epidemiology")\]
Fever is one of the most common [medical signs](https://en.wikipedia.org/wiki/Medical_signs "Medical signs").[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2) It is part of about 30% of healthcare visits by children,[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2) and occurs in up to 75% of adults who are seriously sick.[\[11\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ki2013-11) About 5% of people who go to an emergency room have a fever.[\[130\]](https://en.wikipedia.org/wiki/Fever#cite_note-EMP2012-130)
## History
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=21 "Edit section: History")\]
A number of types of fever were known as early as 460 BC to 370 BC when [Hippocrates](https://en.wikipedia.org/wiki/Hippocrates "Hippocrates") was practicing medicine including that due to [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria") (tertian or every 2 days and quartan or every 3 days).[\[131\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sajadi2012-131) It also became clear around this time that fever was a symptom of disease rather than a disease in and of itself.[\[131\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sajadi2012-131)
Infections presenting with fever were a major source of mortality in humans for about 200,000 years. Until the late nineteenth century, approximately half of all humans died from infections before the age of fifteen.[\[132\]](https://en.wikipedia.org/wiki/Fever#cite_note-132)
An older term, [febricula](https://en.wiktionary.org/wiki/febricula "wikt:febricula") (a [diminutive](https://en.wikipedia.org/wiki/Diminutive "Diminutive") form of the [Latin](https://en.wikipedia.org/wiki/Latin_language "Latin language") word for fever), was once used to refer to a low-grade fever lasting only a few days. This term fell out of use in the early 20th century, and the symptoms it referred to are now thought to have been caused mainly by various minor [viral](https://en.wikipedia.org/wiki/Virus "Virus") [respiratory infections](https://en.wikipedia.org/wiki/Respiratory_infection "Respiratory infection").[\[133\]](https://en.wikipedia.org/wiki/Fever#cite_note-133)
## Society and culture
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=22 "Edit section: Society and culture")\]
### Mythology
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=23 "Edit section: Mythology")\]
[](https://en.wikipedia.org/wiki/File:Virgil_Solis_Febris.jpg)
Febris
- [Febris](https://en.wikipedia.org/wiki/Febris "Febris") (*fever* in [Latin](https://en.wikipedia.org/wiki/Latin "Latin")) is the goddess of fever in [Roman mythology](https://en.wikipedia.org/wiki/Roman_mythology "Roman mythology"). People with fevers would visit her temples.
- Tertiana and Quartana are the goddesses of tertian and quartan fevers of malaria in Roman mythology.[\[134\]](https://en.wikipedia.org/wiki/Fever#cite_note-134)
- [Jvarasura](https://en.wikipedia.org/wiki/Jvarasura "Jvarasura") (*fever-demon* in [Hindi](https://en.wikipedia.org/wiki/Hindi "Hindi")) is the personification of fever and disease in [Hindu](https://en.wikipedia.org/wiki/Hindu_mythology "Hindu mythology") and [Buddhist mythology](https://en.wikipedia.org/wiki/Buddhist_mythology "Buddhist mythology").
### Pediatrics
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=24 "Edit section: Pediatrics")\]
Fever is often viewed with greater concern by parents and healthcare professionals than might be deserved, a phenomenon known as fever phobia,[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2)[\[135\]](https://en.wikipedia.org/wiki/Fever#cite_note-Crocetti2001-135) which is based in both caregiver's and parents' misconceptions about fever in children. Among them, many parents incorrectly believe that fever is a [disease](https://en.wikipedia.org/wiki/Disease "Disease") rather than a [medical sign](https://en.wikipedia.org/wiki/Medical_sign "Medical sign"), that even low fevers are harmful, and that any temperature even briefly or slightly above the oversimplified "normal" number marked on a thermometer is a clinically significant fever.[\[135\]](https://en.wikipedia.org/wiki/Fever#cite_note-Crocetti2001-135) They are also afraid of harmless side effects like [febrile seizures](https://en.wikipedia.org/wiki/Febrile_seizure "Febrile seizure") and dramatically overestimate the likelihood of permanent damage from typical fevers.[\[135\]](https://en.wikipedia.org/wiki/Fever#cite_note-Crocetti2001-135) The underlying problem, according to professor of pediatrics Barton D. Schmitt, is that "as parents we tend to suspect that our children's brains may melt."[\[136\]](https://en.wikipedia.org/wiki/Fever#cite_note-136) As a result of these misconceptions parents are anxious, give the child fever-reducing medicine when the temperature is technically normal or only slightly elevated, and interfere with the child's sleep to give the child more medicine.[\[135\]](https://en.wikipedia.org/wiki/Fever#cite_note-Crocetti2001-135)
## Other animals
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=25 "Edit section: Other animals")\]
Main article: [Thermoregulation](https://en.wikipedia.org/wiki/Thermoregulation "Thermoregulation")
Fever is an important metric for the [diagnosis](https://en.wikipedia.org/wiki/Medical_diagnosis "Medical diagnosis") of [disease in domestic animals](https://en.wikipedia.org/wiki/Livestock_disease "Livestock disease"). The body temperature of animals, which is taken rectally, is different from one species to another. For example, a [horse](https://en.wikipedia.org/wiki/Horse "Horse") is said to have a fever above 101 °F (38\.3 °C).[\[137\]](https://en.wikipedia.org/wiki/Fever#cite_note-137) In species that allow the body to have a wide range of "normal" temperatures, such as [camels](https://en.wikipedia.org/wiki/Camel "Camel"),[\[138\]](https://en.wikipedia.org/wiki/Fever#cite_note-138) whose body temperature varies as the environmental temperature varies,[\[139\]](https://en.wikipedia.org/wiki/Fever#cite_note-139) the body temperature which constitutes a febrile state differs depending on the environmental temperature.[\[140\]](https://en.wikipedia.org/wiki/Fever#cite_note-140) Fever can also be behaviorally induced by invertebrates that do not have immune-system based fever. For instance, some species of grasshopper will thermoregulate to achieve body temperatures that are 2–5 °C higher than normal in order to inhibit the growth of fungal pathogens such as *[Beauveria bassiana](https://en.wikipedia.org/wiki/Beauveria_bassiana "Beauveria bassiana")* and *[Metarhizium acridum](https://en.wikipedia.org/wiki/Metarhizium_acridum "Metarhizium acridum")*.[\[141\]](https://en.wikipedia.org/wiki/Fever#cite_note-Thomas2003-141) Honeybee colonies are also able to induce a fever in response to a fungal parasite *Ascosphaera apis*.[\[141\]](https://en.wikipedia.org/wiki/Fever#cite_note-Thomas2003-141)
## References
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=26 "Edit section: References")\]
1. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-2) [***d***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-3) [***e***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-4) [***f***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-5) [***g***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-6) [***h***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-7) [***i***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-8)
Axelrod YK, Diringer MN (May 2008). "Temperature management in acute neurologic disorders". *Neurologic Clinics*. **26** (2): 585–603, xi. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.ncl.2008.02.005](https://doi.org/10.1016%2Fj.ncl.2008.02.005). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [18514828](https://pubmed.ncbi.nlm.nih.gov/18514828).
2. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-2) [***d***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-3) [***e***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-4) [***f***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-5) [***g***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-6) [***h***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-7) [***i***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-8) [***j***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-9) [***k***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-10) [***l***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-11)
Sullivan JE, Farrar HC (March 2011). ["Fever and antipyretic use in children"](https://doi.org/10.1542%2Fpeds.2010-3852). *Pediatrics*. **127** (3) e20103852: 580–587\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1542/peds.2010-3852](https://doi.org/10.1542%2Fpeds.2010-3852). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [21357332](https://pubmed.ncbi.nlm.nih.gov/21357332).
3. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Sue2014_3-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Sue2014_3-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Sue2014_3-2)
Huether, Sue E. (2014). [*Pathophysiology: The Biologic Basis for Disease in Adults and Children*](https://books.google.com/books?id=l9XsAwAAQBAJ&pg=PA498) (7th ed.). Elsevier Health Sciences. p. 498. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-0-323-29375-4](https://en.wikipedia.org/wiki/Special:BookSources/978-0-323-29375-4 "Special:BookSources/978-0-323-29375-4")
.
4. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-CDC2010_4-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-CDC2010_4-1)
CDC Staff (31 March 2020). ["Taking Care of Someone Who is Sick: Caring for Someone Sick at Home"](https://web.archive.org/web/20150324084355/http://www.cdc.gov/flu/homecare/treatfever.htm). Archived from [the original](https://www.cdc.gov/flu/homecare/treatfever.htm) on 24 March 2015. Retrieved 8 May 2015.
5. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Kl2015_5-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Kl2015_5-1)
Kluger MJ (2015). [*Fever: Its Biology, Evolution, and Function*](https://books.google.com/books?id=gIF9BgAAQBAJ&pg=PA57). Princeton University Press. p. 57. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-1-4008-6983-1](https://en.wikipedia.org/wiki/Special:BookSources/978-1-4008-6983-1 "Special:BookSources/978-1-4008-6983-1")
.
6. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Gar2012p375_6-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Gar2012p375_6-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Gar2012p375_6-2)
Garmel GM, Mahadevan SV, eds. (2012). ["Fever in adults"](https://books.google.com/books?id=pyAlcOfBhjIC&q=An%20Introduction%20to%20Clinical%20Emergency%20Medicine&pg=PA375). *An introduction to clinical emergency medicine* (2nd ed.). Cambridge: Cambridge University Press. p. 375. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-0-521-74776-9](https://en.wikipedia.org/wiki/Special:BookSources/978-0-521-74776-9 "Special:BookSources/978-0-521-74776-9")
.
7. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-2) [***d***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-3) [***e***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-4) [***f***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-5) [***g***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-6) [***h***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-7) [***i***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-8) [***j***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-9) [***k***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-10) [***l***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-11) [***m***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-12) [***n***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-13) [***o***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-14) [***p***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-15)
Dinarello CA, Porat R (2018). "Chapter 15: Fever". In Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo, J (eds.). [*Harrison's Principles of Internal Medicine*](https://books.google.com/books?id=XGQntQEACAAJ&q=9781259644030). Vol. 1–2 (20th ed.). New York: McGraw-Hill. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-1-259-64403-0](https://en.wikipedia.org/wiki/Special:BookSources/978-1-259-64403-0 "Special:BookSources/978-1-259-64403-0")
. Retrieved 31 March 2020.
8. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-CC09_8-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-CC09_8-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-CC09_8-2) [***d***](https://en.wikipedia.org/wiki/Fever#cite_ref-CC09_8-3) [***e***](https://en.wikipedia.org/wiki/Fever#cite_ref-CC09_8-4) [***f***](https://en.wikipedia.org/wiki/Fever#cite_ref-CC09_8-5)
Laupland KB (July 2009). "Fever in the critically ill medical patient". *Critical Care Medicine*. **37** (7 Suppl): S273-8. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1097/CCM.0b013e3181aa6117](https://doi.org/10.1097%2FCCM.0b013e3181aa6117). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [19535958](https://pubmed.ncbi.nlm.nih.gov/19535958).
9. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ric2015_9-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ric2015_9-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ric2015_9-2) [***d***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ric2015_9-3) [***e***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ric2015_9-4)
Richardson M, Purssell E (September 2015). "Who's afraid of fever?". *Archives of Disease in Childhood*. **100** (9): 818–820\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1136/archdischild-2014-307483](https://doi.org/10.1136%2Farchdischild-2014-307483). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [25977564](https://pubmed.ncbi.nlm.nih.gov/25977564). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [206857750](https://api.semanticscholar.org/CorpusID:206857750).
10. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Gar2012_10-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Gar2012_10-1)
Garmel GM, Mahadevan SV, eds. (2012). *An introduction to clinical emergency medicine* (2nd ed.). Cambridge: Cambridge University Press. p. 401. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-0-521-74776-9](https://en.wikipedia.org/wiki/Special:BookSources/978-0-521-74776-9 "Special:BookSources/978-0-521-74776-9")
.
11. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ki2013_11-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ki2013_11-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ki2013_11-2)
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Franjić, Siniša (31 March 2019). ["Fever Can Be A Symptom of Many Diseases"](https://doi.org/10.47363%2Fjmhc%2F2021%283%29146). *Journal of Medicine and HealthCare*: 1–3\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.47363/jmhc/2021(3)146](https://doi.org/10.47363%2Fjmhc%2F2021%283%29146). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [243837498](https://api.semanticscholar.org/CorpusID:243837498).
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Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, Alvarado-Arnez LE, Bonilla-Aldana DK, Franco-Paredes C (13 March 2020). ["Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102608). *Travel Medicine and Infectious Disease*. **34** 101623. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.tmaid.2020.101623](https://doi.org/10.1016%2Fj.tmaid.2020.101623). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [7102608](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102608). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [32179124](https://pubmed.ncbi.nlm.nih.gov/32179124).
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Dayal R, Agarwal D (January 2016). "Fever in Children and Fever of Unknown Origin". *Indian Journal of Pediatrics*. **83** (1): 38–43\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1007/s12098-015-1724-4](https://doi.org/10.1007%2Fs12098-015-1724-4). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [25724501](https://pubmed.ncbi.nlm.nih.gov/25724501). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [34481402](https://api.semanticscholar.org/CorpusID:34481402).
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["Fever"](https://www.medlineplus.gov/ency/article/003090.htm). *MedlinePlus*. 30 August 2014. [Archived](https://web.archive.org/web/20090511181606/http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm) from the original on 11 May 2009.
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Schaffner A (March 2006). "Fieber – nützliches oder schädliches, zu behandelndes Symptom?" \[Fever–useful or noxious symptom that should be treated?\]. *Therapeutische Umschau* (in German). **63** (3): 185–188\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1024/0040-5930.63.3.185](https://doi.org/10.1024%2F0040-5930.63.3.185). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [16613288](https://pubmed.ncbi.nlm.nih.gov/16613288).
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Niven DJ, Stelfox HT, Laupland KB (June 2013). "Antipyretic therapy in febrile critically ill adults: A systematic review and meta-analysis". *Journal of Critical Care*. **28** (3): 303–310\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.jcrc.2012.09.009](https://doi.org/10.1016%2Fj.jcrc.2012.09.009). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [23159136](https://pubmed.ncbi.nlm.nih.gov/23159136).
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Ray, Juliet J. (December 2015). ["Fever: suppress or let it ride?"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4703655). *Journal of Thoracic Disease*. **7** (12): E633–E636. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.3978/j.issn.2072-1439.2015.12.28](https://doi.org/10.3978%2Fj.issn.2072-1439.2015.12.28). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [4703655](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4703655). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [26793378](https://pubmed.ncbi.nlm.nih.gov/26793378).
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Crocetti M, Moghbeli N, Serwint J (June 2001). "Fever Phobia Revisited: Have Parental Misconceptions About Fever Changed in 20 Years?". *Pediatrics*. **107** (6): 1241–1246\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1542/peds.107.6.1241](https://doi.org/10.1542%2Fpeds.107.6.1241). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [11389237](https://pubmed.ncbi.nlm.nih.gov/11389237).
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Harden, L. M.; Kent, S.; Pittman, Q. J.; Roth, J. (1 November 2015). ["Fever and sickness behavior: Friend or foe?"](https://www.sciencedirect.com/science/article/pii/S0889159115004079). *Brain, Behavior, and Immunity*. **50**: 322–333\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.bbi.2015.07.012](https://doi.org/10.1016%2Fj.bbi.2015.07.012). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0889-1591](https://search.worldcat.org/issn/0889-1591). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [26187566](https://pubmed.ncbi.nlm.nih.gov/26187566). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [19396134](https://api.semanticscholar.org/CorpusID:19396134).
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Beard, Robin M.; Day, Michael W. (June 2008). ["Fever and Hyperthermia"](https://doi.org/10.1097%2F01.NURSE.0000320353.79079.a5). *Nursing2022*. **38** (6): 28–31\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1097/01.NURSE.0000320353.79079.a5](https://doi.org/10.1097%2F01.NURSE.0000320353.79079.a5). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0360-4039](https://search.worldcat.org/issn/0360-4039). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [18497656](https://pubmed.ncbi.nlm.nih.gov/18497656).
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French, Neil; Nakiyingi, Jessica; Lugada, Eric; Watera, Christine; Whitworth, James A. G.; Gilks, Charles F. (May 2001). ["Increasing rates of malarial fever with deteriorating immune status in HIV-1-infected Ugandan adults"](https://journals.lww.com/aidsonline/Fulltext/2001/05040/Increasing_rates_of_malarial_fever_with.10.aspx). *AIDS*. **15** (7): 899–906\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1097/00002030-200105040-00010](https://doi.org/10.1097%2F00002030-200105040-00010). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0269-9370](https://search.worldcat.org/issn/0269-9370). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [11399962](https://pubmed.ncbi.nlm.nih.gov/11399962). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [25470703](https://api.semanticscholar.org/CorpusID:25470703). [Archived](https://web.archive.org/web/20220222192422/https://journals.lww.com/aidsonline/Fulltext/2001/05040/Increasing_rates_of_malarial_fever_with.10.aspx) from the original on 22 February 2022.
72. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-72)**
Heymann, D. L.; Weisfeld, J. S.; Webb, P. A.; Johnson, K. M.; Cairns, T.; Berquist, H. (1 September 1980). "Ebola Hemorrhagic Fever: Tandala, Zaire, 1977–1978". *Journal of Infectious Diseases*. **142** (3): 372–376\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1093/infdis/142.3.372](https://doi.org/10.1093%2Finfdis%2F142.3.372). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0022-1899](https://search.worldcat.org/issn/0022-1899). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [7441008](https://pubmed.ncbi.nlm.nih.gov/7441008).
73. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-73)**
Feldmann, Heinz; Geisbert, Thomas W (March 2011). ["Ebola haemorrhagic fever"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406178). *The Lancet*. **377** (9768): 849–862\. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[2011Lanc..377..849F](https://ui.adsabs.harvard.edu/abs/2011Lanc..377..849F). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/s0140-6736(10)60667-8](https://doi.org/10.1016%2Fs0140-6736%2810%2960667-8). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0140-6736](https://search.worldcat.org/issn/0140-6736). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [3406178](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406178). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [21084112](https://pubmed.ncbi.nlm.nih.gov/21084112).
74. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-74)**
Oakley, Miranda S.; Gerald, Noel; McCutchan, Thomas F.; Aravind, L.; Kumar, Sanjai (October 2011). "Clinical and molecular aspects of malaria fever". *Trends in Parasitology*. **27** (10): 442–449\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.pt.2011.06.004](https://doi.org/10.1016%2Fj.pt.2011.06.004). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [1471-4922](https://search.worldcat.org/issn/1471-4922). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [21795115](https://pubmed.ncbi.nlm.nih.gov/21795115).
75. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-75)**
Colunga-Salas, Pablo; Sánchez-Montes, Sokani; Volkow, Patricia; Ruíz-Remigio, Adriana; Becker, Ingeborg (17 September 2020). ["Lyme disease and relapsing fever in Mexico: An overview of human and wildlife infections"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7497999). *PLOS ONE*. **15** (9) e0238496. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[2020PLoSO..1538496C](https://ui.adsabs.harvard.edu/abs/2020PLoSO..1538496C). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1371/journal.pone.0238496](https://doi.org/10.1371%2Fjournal.pone.0238496). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [1932-6203](https://search.worldcat.org/issn/1932-6203). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [7497999](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7497999). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [32941463](https://pubmed.ncbi.nlm.nih.gov/32941463).
76. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-Puechal_2014_76-0)**
Puéchal X, Terrier B, Mouthon L, Costedoat-Chalumeau N, Guillevin L, Le Jeunne C (March 2014). "Relapsing polychondritis". *Joint, Bone, Spine*. **81** (2): 118–124\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.jbspin.2014.01.001](https://doi.org/10.1016%2Fj.jbspin.2014.01.001). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [24556284](https://pubmed.ncbi.nlm.nih.gov/24556284). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [205754989](https://api.semanticscholar.org/CorpusID:205754989).
77. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-77)**
Arnhold, Jürgen (2020). "Cell and Tissue Destruction in Selected Disorders". *Cell and Tissue Destruction*. Elsevier. pp. 249–287\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/b978-0-12-816388-7.00009-7](https://doi.org/10.1016%2Fb978-0-12-816388-7.00009-7). [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-0-12-816388-7](https://en.wikipedia.org/wiki/Special:BookSources/978-0-12-816388-7 "Special:BookSources/978-0-12-816388-7")
. [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [209284148](https://api.semanticscholar.org/CorpusID:209284148).
78. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-78)**
Arnhold, Jürgen (2019). *Cell and tissue destruction: mechanisms, protection, disorders*. Elsevier Science. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-0-12-816388-7](https://en.wikipedia.org/wiki/Special:BookSources/978-0-12-816388-7 "Special:BookSources/978-0-12-816388-7")
. [OCLC](https://en.wikipedia.org/wiki/OCLC_\(identifier\) "OCLC (identifier)") [1120070914](https://search.worldcat.org/oclc/1120070914).
79. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-79)**
["Signs and Symptoms of Cancer \| Do I Have Cancer?"](https://www.cancer.org/cancer/cancer-basics/signs-and-symptoms-of-cancer.html). *www.cancer.org*. Retrieved 20 June 2020.
80. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-80)**
Centerwall, Willard R. (1965). *Phenylketonuria: an inherited metabolic disorder associated with mental retardation*. U.S. Department of Health, Education, and Welfare, Welfare Administration, Children's Bureau. [OCLC](https://en.wikipedia.org/wiki/OCLC_\(identifier\) "OCLC (identifier)") [392284](https://search.worldcat.org/oclc/392284).
81. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-81)**
Dean, Laura (2005). [*Blood transfusions and the immune system*](https://www.ncbi.nlm.nih.gov/books/NBK2265/). National Center for Biotechnology Information (US).
82. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-82)**
Ogoina D (August 2011). ["Fever, fever patterns and diseases called 'fever' – a review"](https://doi.org/10.1016%2Fj.jiph.2011.05.002). *Journal of Infection and Public Health*. **4** (3): 108–124\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.jiph.2011.05.002](https://doi.org/10.1016%2Fj.jiph.2011.05.002). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [21843857](https://pubmed.ncbi.nlm.nih.gov/21843857).
83. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-83)** Typhoid fever may show a specific fever pattern, with a slow stepwise increase and a high plateau (drops due to fever-reducing drugs are excluded).\[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
84. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-84)**
Dall, Lawrence; Stanford, James F. (1990). "Fever, Chills, and Night Sweats". In Walker, H. Kenneth; Hall, W. Dallas; Hurst, J. Willis (eds.). [*Clinical Methods: The History, Physical, and Laboratory Examinations*](https://www.ncbi.nlm.nih.gov/books/NBK324/) (3rd ed.). Boston: Butterworths. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[0-409-90077-X](https://en.wikipedia.org/wiki/Special:BookSources/0-409-90077-X "Special:BookSources/0-409-90077-X")
. [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [21250166](https://pubmed.ncbi.nlm.nih.gov/21250166).
85. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-85)**
Inayatullah, Muhammad; Nasir, Shabbir Ahmed (2016). *Bedside Techniques: Methods of Clinical Examination* (4th ed.). Paramount Books (Pvt.) Limited. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
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.
\[*[page needed](https://en.wikipedia.org/wiki/Wikipedia:Citing_sources "Wikipedia:Citing sources")*\]
86. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-86)**
["African Trypanosomiasis – Disease"](https://www.cdc.gov/parasites/sleepingsickness/disease.html). *CDC*. 28 April 2020. [Archived](https://web.archive.org/web/20210718232904/https://www.cdc.gov/parasites/sleepingsickness/disease.html) from the original on 18 July 2021. Retrieved 18 July 2021.
87. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-87)**
["Brucella/Brucellosis"](https://www.lecturio.com/concepts/brucellosis/). *The Lecturio Medical Concept Library*. Retrieved 19 July 2021.
88. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-88)**
["Enteric Fever (Typhoid Fever)"](https://www.lecturio.com/concepts/enteric-fever-typhoid-fever/). *The Lecturio Medical Concept Library*. 27 August 2020. Retrieved 19 July 2021.
89. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ferri_2009_89-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ferri_2009_89-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ferri_2009_89-2)
Ferri FF (2009). ["Chapter 332. Protozoal infections"](https://books.google.com/books?id=ZbisJsvDEegC&pg=PA1159). *Ferri's Color Atlas and Text of Clinical Medicine*. Elsevier Health Sciences. pp. 1159ff. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-1-4160-4919-7](https://en.wikipedia.org/wiki/Special:BookSources/978-1-4160-4919-7 "Special:BookSources/978-1-4160-4919-7")
. [Archived](https://web.archive.org/web/20160603093438/https://books.google.com/books?id=ZbisJsvDEegC&pg=PA1159) from the original on 3 June 2016. Retrieved 31 March 2020.
90. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-90)**
Muhammad I, Nasir, SA (2009). *Bedside Techniques: Methods of Clinical Examination*. [Multan, Pakistan](https://en.wikipedia.org/wiki/Multan,_Pakistan "Multan, Pakistan"): Saira Publishers/Salamat Iqbal Press.
\[*[page needed](https://en.wikipedia.org/wiki/Wikipedia:Citing_sources "Wikipedia:Citing sources")*\]\[*[better source needed](https://en.wikipedia.org/wiki/Wikipedia:Verifiability#Questionable_sources "Wikipedia:Verifiability")*\]
91. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-91)**
Singh, B.; Daneshvar, C. (1 April 2013). ["Human Infections and Detection of Plasmodium knowlesi"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623376). *Clinical Microbiology Reviews*. **26** (2): 165–184\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1128/CMR.00079-12](https://doi.org/10.1128%2FCMR.00079-12). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [3623376](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623376). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [23554413](https://pubmed.ncbi.nlm.nih.gov/23554413).
92. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-92)**
Chin, W.; Contacos, P. G.; Coatney, G. R.; Kimball, H. R. (20 August 1965). "A Naturally Acquired Quotidian-Type Malaria in Man Transferable to Monkeys". *Science*. **149** (3686): 865. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[1965Sci...149..865C](https://ui.adsabs.harvard.edu/abs/1965Sci...149..865C). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1126/science.149.3686.865](https://doi.org/10.1126%2Fscience.149.3686.865). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [14332847](https://pubmed.ncbi.nlm.nih.gov/14332847). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [27841173](https://api.semanticscholar.org/CorpusID:27841173).
93. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-93)**
["Hodgkin Lymphoma: Practice Essentials, Background, Pathophysiology"](https://emedicine.medscape.com/article/201886-clinical). *Medscape*. 9 November 2021.
94. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-94)**
Hilson AJ (July 1995). "Pel-Ebstein fever". *The New England Journal of Medicine*. **333** (1): 66–67\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1056/NEJM199507063330118](https://doi.org/10.1056%2FNEJM199507063330118). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [7777006](https://pubmed.ncbi.nlm.nih.gov/7777006).
, which cites [Richard Asher](https://en.wikipedia.org/wiki/Richard_Asher "Richard Asher")'s lecture, "Making Sense" \[*Lancet* (1959) **2**: 359\].
95. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-95)**
Magrath, Melissa; Pearlman, Michelle; Peng, Lan; Lee, William (30 June 2018). ["Granulomatous Hepatitis and Persistent Fever of Unknown Origin: A Case Report"](https://doi.org/10.33425%2F2639-9334.1009). *Gastroenterology, Hepatology & Digestive Disorders*. **1** (2): 1–2\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.33425/2639-9334.1009](https://doi.org/10.33425%2F2639-9334.1009). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [2639-9334](https://search.worldcat.org/issn/2639-9334). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [86786427](https://api.semanticscholar.org/CorpusID:86786427).
96. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Klastersky_2014_13%E2%80%9326_96-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Klastersky_2014_13%E2%80%9326_96-1)
Klastersky, Jean A. (2014), "Prevention of Febrile Neutropenia", *Febrile Neutropenia*, Tarporley: Springer Healthcare Ltd., pp. 13–26, [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1007/978-1-907673-70-2\_2](https://doi.org/10.1007%2F978-1-907673-70-2_2), [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-1-907673-69-6](https://en.wikipedia.org/wiki/Special:BookSources/978-1-907673-69-6 "Special:BookSources/978-1-907673-69-6")
`{{citation}}`: CS1 maint: work parameter with ISBN ([link](https://en.wikipedia.org/wiki/Category:CS1_maint:_work_parameter_with_ISBN "Category:CS1 maint: work parameter with ISBN"))
97. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-97)**
White, Lindsey; Ybarra, Michael (1 December 2017). ["Neutropenic Fever"](https://linkinghub.elsevier.com/retrieve/pii/S0889858817301284). *Hematology/Oncology Clinics of North America*. **31** (6): 981–993\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.hoc.2017.08.004](https://doi.org/10.1016%2Fj.hoc.2017.08.004). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [29078933](https://pubmed.ncbi.nlm.nih.gov/29078933) – via ClinicalKey.
98. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-98)**
Rolston, Kenneth VI; Rubenstein, Edward B., eds. (2001). *Textbook of febrile neutropenia*. Martin Dunitz. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-1-84184-033-8](https://en.wikipedia.org/wiki/Special:BookSources/978-1-84184-033-8 "Special:BookSources/978-1-84184-033-8")
. [OCLC](https://en.wikipedia.org/wiki/OCLC_\(identifier\) "OCLC (identifier)") [48195937](https://search.worldcat.org/oclc/48195937).
99. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-MDMA-Hyperpyrexia_systematic_review_99-0)**
Grunau BE, Wiens MO, Brubacher JR (September 2010). ["Dantrolene in the treatment of MDMA-related hyperpyrexia: a systematic review"](https://doi.org/10.1017%2Fs1481803500012598). *Canadian Journal of Emergency Medicine*. **12** (5): 435–442\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1017/s1481803500012598](https://doi.org/10.1017%2Fs1481803500012598). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [20880437](https://pubmed.ncbi.nlm.nih.gov/20880437). "Dantrolene may also be associated with improved survival and reduced complications, especially in patients with extreme (≥ 42 °C) or severe (≥ 40 °C) hyperpyrexia"
100. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-Neurobiology_of_hyperthermia_100-0)**
Sharma HS, ed. (2007). [*Neurobiology of Hyperthermia*](https://books.google.com/books?id=Vk1UTlmEwrQC&pg=485) (1st ed.). Elsevier. pp. 175–177, 485. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-0-08-054999-6](https://en.wikipedia.org/wiki/Special:BookSources/978-0-08-054999-6 "Special:BookSources/978-0-08-054999-6")
. [Archived](https://web.archive.org/web/20170908174330/https://books.google.com/books?id=Vk1UTlmEwrQC&pg=485#v=onepage&q=hyperpyrexia%20core%20temperature&f=false) from the original on 8 September 2017. Retrieved 19 November 2016. "Despite the myriad of complications associated with heat illness, an elevation of core temperature above 41.0 °C (often referred to as fever or hyperpyrexia) is the most widely recognized symptom of this syndrome."
101. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-101)** See section in Chapter 15 therein, the section on "Fever versus hyperthermia".
102. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-EM01_102-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-EM01_102-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-EM01_102-2)
McGugan EA (March 2001). "Hyperpyrexia in the emergency department". *Emergency Medicine*. **13** (1): 116–120\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1046/j.1442-2026.2001.00189.x](https://doi.org/10.1046%2Fj.1442-2026.2001.00189.x). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [11476402](https://pubmed.ncbi.nlm.nih.gov/11476402).
103. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-Marx_2006_2506_103-0)** Marx (2006), p. 2506.
104. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-Fischler_104-0)**
Fischler MP, Reinhart WH (May 1997). "\[Fever: friend or enemy?\]". *Schweizerische Medizinische Wochenschrift* (in German). **127** (20): 864–870\. [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [9289813](https://pubmed.ncbi.nlm.nih.gov/9289813).
105. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Craven2003_105-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Craven2003_105-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Craven2003_105-2) [***d***](https://en.wikipedia.org/wiki/Fever#cite_ref-Craven2003_105-3)
Craven RF, Hirnle CJ (2003). [*Fundamentals of Nursing: Human Health and Function*](https://archive.org/details/fundamentalsofnu0000unse_c8z5) (4th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-0-7817-5818-5](https://en.wikipedia.org/wiki/Special:BookSources/978-0-7817-5818-5 "Special:BookSources/978-0-7817-5818-5")
. Retrieved 2 April 2020.
106. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-LewisDirksenHeitkemper2005_106-0)**
Lewis SM, Dirksen SR, Heitkemper MM (2005). [*Medical-Surgical Nursing: Assessment and Management of Clinical Problems*](https://books.google.com/books?id=3TerPAAACAAJ) (6th ed.). Amsterdam, NL: Elsevier-Health Sciences. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
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Tefera M (July 2004). "Observations on the clinical examination of the camel (Camelus dromedarius) in the field". *Tropical Animal Health and Production*. **36** (5): 435–449\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1023/b:trop.0000035006.37928.cf](https://doi.org/10.1023%2Fb%3Atrop.0000035006.37928.cf). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [15449833](https://pubmed.ncbi.nlm.nih.gov/15449833). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [26358556](https://api.semanticscholar.org/CorpusID:26358556).
141. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Thomas2003_141-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Thomas2003_141-1)
Thomas MB, Blanford S (July 2003). "Thermal biology in insect-parasite interactions". *Trends in Ecology & Evolution*. **18** (7): 344–350\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/S0169-5347(03)00069-7](https://doi.org/10.1016%2FS0169-5347%2803%2900069-7).
## External links
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=27 "Edit section: External links")\]
| | |
|---|---|
| Classification | [D](https://www.wikidata.org/wiki/Q38933 "d:Q38933") **[ICD](https://en.wikipedia.org/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems "International Statistical Classification of Diseases and Related Health Problems")\-[10](https://en.wikipedia.org/wiki/ICD-10 "ICD-10")**: [R50](https://icd.who.int/browse10/2019/en#/R50) **[ICD](https://en.wikipedia.org/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems "International Statistical Classification of Diseases and Related Health Problems")\-[9-CM](https://en.wikipedia.org/wiki/List_of_ICD-9_codes "List of ICD-9 codes")**: [780\.6](http://www.icd9data.com/getICD9Code.ashx?icd9=780.6) **[MeSH](https://en.wikipedia.org/wiki/Medical_Subject_Headings "Medical Subject Headings")**: [D005334](https://meshb.nlm.nih.gov/record/ui?ui=D005334) **[DiseasesDB](https://en.wikipedia.org/wiki/Diseases_Database "Diseases Database")**: [18924](http://www.diseasesdatabase.com/ddb18924.htm) |
| External resources | **[MedlinePlus](https://en.wikipedia.org/wiki/MedlinePlus "MedlinePlus")**: [003090](https://www.nlm.nih.gov/medlineplus/ency/article/003090.htm) **[eMedicine](https://en.wikipedia.org/wiki/EMedicine "EMedicine")**: [med/785](https://emedicine.medscape.com/med/785-overview) |
[](https://en.wikipedia.org/wiki/File:Commons-logo.svg)
Wikimedia Commons has media related to [Fever](https://commons.wikimedia.org/wiki/Category:Fever "commons:Category:Fever").
- [Fever and Taking Your Child's Temperature](http://kidshealth.org/parent/general/body/fever.html)
- [US National Institute of Health factsheet](https://www.medlineplus.gov/ency/article/003090.htm)
- [Drugs most commonly associated with the adverse event Pyrexia (Fever) as reported the FDA](http://www.drugcite.com/indi/?i=PYREXIA) [Archived](https://web.archive.org/web/20120309114919/http://www.drugcite.com/indi/?i=PYREXIA) 9 March 2012 at the [Wayback Machine](https://en.wikipedia.org/wiki/Wayback_Machine "Wayback Machine")
- [Fever](https://medlineplus.gov/fever.html) at MedlinePlus
- [Why are We So Afraid of Fevers?](https://www.nytimes.com/2021/01/11/well/live/fever-benefits.html) at *The New York Times*
| [v](https://en.wikipedia.org/wiki/Template:General_symptoms_and_signs "Template:General symptoms and signs") [t](https://en.wikipedia.org/wiki/Template_talk:General_symptoms_and_signs "Template talk:General symptoms and signs") [e](https://en.wikipedia.org/wiki/Special:EditPage/Template:General_symptoms_and_signs "Special:EditPage/Template:General symptoms and signs")[Signs and symptoms](https://en.wikipedia.org/wiki/Signs_and_symptoms "Signs and symptoms") that are general or [constitutional](https://en.wikipedia.org/wiki/Constitutional_symptoms "Constitutional symptoms") | |
|---|---|
| [Temperature](https://en.wikipedia.org/wiki/Temperature "Temperature") | |
| | |
| *heat* | [Fever]() [of unknown origin](https://en.wikipedia.org/wiki/Fever_of_unknown_origin "Fever of unknown origin") [drug-induced](https://en.wikipedia.org/wiki/Drug-induced_hyperthermia "Drug-induced hyperthermia") [postoperative](https://en.wikipedia.org/wiki/Postoperative_fever "Postoperative fever") [Hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia") [Hyperhidrosis](https://en.wikipedia.org/wiki/Hyperhidrosis "Hyperhidrosis") [Night sweats](https://en.wikipedia.org/wiki/Night_sweats "Night sweats") |
| *cold* | [Chills](https://en.wikipedia.org/wiki/Chills "Chills") [Hypothermia](https://en.wikipedia.org/wiki/Hypothermia "Hypothermia") |
| Aches and [pains](https://en.wikipedia.org/wiki/Pain "Pain") | [Headache](https://en.wikipedia.org/wiki/Headache "Headache") [Chronic pain](https://en.wikipedia.org/wiki/Chronic_pain "Chronic pain") [Cancer pain](https://en.wikipedia.org/wiki/Cancer_pain "Cancer pain") [Myalgia](https://en.wikipedia.org/wiki/Myalgia "Myalgia") [Tenderness](https://en.wikipedia.org/wiki/Tenderness_\(medicine\) "Tenderness (medicine)") |
| [Malaise](https://en.wikipedia.org/wiki/Malaise "Malaise") and [fatigue](https://en.wikipedia.org/wiki/Fatigue "Fatigue") | [Lassitude](https://en.wikipedia.org/wiki/Fatigue "Fatigue") [Lethargy](https://en.wikipedia.org/wiki/Lethargy "Lethargy") [Atrophy](https://en.wikipedia.org/wiki/Atrophy "Atrophy") [of muscle](https://en.wikipedia.org/wiki/Muscle_atrophy "Muscle atrophy") [Asthenia](https://en.wikipedia.org/wiki/Weakness "Weakness") |
| Miscellaneous | [Cachexia](https://en.wikipedia.org/wiki/Cachexia "Cachexia") [Anorexia](https://en.wikipedia.org/wiki/Anorexia "Anorexia") [Polyphagia](https://en.wikipedia.org/wiki/Polyphagia "Polyphagia") and [polydipsia](https://en.wikipedia.org/wiki/Polydipsia "Polydipsia") [Flu-like symptoms](https://en.wikipedia.org/wiki/Influenza-like_illness "Influenza-like illness") |
| [Authority control databases](https://en.wikipedia.org/wiki/Help:Authority_control "Help:Authority control") [](https://www.wikidata.org/wiki/Q38933#identifiers "Edit this at Wikidata") | |
|---|---|
| International | [GND](https://d-nb.info/gnd/4017064-0) |
| National | [United States](https://id.loc.gov/authorities/sh85047994) [Czech Republic](https://aleph.nkp.cz/F/?func=find-c&local_base=aut&ccl_term=ica=ph441087&CON_LNG=ENG) [Israel](https://www.nli.org.il/en/authorities/987007531251705171) |
| Other | [Yale LUX](https://lux.collections.yale.edu/view/concept/fed199a3-0ef0-4530-8e82-a66762b0cf64) |
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Fever
123 languages
[Add topic](https://en.wikipedia.org/wiki/Fever) |
| Readable Markdown | | Fever | |
|---|---|
| Other names | Pyrexia, febrile response, febrile[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1) |
| [](https://en.wikipedia.org/wiki/File:Symptoms-fever.jpg) | |
| Person with fever | |
| [Specialty](https://en.wikipedia.org/wiki/Medical_specialty "Medical specialty") | [Infectious disease](https://en.wikipedia.org/wiki/Infectious_disease_\(medical_specialty\) "Infectious disease (medical specialty)"), [pediatrics](https://en.wikipedia.org/wiki/Pediatrics "Pediatrics") |
| [Symptoms](https://en.wikipedia.org/wiki/Signs_and_symptoms "Signs and symptoms") | **Initially**: [shivering](https://en.wikipedia.org/wiki/Shivering "Shivering"), feeling [cold](https://en.wikipedia.org/wiki/Cold "Cold"), [chills](https://en.wikipedia.org/wiki/Chills "Chills")[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2) **Later**: [flushed](https://en.wikipedia.org/wiki/Flushed "Flushed"), [sweating](https://en.wikipedia.org/wiki/Sweat "Sweat")[\[3\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sue2014-3) |
| [Complications](https://en.wikipedia.org/wiki/Complication_\(medicine\) "Complication (medicine)") | [Febrile seizure](https://en.wikipedia.org/wiki/Febrile_seizure "Febrile seizure")[\[4\]](https://en.wikipedia.org/wiki/Fever#cite_note-CDC2010-4) |
| [Causes](https://en.wikipedia.org/wiki/Cause_\(medicine\) "Cause (medicine)") | [Virus](https://en.wikipedia.org/wiki/Virus "Virus"), [bacteria](https://en.wikipedia.org/wiki/Bacteria "Bacteria"), increase in the body's temperature [set point](https://en.wikipedia.org/wiki/Human_body_temperature#Fever "Human body temperature")[\[5\]](https://en.wikipedia.org/wiki/Fever#cite_note-Kl2015-5)[\[6\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012p375-6) |
| [Diagnostic method](https://en.wikipedia.org/wiki/Medical_diagnosis "Medical diagnosis") | Temperature higher than the normal range of 37.2 and 38.3 °C (99.0 and 100.9 °F)[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1)[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[8\]](https://en.wikipedia.org/wiki/Fever#cite_note-CC09-8) |
| [Differential diagnosis](https://en.wikipedia.org/wiki/Differential_diagnosis "Differential diagnosis") | [Hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia")[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1) |
| Treatment | Based on underlying cause, not required for fever itself[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2)[\[9\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ric2015-9) |
| [Medication](https://en.wikipedia.org/wiki/Medication "Medication") | [Antipyretics](https://en.wikipedia.org/wiki/Antipyretic "Antipyretic") ([ibuprofen](https://en.wikipedia.org/wiki/Ibuprofen "Ibuprofen"), [paracetamol](https://en.wikipedia.org/wiki/Paracetamol "Paracetamol") \[acetaminophen\])[\[9\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ric2015-9)[\[10\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012-10) |
| Frequency | Common[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2)[\[11\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ki2013-11) |
**Fever** or **pyrexia** in humans is a symptom of an anti-infection defense mechanism that appears with [body temperature](https://en.wikipedia.org/wiki/Human_body_temperature "Human body temperature") exceeding the normal range caused by an increase in the body's temperature [set point](https://en.wikipedia.org/wiki/Human_body_temperature#Fever "Human body temperature") in the [hypothalamus](https://en.wikipedia.org/wiki/Hypothalamus "Hypothalamus").[\[5\]](https://en.wikipedia.org/wiki/Fever#cite_note-Kl2015-5)[\[6\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012p375-6)[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[12\]](https://en.wikipedia.org/wiki/Fever#cite_note-12) There is no single agreed-upon upper limit for normal temperature: sources use values ranging between 37.2 and 38.3 °C (99.0 and 100.9 °F) in humans.[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1)[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[8\]](https://en.wikipedia.org/wiki/Fever#cite_note-CC09-8)
The increase in set point triggers increased [muscle contractions](https://en.wikipedia.org/wiki/Muscle_tone "Muscle tone") and causes a feeling of [cold](https://en.wikipedia.org/wiki/Cold "Cold") or [chills](https://en.wikipedia.org/wiki/Chills "Chills").[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2) This results in greater heat production and efforts to conserve heat.[\[3\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sue2014-3) When the set point temperature returns to normal, a person feels hot, becomes [flushed](https://en.wikipedia.org/wiki/Flushing_\(physiology\) "Flushing (physiology)"), and may begin to [sweat](https://en.wikipedia.org/wiki/Perspiration "Perspiration").[\[3\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sue2014-3) Rarely a fever may trigger a [febrile seizure](https://en.wikipedia.org/wiki/Febrile_seizure "Febrile seizure"), with this being more common in young children.[\[4\]](https://en.wikipedia.org/wiki/Fever#cite_note-CDC2010-4) Fevers do not typically go higher than 41 to 42 °C (106 to 108 °F).[\[6\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012p375-6)
A fever can be caused by many [medical conditions](https://en.wikipedia.org/wiki/Medical_conditions "Medical conditions") ranging from non-serious to [life-threatening](https://en.wikipedia.org/wiki/Life-threatening "Life-threatening").[\[13\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012p5-13) This includes [viral](https://en.wikipedia.org/wiki/Viral_infection "Viral infection"), [bacterial](https://en.wikipedia.org/wiki/Bacterial_infection "Bacterial infection"), and [parasitic infections](https://en.wikipedia.org/wiki/Parasitic_infections "Parasitic infections")—such as [influenza](https://en.wikipedia.org/wiki/Influenza "Influenza"), the [common cold](https://en.wikipedia.org/wiki/Common_cold "Common cold"), [meningitis](https://en.wikipedia.org/wiki/Meningitis "Meningitis"), [urinary tract infections](https://en.wikipedia.org/wiki/Urinary_tract_infections "Urinary tract infections"), [appendicitis](https://en.wikipedia.org/wiki/Appendicitis "Appendicitis"), [Lassa fever](https://en.wikipedia.org/wiki/Lassa_fever "Lassa fever"), [COVID-19](https://en.wikipedia.org/wiki/COVID-19 "COVID-19"), and [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria").[\[13\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012p5-13)[\[14\]](https://en.wikipedia.org/wiki/Fever#cite_note-Rod2020-14) Non-infectious causes include [vasculitis](https://en.wikipedia.org/wiki/Vasculitis "Vasculitis"), [deep vein thrombosis](https://en.wikipedia.org/wiki/Deep_vein_thrombosis "Deep vein thrombosis"), [connective tissue disease](https://en.wikipedia.org/wiki/Connective_tissue_disease "Connective tissue disease"), side effects of medication or vaccination, and [cancer](https://en.wikipedia.org/wiki/Cancer "Cancer").[\[13\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012p5-13)[\[15\]](https://en.wikipedia.org/wiki/Fever#cite_note-15) It differs from [hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia"), in that hyperthermia is an increase in body temperature over the temperature set point, due to either too much heat production or not enough [heat loss](https://en.wikipedia.org/wiki/Thermoregulation "Thermoregulation").[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1)
Treatment to reduce fever is generally not required.[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2)[\[9\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ric2015-9) Treatment of associated pain and inflammation, however, may be useful and help a person rest.[\[9\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ric2015-9) Medications such as [ibuprofen](https://en.wikipedia.org/wiki/Ibuprofen "Ibuprofen") or [paracetamol](https://en.wikipedia.org/wiki/Paracetamol "Paracetamol") (acetaminophen) may help with this as well as lower temperature.[\[9\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ric2015-9)[\[10\]](https://en.wikipedia.org/wiki/Fever#cite_note-Gar2012-10) Children younger than three months require medical attention, as might people with serious medical problems such as a [compromised immune system](https://en.wikipedia.org/wiki/Compromised_immune_system "Compromised immune system") or people with other symptoms.[\[16\]](https://en.wikipedia.org/wiki/Fever#cite_note-16) [Hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia") requires treatment.[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2)
Fever is one of the most common [medical signs](https://en.wikipedia.org/wiki/Medical_signs "Medical signs").[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2) It is part of about 30% of healthcare visits by children[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2) and occurs in up to 75% of adults who are seriously sick.[\[11\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ki2013-11) While fever evolved as a defense mechanism, [treating a fever](https://en.wikipedia.org/wiki/Antipyretic "Antipyretic") does not appear to improve or worsen outcomes.[\[17\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sch2006-17)[\[18\]](https://en.wikipedia.org/wiki/Fever#cite_note-Antipyretic_therapy_in_febrile_crit-18)[\[19\]](https://en.wikipedia.org/wiki/Fever#cite_note-:0-19) Fever is often viewed with greater concern by parents and healthcare professionals than is usually deserved, a phenomenon known as "fever phobia".[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2)[\[20\]](https://en.wikipedia.org/wiki/Fever#cite_note-20)
## Associated symptoms
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=1 "Edit section: Associated symptoms")\]
A fever is usually accompanied by [sickness behavior](https://en.wikipedia.org/wiki/Sickness_behavior "Sickness behavior"), which consists of [lethargy](https://en.wikipedia.org/wiki/Lethargy "Lethargy"), [depression](https://en.wikipedia.org/wiki/Depression_\(mood\) "Depression (mood)"), [loss of appetite](https://en.wikipedia.org/wiki/Anorexia_\(symptom\) "Anorexia (symptom)"), [sleepiness](https://en.wikipedia.org/wiki/Sleepiness "Sleepiness"), [hyperalgesia](https://en.wikipedia.org/wiki/Hyperalgesia "Hyperalgesia"), [dehydration](https://en.wikipedia.org/wiki/Dehydration "Dehydration"),[\[21\]](https://en.wikipedia.org/wiki/Fever#cite_note-21)[\[22\]](https://en.wikipedia.org/wiki/Fever#cite_note-22) and the inability to concentrate. Sleeping with a fever can often cause intense or confusing [nightmares](https://en.wikipedia.org/wiki/Nightmare "Nightmare"), commonly called "[fever dreams](https://en.wikipedia.org/wiki/Fever_dream "Fever dream")".[\[23\]](https://en.wikipedia.org/wiki/Fever#cite_note-23) Mild to severe [delirium](https://en.wikipedia.org/wiki/Delirium "Delirium") (which can also cause [hallucinations](https://en.wikipedia.org/wiki/Hallucinations "Hallucinations")) may also present itself during high fevers.[\[24\]](https://en.wikipedia.org/wiki/Fever#cite_note-24)
## Differential diagnosis
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=2 "Edit section: Differential diagnosis")\]
[Hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia") is an elevation of body temperature over the temperature set point, due to either too much heat production or not enough [heat loss](https://en.wikipedia.org/wiki/Thermoregulation "Thermoregulation").[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1)[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7) Hyperthermia is thus not considered fever.[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7): 103 [\[25\]](https://en.wikipedia.org/wiki/Fever#cite_note-25) Hyperthermia should not be confused with [hyperpyrexia](https://en.wikipedia.org/wiki/Hyperpyrexia "Hyperpyrexia") (which is a very high fever).[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7): 102
Clinically, it is important to distinguish between fever and hyperthermia as hyperthermia may quickly lead to death and does not respond to antipyretic medications. The distinction may however be difficult to make in an emergency setting, and is often established by identifying possible causes.[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7): 103
Temperature is regulated in the [hypothalamus](https://en.wikipedia.org/wiki/Hypothalamus "Hypothalamus"). The trigger of a fever, called a pyrogen, results in the release of [prostaglandin E2](https://en.wikipedia.org/wiki/Prostaglandin_E2 "Prostaglandin E2") (PGE2). PGE2 in turn acts on the hypothalamus, which creates a systemic response in the body, causing heat-generating effects to match a new higher temperature set point. There are four receptors in which PGE2 can bind (EP1-4), with a previous study showing the EP3 subtype is what mediates the fever response.[\[26\]](https://en.wikipedia.org/wiki/Fever#cite_note-26) Hence, the hypothalamus can be seen as working like a [thermostat](https://en.wikipedia.org/wiki/Thermostat "Thermostat").[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7) When the set point is raised, the body increases its temperature through both active generation of heat and retention of heat. Peripheral [vasoconstriction](https://en.wikipedia.org/wiki/Vasoconstriction "Vasoconstriction") both reduces heat loss through the skin and causes the person to feel cold. [Norepinephrine](https://en.wikipedia.org/wiki/Norepinephrine "Norepinephrine") increases [thermogenesis](https://en.wikipedia.org/wiki/Thermogenesis "Thermogenesis") in [brown adipose tissue](https://en.wikipedia.org/wiki/Brown_adipose_tissue "Brown adipose tissue"), and muscle contraction through shivering raises the [metabolic rate](https://en.wikipedia.org/wiki/Basal_metabolic_rate "Basal metabolic rate").[\[27\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid25976513-27)
If these measures are insufficient to make the blood temperature in the brain match the new set point in the hypothalamus, the brain orchestrates heat effector mechanisms via the [autonomic nervous system](https://en.wikipedia.org/wiki/Autonomic_nervous_system "Autonomic nervous system") or primary motor center for shivering. These may be:[\[28\]](https://en.wikipedia.org/wiki/Fever#cite_note-28)[\[29\]](https://en.wikipedia.org/wiki/Fever#cite_note-29)[\[30\]](https://en.wikipedia.org/wiki/Fever#cite_note-30)
- Increased heat production by increased [muscle tone](https://en.wikipedia.org/wiki/Muscle_tone "Muscle tone"), [shivering](https://en.wikipedia.org/wiki/Shivering "Shivering") (muscle movements to produce heat) and release of hormones like [epinephrine](https://en.wikipedia.org/wiki/Epinephrine "Epinephrine"); and
- Prevention of heat loss, e.g., through [vasoconstriction](https://en.wikipedia.org/wiki/Vasoconstriction "Vasoconstriction").
When the hypothalamic set point moves back to baseline—either spontaneously or via medication—normal functions such as sweating, and the reverse of the foregoing processes (e.g., vasodilation, end of shivering, and nonshivering heat production) are used to cool the body to the new, lower setting.\[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
This contrasts with [hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia"), in which the normal setting remains, and the body overheats through undesirable retention of excess heat or over-production of heat. Hyperthermia is usually the result of an excessively hot environment ([heat stroke](https://en.wikipedia.org/wiki/Heat_stroke "Heat stroke")) or an adverse reaction to drugs. Fever can be differentiated from hyperthermia by the circumstances surrounding it and its response to [anti-pyretic](https://en.wikipedia.org/wiki/Anti-pyretic "Anti-pyretic") medications.[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)\[*[verification needed](https://en.wikipedia.org/wiki/Wikipedia:Verifiability "Wikipedia:Verifiability")*\]
In infants, the autonomic nervous system may also activate [brown adipose tissue](https://en.wikipedia.org/wiki/Brown_adipose_tissue "Brown adipose tissue") to produce heat (non-shivering thermogenesis).[\[31\]](https://en.wikipedia.org/wiki/Fever#cite_note-31)
Increased heart rate and vasoconstriction contribute to increased [blood pressure](https://en.wikipedia.org/wiki/Blood_pressure "Blood pressure") in fever.[\[32\]](https://en.wikipedia.org/wiki/Fever#cite_note-32)
A pyrogen is a substance that induces fever.[\[33\]](https://en.wikipedia.org/wiki/Fever#cite_note-33) In the presence of an infectious agent, such as bacteria, viruses, viroids, *etc*., the immune response of the body is to inhibit their growth and eliminate them. The most common pyrogens are endotoxins, which are [lipopolysaccharides](https://en.wikipedia.org/wiki/Lipopolysaccharide "Lipopolysaccharide") (LPS) produced by [Gram-negative bacteria](https://en.wikipedia.org/wiki/Gram-negative_bacteria "Gram-negative bacteria") such as *[E. coli](https://en.wikipedia.org/wiki/Escherichia_coli "Escherichia coli").* But pyrogens include non-endotoxic substances (derived from microorganisms other than gram-negative-bacteria or from chemical substances) as well.[\[34\]](https://en.wikipedia.org/wiki/Fever#cite_note-34) The types of pyrogens include internal (endogenous) and external (exogenous) to the body.[\[35\]](https://en.wikipedia.org/wiki/Fever#cite_note-35)
The "pyrogenicity" of given pyrogens varies: in extreme cases, bacterial pyrogens can act as [superantigens](https://en.wikipedia.org/wiki/Superantigens "Superantigens") and cause rapid and dangerous fevers.[\[36\]](https://en.wikipedia.org/wiki/Fever#cite_note-36)
Endogenous pyrogens are [cytokines](https://en.wikipedia.org/wiki/Cytokine "Cytokine") released from [monocytes](https://en.wikipedia.org/wiki/Monocyte "Monocyte") (which are part of the [immune system](https://en.wikipedia.org/wiki/Immune_system "Immune system")).[\[37\]](https://en.wikipedia.org/wiki/Fever#cite_note-37) In general, they stimulate chemical responses, often in the presence of an [antigen](https://en.wikipedia.org/wiki/Antigen "Antigen"), leading to a fever. Whilst they can be a product of external factors like exogenous pyrogens, they can also be induced by internal factors like [damage associated molecular patterns](https://en.wikipedia.org/wiki/Damage_associated_molecular_pattern "Damage associated molecular pattern") such as cases like [rheumatoid arthritis](https://en.wikipedia.org/wiki/Rheumatoid_arthritis "Rheumatoid arthritis") or lupus.[\[38\]](https://en.wikipedia.org/wiki/Fever#cite_note-38)
Major endogenous pyrogens are [interleukin 1](https://en.wikipedia.org/wiki/Interleukin_1 "Interleukin 1") (α and β)[\[39\]](https://en.wikipedia.org/wiki/Fever#cite_note-boron-58-39): 1237–1248 and [interleukin 6](https://en.wikipedia.org/wiki/Interleukin_6 "Interleukin 6") (IL-6).[\[40\]](https://en.wikipedia.org/wiki/Fever#cite_note-40) Minor endogenous pyrogens include [interleukin-8](https://en.wikipedia.org/wiki/Interleukin-8 "Interleukin-8"), [tumor necrosis factor-β](https://en.wikipedia.org/wiki/Lymphotoxin_alpha "Lymphotoxin alpha"), [macrophage inflammatory protein](https://en.wikipedia.org/wiki/Macrophage_inflammatory_protein "Macrophage inflammatory protein")\-α and macrophage inflammatory protein-β as well as [interferon-α](https://en.wikipedia.org/wiki/Interferon-%CE%B1 "Interferon-α"), [interferon-β](https://en.wikipedia.org/wiki/IFN-%CE%B2 "IFN-β"), and [interferon-γ](https://en.wikipedia.org/wiki/Interferon-gamma "Interferon-gamma").[\[39\]](https://en.wikipedia.org/wiki/Fever#cite_note-boron-58-39): 1237–1248 [Tumor necrosis factor-α](https://en.wikipedia.org/wiki/Tumor_necrosis_factor-%CE%B1 "Tumor necrosis factor-α") (TNF) also acts as a pyrogen, mediated by [interleukin 1](https://en.wikipedia.org/wiki/Interleukin_1 "Interleukin 1") (IL-1) release.[\[41\]](https://en.wikipedia.org/wiki/Fever#cite_note-41) These cytokine factors are released into general circulation, where they migrate to the brain's [circumventricular organs](https://en.wikipedia.org/wiki/Circumventricular_organ "Circumventricular organ") where they are more easily absorbed than in areas protected by the [blood–brain barrier](https://en.wikipedia.org/wiki/Blood%E2%80%93brain_barrier "Blood–brain barrier").[\[42\]](https://en.wikipedia.org/wiki/Fever#cite_note-42) The cytokines then bind to [endothelial receptors](https://en.wikipedia.org/wiki/Endothelium "Endothelium") on vessel walls to receptors on [microglial cells](https://en.wikipedia.org/wiki/Microglial_cell "Microglial cell"), resulting in activation of the [arachidonic acid pathway](https://en.wikipedia.org/wiki/Arachidonic_acid_pathway "Arachidonic acid pathway").[\[43\]](https://en.wikipedia.org/wiki/Fever#cite_note-43)
Of these, IL-1β, TNF, and IL-6 are able to raise the temperature setpoint of an organism and cause fever. These proteins produce a [cyclooxygenase](https://en.wikipedia.org/wiki/Cyclooxygenase "Cyclooxygenase") which induces the hypothalamic production of PGE2 which then stimulates the release of neurotransmitters such as [cyclic adenosine monophosphate](https://en.wikipedia.org/wiki/Cyclic_adenosine_monophosphate "Cyclic adenosine monophosphate") and increases body temperature.[\[44\]](https://en.wikipedia.org/wiki/Fever#cite_note-44)
Exogenous pyrogens are external to the body and are of microbial origin. In general, these pyrogens, including bacterial cell wall products, may act on Toll-like receptors in the hypothalamus and elevate the thermoregulatory setpoint.[\[45\]](https://en.wikipedia.org/wiki/Fever#cite_note-45)
An example of a class of exogenous pyrogens are bacterial [lipopolysaccharides](https://en.wikipedia.org/wiki/Lipopolysaccharide "Lipopolysaccharide") (LPS) present in the cell wall of [gram-negative bacteria](https://en.wikipedia.org/wiki/Gram-negative_bacteria "Gram-negative bacteria"). According to one mechanism of pyrogen action, an immune system protein, [lipopolysaccharide-binding protein](https://en.wikipedia.org/wiki/Lipopolysaccharide-binding_protein "Lipopolysaccharide-binding protein") (LBP), binds to LPS, and the LBP–LPS complex then binds to a [CD14](https://en.wikipedia.org/wiki/CD14 "CD14") receptor on a [macrophage](https://en.wikipedia.org/wiki/Macrophage "Macrophage"). The LBP-LPS binding to CD14 results in cellular synthesis and release of various endogenous [cytokines](https://en.wikipedia.org/wiki/Cytokine "Cytokine"), e.g., interleukin 1 (IL-1), interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNFα). A further downstream event is activation of the [arachidonic acid pathway](https://en.wikipedia.org/wiki/Arachidonic_acid_pathway "Arachidonic acid pathway").[\[46\]](https://en.wikipedia.org/wiki/Fever#cite_note-46)
### Neural circuit mechanism with PGE2 action
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=9 "Edit section: Neural circuit mechanism with PGE2 action")\]
PGE2 release comes from the [arachidonic acid](https://en.wikipedia.org/wiki/Arachidonic_acid "Arachidonic acid") pathway. This pathway (as it relates to fever), is mediated by the [enzymes](https://en.wikipedia.org/wiki/Enzyme "Enzyme") [phospholipase A2](https://en.wikipedia.org/wiki/Phospholipase "Phospholipase") (PLA2), [cyclooxygenase-2](https://en.wikipedia.org/wiki/Cyclooxygenase "Cyclooxygenase") (COX-2), and [prostaglandin E2 synthase](https://en.wikipedia.org/wiki/Prostaglandin_E2_synthase "Prostaglandin E2 synthase"). These enzymes ultimately mediate the synthesis and release of PGE2.[\[47\]](https://en.wikipedia.org/wiki/Fever#cite_note-47)
PGE2 is the ultimate mediator of the febrile response. The setpoint temperature of the body will remain elevated until PGE2 is no longer present. PGE2 acts on neurons in the [preoptic area](https://en.wikipedia.org/wiki/Preoptic_area "Preoptic area") (POA) through the [prostaglandin E receptor 3](https://en.wikipedia.org/wiki/Prostaglandin_E_receptor_3 "Prostaglandin E receptor 3") (EP3).[\[48\]](https://en.wikipedia.org/wiki/Fever#cite_note-48)[\[49\]](https://en.wikipedia.org/wiki/Fever#cite_note-:1-49)[\[50\]](https://en.wikipedia.org/wiki/Fever#cite_note-50)[\[51\]](https://en.wikipedia.org/wiki/Fever#cite_note-:2-51) EP3-expressing neurons in the POA innervate the [dorsomedial hypothalamus](https://en.wikipedia.org/wiki/Dorsomedial_hypothalamus "Dorsomedial hypothalamus") (DMH),[\[52\]](https://en.wikipedia.org/wiki/Fever#cite_note-52)[\[53\]](https://en.wikipedia.org/wiki/Fever#cite_note-:3-53) the rostral [raphe](https://en.wikipedia.org/wiki/Raphe "Raphe") pallidus nucleus in the [medulla oblongata](https://en.wikipedia.org/wiki/Medulla_oblongata "Medulla oblongata") (rRPa),[\[49\]](https://en.wikipedia.org/wiki/Fever#cite_note-:1-49)[\[53\]](https://en.wikipedia.org/wiki/Fever#cite_note-:3-53) and the [paraventricular nucleus](https://en.wikipedia.org/wiki/Paraventricular_nucleus "Paraventricular nucleus") (PVN) of the [hypothalamus](https://en.wikipedia.org/wiki/Hypothalamus "Hypothalamus").[\[54\]](https://en.wikipedia.org/wiki/Fever#cite_note-54) Under normal conditions, EP3-expressing neurons in the POA are important [thermoregulatory](https://en.wikipedia.org/wiki/Thermoregulation "Thermoregulation") neurons, which provide continuous inhibitory signals with the transmitter [GABA](https://en.wikipedia.org/wiki/GABA "GABA") to control [sympathetic](https://en.wikipedia.org/wiki/Sympathetic_nervous_system "Sympathetic nervous system") output neurons in the DMH and rRPa, thereby performing bidirectional regulation of basal body temperature.[\[51\]](https://en.wikipedia.org/wiki/Fever#cite_note-:2-51) During infection, PGE2 produced in the brain inhibits the activity of EP3-expressing neurons in the POA to attenuate the inhibition of sympathetic output, and thereby activates the sympathetic output system, which evokes non-shivering thermogenesis to produce body heat and skin vasoconstriction to decrease heat loss from the body surface, leading to fever.[\[51\]](https://en.wikipedia.org/wiki/Fever#cite_note-:2-51) It is presumed that the innervation from the POA to the PVN mediates the neuroendocrine effects of fever through the pathway involving [pituitary gland](https://en.wikipedia.org/wiki/Pituitary_gland "Pituitary gland") and various [endocrine organs](https://en.wikipedia.org/wiki/Endocrine_organs "Endocrine organs").
A range for [normal temperatures](https://en.wikipedia.org/wiki/Normal_human_body_temperature "Normal human body temperature") has been found.[\[8\]](https://en.wikipedia.org/wiki/Fever#cite_note-CC09-8) Central temperatures, such as rectal temperatures, are more accurate than peripheral temperatures.[\[60\]](https://en.wikipedia.org/wiki/Fever#cite_note-Niven2015-60) Fever is generally agreed to be present if the elevated temperature[\[61\]](https://en.wikipedia.org/wiki/Fever#cite_note-61) is caused by a raised set point and:
- Temperature in the [anus](https://en.wikipedia.org/wiki/Human_anus "Human anus") (rectum/rectal) is at or over 37.5–38.3 °C (99.5–100.9 °F).[\[1\]](https://en.wikipedia.org/wiki/Fever#cite_note-NC08-1)[\[8\]](https://en.wikipedia.org/wiki/Fever#cite_note-CC09-8) An [ear](https://en.wikipedia.org/wiki/Ear "Ear") (tympanic) or [forehead](https://en.wikipedia.org/wiki/Forehead "Forehead") (temporal) temperature may also be used.[\[62\]](https://en.wikipedia.org/wiki/Fever#cite_note-62)[\[63\]](https://en.wikipedia.org/wiki/Fever#cite_note-63)
- Temperature in the mouth (oral) is at or over 37.2 °C (99.0 °F) in the morning or over 37.7 °C (99.9 °F) in the afternoon[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[64\]](https://en.wikipedia.org/wiki/Fever#cite_note-Reiew09-64)
- Temperature under the arm (axillary) is usually about 0.6 °C (1.1 °F) below core body temperature.[\[65\]](https://en.wikipedia.org/wiki/Fever#cite_note-Pecoraro_Petri_Costantino_Squizzato_pp._1071%E2%80%931083-65)
In adults, the [normal range](https://en.wikipedia.org/wiki/Normal_human_body_temperature "Normal human body temperature") of temperatures in healthy individuals is 36.32–37.76 °C (97.4–100.0 °F) (rectal), 35.76–37.52 °C (96.4–99.5 °F) ([ear](https://en.wikipedia.org/wiki/Tympanic_membrane "Tympanic membrane")), 35.61–37.61 °C (96.1–99.7 °F) (urine), 35.73–37.41 °C (96.3–99.3 °F) (oral), and 35.01–36.93 °C (95.0–98.5 °F) (axillary), with no significant gender differences.[\[66\]](https://en.wikipedia.org/wiki/Fever#cite_note-geneva2019-66)
Normal body temperatures vary depending on many factors, including age, sex, time of day, ambient temperature, activity level, and more.[\[67\]](https://en.wikipedia.org/wiki/Fever#cite_note-Garami-67)[\[68\]](https://en.wikipedia.org/wiki/Fever#cite_note-68) Normal daily temperature variation has been described as 0.5 °C (0.9 °F).[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7): 4012 A raised temperature is not always a fever.[\[67\]](https://en.wikipedia.org/wiki/Fever#cite_note-Garami-67) For example, the temperature rises in healthy people when they exercise, but this is not considered a fever, as the set point is normal.[\[67\]](https://en.wikipedia.org/wiki/Fever#cite_note-Garami-67) On the other hand, a "normal" temperature may be a fever, if it is unusually high for that person; for example, [medically frail](https://en.wikipedia.org/wiki/Medically_frail "Medically frail") elderly people have a decreased ability to generate body heat, so a "normal" temperature of 37.3 °C (99.1 °F) may represent a clinically significant fever.[\[67\]](https://en.wikipedia.org/wiki/Fever#cite_note-Garami-67)[\[69\]](https://en.wikipedia.org/wiki/Fever#cite_note-69)
### Associated conditions
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=11 "Edit section: Associated conditions")\]
Fever is a common [symptom](https://en.wikipedia.org/wiki/Symptom "Symptom") of many medical conditions:
- [Infectious disease](https://en.wikipedia.org/wiki/Infectious_disease "Infectious disease"), e.g., [COVID-19](https://en.wikipedia.org/wiki/COVID-19 "COVID-19"),[\[14\]](https://en.wikipedia.org/wiki/Fever#cite_note-Rod2020-14) [dengue](https://en.wikipedia.org/wiki/Dengue "Dengue"), [Ebola](https://en.wikipedia.org/wiki/Ebola_virus_disease "Ebola virus disease"), [gastroenteritis](https://en.wikipedia.org/wiki/Gastroenteritis "Gastroenteritis"), [HIV](https://en.wikipedia.org/wiki/HIV "HIV"), [influenza](https://en.wikipedia.org/wiki/Influenza "Influenza"), [Lyme disease](https://en.wikipedia.org/wiki/Lyme_disease "Lyme disease"), [rocky mountain spotted fever](https://en.wikipedia.org/wiki/Rocky_mountain_spotted_fever "Rocky mountain spotted fever"), [secondary syphilis](https://en.wikipedia.org/wiki/Syphilis#Secondary "Syphilis"), [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria"), [mononucleosis](https://en.wikipedia.org/wiki/Infectious_mononucleosis "Infectious mononucleosis"), as well as infections of the skin, e.g., [abscesses](https://en.wikipedia.org/wiki/Abscess "Abscess") and [boils](https://en.wikipedia.org/wiki/Boils "Boils").[\[70\]](https://en.wikipedia.org/wiki/Fever#cite_note-70)[\[71\]](https://en.wikipedia.org/wiki/Fever#cite_note-71)[\[72\]](https://en.wikipedia.org/wiki/Fever#cite_note-72)[\[73\]](https://en.wikipedia.org/wiki/Fever#cite_note-73)[\[74\]](https://en.wikipedia.org/wiki/Fever#cite_note-74)[\[75\]](https://en.wikipedia.org/wiki/Fever#cite_note-75)
- [Immunological](https://en.wikipedia.org/wiki/Immunology "Immunology") diseases, e.g., [relapsing polychondritis](https://en.wikipedia.org/wiki/Relapsing_polychondritis "Relapsing polychondritis"),[\[76\]](https://en.wikipedia.org/wiki/Fever#cite_note-Puechal_2014-76) [autoimmune hepatitis](https://en.wikipedia.org/wiki/Autoimmune_hepatitis "Autoimmune hepatitis"), [granulomatosis with polyangiitis](https://en.wikipedia.org/wiki/Granulomatosis_with_polyangiitis "Granulomatosis with polyangiitis"), [Horton disease](https://en.wikipedia.org/wiki/Horton_disease "Horton disease"), [inflammatory bowel diseases](https://en.wikipedia.org/wiki/Inflammatory_bowel_disease "Inflammatory bowel disease"), [Kawasaki disease](https://en.wikipedia.org/wiki/Kawasaki_disease "Kawasaki disease"), [lupus erythematosus](https://en.wikipedia.org/wiki/Lupus_erythematosus "Lupus erythematosus"), [sarcoidosis](https://en.wikipedia.org/wiki/Sarcoidosis "Sarcoidosis"), [Still's disease](https://en.wikipedia.org/wiki/Adult-onset_Still%27s_disease "Adult-onset Still's disease"), [rheumatoid arthritis](https://en.wikipedia.org/wiki/Rheumatoid_arthritis "Rheumatoid arthritis"), [lymphoproliferative disorders](https://en.wikipedia.org/wiki/Lymphoproliferative_disorders "Lymphoproliferative disorders") and [psoriasis](https://en.wikipedia.org/wiki/Psoriasis "Psoriasis");\[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
- Tissue destruction, as a result of [cerebral bleeding](https://en.wikipedia.org/wiki/Cerebral_hemorrhage "Cerebral hemorrhage"), [crush syndrome](https://en.wikipedia.org/wiki/Crush_syndrome "Crush syndrome"), [hemolysis](https://en.wikipedia.org/wiki/Hemolysis "Hemolysis"), [infarction](https://en.wikipedia.org/wiki/Infarction "Infarction"), [rhabdomyolysis](https://en.wikipedia.org/wiki/Rhabdomyolysis "Rhabdomyolysis"), [surgery](https://en.wikipedia.org/wiki/Surgery "Surgery"), etc.;[\[77\]](https://en.wikipedia.org/wiki/Fever#cite_note-77)[\[78\]](https://en.wikipedia.org/wiki/Fever#cite_note-78)
- [Cancers](https://en.wikipedia.org/wiki/Cancer "Cancer"), particularly blood cancers such as [leukemia](https://en.wikipedia.org/wiki/Leukemia "Leukemia") and [lymphomas](https://en.wikipedia.org/wiki/Lymphoma "Lymphoma");[\[79\]](https://en.wikipedia.org/wiki/Fever#cite_note-79)
- [Metabolic disorders](https://en.wikipedia.org/wiki/Metabolic_disorder "Metabolic disorder"), e.g., [gout](https://en.wikipedia.org/wiki/Gout "Gout"), and [porphyria](https://en.wikipedia.org/wiki/Porphyria "Porphyria");[\[80\]](https://en.wikipedia.org/wiki/Fever#cite_note-80)
- Inherited metabolic disorder, e.g., [Fabry disease](https://en.wikipedia.org/wiki/Fabry_disease "Fabry disease").[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)
Adult and pediatric manifestations for the same disease may differ; for instance, in [COVID-19](https://en.wikipedia.org/wiki/COVID-19 "COVID-19"), one metastudy describes 92.8% of adults versus 43.9% of children presenting with fever.[\[14\]](https://en.wikipedia.org/wiki/Fever#cite_note-Rod2020-14)
In addition, fever can result from a reaction to an incompatible blood product.[\[81\]](https://en.wikipedia.org/wiki/Fever#cite_note-81)
[](https://en.wikipedia.org/wiki/File:Fever_Patterns_v1.2.svg)
Different fever patterns observed in *Plasmodium* infections
Various patterns of measured patient temperatures have been observed, some of which may be indicative of a particular [medical diagnosis](https://en.wikipedia.org/wiki/Medical_diagnosis "Medical diagnosis"):
- [Continuous fever](https://en.wikipedia.org/wiki/Continuous_fever "Continuous fever"), where temperature remains above normal and does not fluctuate more than 1 °C in 24 hours[\[82\]](https://en.wikipedia.org/wiki/Fever#cite_note-82) (e.g. in [bacterial pneumonia](https://en.wikipedia.org/wiki/Bacterial_pneumonia "Bacterial pneumonia"), [typhoid fever](https://en.wikipedia.org/wiki/Typhoid_fever "Typhoid fever"), [infective endocarditis](https://en.wikipedia.org/wiki/Infective_endocarditis "Infective endocarditis"), [tuberculosis](https://en.wikipedia.org/wiki/Tuberculosis "Tuberculosis"), or [typhus](https://en.wikipedia.org/wiki/Typhus "Typhus")).[\[83\]](https://en.wikipedia.org/wiki/Fever#cite_note-83)[\[84\]](https://en.wikipedia.org/wiki/Fever#cite_note-84)
- [Intermittent fever](https://en.wikipedia.org/wiki/Intermittent_fever "Intermittent fever") is present only for a certain period, later cycling back to normal (e.g., in [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria"), [leishmaniasis](https://en.wikipedia.org/wiki/Visceral_leishmaniasis "Visceral leishmaniasis"), [pyemia](https://en.wikipedia.org/wiki/Pyemia "Pyemia"), [sepsis](https://en.wikipedia.org/wiki/Sepsis "Sepsis"),[\[85\]](https://en.wikipedia.org/wiki/Fever#cite_note-85) or [African trypanosomiasis](https://en.wikipedia.org/wiki/African_trypanosomiasis "African trypanosomiasis")).[\[86\]](https://en.wikipedia.org/wiki/Fever#cite_note-86)
- [Remittent fever](https://en.wikipedia.org/wiki/Remittent_fever "Remittent fever"), where the temperature remains above normal throughout the day and fluctuates more than 1 °C in 24 hours (e.g., in [infective endocarditis](https://en.wikipedia.org/wiki/Infective_endocarditis "Infective endocarditis") or [brucellosis](https://en.wikipedia.org/wiki/Brucellosis "Brucellosis")).[\[87\]](https://en.wikipedia.org/wiki/Fever#cite_note-87)
- [Pel–Ebstein fever](https://en.wikipedia.org/wiki/Pel%E2%80%93Ebstein_fever "Pel–Ebstein fever") is a cyclic fever that is rarely seen in patients with [Hodgkin's lymphoma](https://en.wikipedia.org/wiki/Hodgkin%27s_lymphoma "Hodgkin's lymphoma").\[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
- Undulant fever, seen in [brucellosis](https://en.wikipedia.org/wiki/Brucellosis "Brucellosis").\[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
- [Typhoid fever](https://en.wikipedia.org/wiki/Typhoid_fever "Typhoid fever") is a [continuous fever](https://en.wikipedia.org/wiki/Continuous_fever "Continuous fever") showing a characteristic *step-ladder pattern,* a step-wise increase in temperature with a high plateau.[\[88\]](https://en.wikipedia.org/wiki/Fever#cite_note-88)
Among the types of intermittent fever are ones specific to cases of malaria caused by different pathogens. These are:[\[89\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ferri_2009-89)[\[90\]](https://en.wikipedia.org/wiki/Fever#cite_note-90)
- Quotidian fever, with a 24-hour periodicity, typical of [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria") caused by *[Plasmodium knowlesi](https://en.wikipedia.org/wiki/Plasmodium_knowlesi "Plasmodium knowlesi")* (*P. knowlesi*);[\[91\]](https://en.wikipedia.org/wiki/Fever#cite_note-91)[\[92\]](https://en.wikipedia.org/wiki/Fever#cite_note-92)
- [Tertian fever](https://en.wikipedia.org/wiki/Tertian_fever "Tertian fever"), with a 48-hour periodicity, typical of later course [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria") caused by *[P. falciparum](https://en.wikipedia.org/wiki/Plasmodium_falciparum "Plasmodium falciparum")*, *[P. vivax](https://en.wikipedia.org/wiki/Plasmodium_vivax "Plasmodium vivax")*, or *[P. ovale](https://en.wikipedia.org/wiki/Plasmodium_ovale "Plasmodium ovale")*;[\[89\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ferri_2009-89)
- [Quartan fever](https://en.wikipedia.org/wiki/Quartan_fever "Quartan fever"), with a 72-hour periodicity, typical of later course [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria") caused by *[P. malariae](https://en.wikipedia.org/wiki/Plasmodium_malariae "Plasmodium malariae")*.[\[89\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ferri_2009-89)
In addition, there is disagreement regarding whether a specific fever pattern is associated with [Hodgkin's lymphoma](https://en.wikipedia.org/wiki/Hodgkin%27s_lymphoma "Hodgkin's lymphoma")—the [Pel–Ebstein fever](https://en.wikipedia.org/wiki/Pel%E2%80%93Ebstein_fever "Pel–Ebstein fever"), with patients argued to present high temperature for one week, followed by low for the next week, and so on, where the generality of this pattern is debated.[\[93\]](https://en.wikipedia.org/wiki/Fever#cite_note-93)[\[94\]](https://en.wikipedia.org/wiki/Fever#cite_note-94)
Persistent fever that cannot be explained after repeated routine clinical inquiries is called [fever of unknown origin](https://en.wikipedia.org/wiki/Fever_of_unknown_origin "Fever of unknown origin").[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[95\]](https://en.wikipedia.org/wiki/Fever#cite_note-95) A [neutropenic fever](https://en.wikipedia.org/wiki/Neutropenic_fever "Neutropenic fever"), also called febrile neutropenia, is a fever in the absence of normal immune system function.[\[96\]](https://en.wikipedia.org/wiki/Fever#cite_note-Klastersky_2014_13%E2%80%9326-96) Because of the lack of infection-fighting [neutrophils](https://en.wikipedia.org/wiki/Neutrophil "Neutrophil"), a bacterial infection can spread rapidly; this fever is, therefore, usually considered to require urgent medical attention.[\[97\]](https://en.wikipedia.org/wiki/Fever#cite_note-97) This kind of fever is more commonly seen in people receiving immune-suppressing [chemotherapy](https://en.wikipedia.org/wiki/Chemotherapy "Chemotherapy") than in apparently healthy people.[\[96\]](https://en.wikipedia.org/wiki/Fever#cite_note-Klastersky_2014_13%E2%80%9326-96)[\[98\]](https://en.wikipedia.org/wiki/Fever#cite_note-98)
Hyperpyrexia is an extreme elevation of [body temperature](https://en.wikipedia.org/wiki/Body_temperature "Body temperature") which, depending upon the source, is classified as a [core body temperature](https://en.wikipedia.org/wiki/Core_body_temperature "Core body temperature") greater than or equal to 40 or 41 °C (104 or 106 °F); the range of hyperpyrexia includes cases considered severe (≥ 40 °C) and extreme (≥ 42 °C).[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[99\]](https://en.wikipedia.org/wiki/Fever#cite_note-MDMA-Hyperpyrexia_systematic_review-99)[\[100\]](https://en.wikipedia.org/wiki/Fever#cite_note-Neurobiology_of_hyperthermia-100) It differs from [hyperthermia](https://en.wikipedia.org/wiki/Hyperthermia "Hyperthermia") in that one's [thermoregulatory system's set point](https://en.wikipedia.org/wiki/Human_thermoregulation#Control_system "Human thermoregulation") for body temperature is set above normal, then heat is generated to achieve it. In contrast, hyperthermia involves body temperature rising above its set point due to outside factors.[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7)[\[101\]](https://en.wikipedia.org/wiki/Fever#cite_note-101) The high temperatures of hyperpyrexia are considered [medical emergencies](https://en.wikipedia.org/wiki/Medical_emergency "Medical emergency"), as they may indicate a serious underlying condition or lead to severe morbidity (including permanent [brain damage](https://en.wikipedia.org/wiki/Brain_damage "Brain damage")), or to death.[\[102\]](https://en.wikipedia.org/wiki/Fever#cite_note-EM01-102) A common cause of hyperpyrexia is an [intracranial hemorrhage](https://en.wikipedia.org/wiki/Intracranial_hemorrhage "Intracranial hemorrhage").[\[7\]](https://en.wikipedia.org/wiki/Fever#cite_note-Harrisons20th-7) Other causes in emergency room settings include [malignant catatonia](https://en.wikipedia.org/wiki/Catatonia "Catatonia"), [sepsis](https://en.wikipedia.org/wiki/Sepsis "Sepsis"), [Kawasaki syndrome](https://en.wikipedia.org/wiki/Kawasaki_syndrome "Kawasaki syndrome"),[\[103\]](https://en.wikipedia.org/wiki/Fever#cite_note-Marx_2006_2506-103) [neuroleptic malignant syndrome](https://en.wikipedia.org/wiki/Neuroleptic_malignant_syndrome "Neuroleptic malignant syndrome"), [drug overdose](https://en.wikipedia.org/wiki/Drug_overdose "Drug overdose"), [serotonin syndrome](https://en.wikipedia.org/wiki/Serotonin_syndrome "Serotonin syndrome"), and [thyroid storm](https://en.wikipedia.org/wiki/Thyroid_storm "Thyroid storm").[\[102\]](https://en.wikipedia.org/wiki/Fever#cite_note-EM01-102)
[](https://en.wikipedia.org/wiki/File:Fever-conceptual.svg)
Hyperthermia: Characterized on the left. Normal body temperature (thermoregulatory set point) is shown in green, while the hyperthermic temperature is shown in red. As can be seen, hyperthermia can be conceptualized as an increase above the thermoregulatory set point.
Hypothermia: Characterized in the center: Normal body temperature is shown in green, while the hypothermic temperature is shown in blue. As can be seen, hypothermia can be conceptualized as a decrease below the thermoregulatory set point.
Fever: Characterized on the right: Normal body temperature is shown in green. It reads "New Normal" because the thermoregulatory set point has risen. This has caused what was the normal body temperature (in blue) to be considered hypothermic.
Fever is thought to contribute to host defense,[\[17\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sch2006-17) as the reproduction of [pathogens](https://en.wikipedia.org/wiki/Pathogen "Pathogen") with strict temperature requirements can be hindered, and the rates of some important immunological reactions are increased by temperature.[\[104\]](https://en.wikipedia.org/wiki/Fever#cite_note-Fischler-104) Fever has been described in teaching texts as assisting the healing process in various ways, including:
- increased mobility of [leukocytes](https://en.wikipedia.org/wiki/Leukocytes "Leukocytes");[\[105\]](https://en.wikipedia.org/wiki/Fever#cite_note-Craven2003-105): 1044
- enhanced leukocyte [phagocytosis](https://en.wikipedia.org/wiki/Phagocytosis "Phagocytosis");[\[105\]](https://en.wikipedia.org/wiki/Fever#cite_note-Craven2003-105): 1030
- decreased [endotoxin](https://en.wikipedia.org/wiki/Endotoxin "Endotoxin") effects;[\[105\]](https://en.wikipedia.org/wiki/Fever#cite_note-Craven2003-105): 1029 and
- increased [proliferation](https://en.wikipedia.org/wiki/Cell_proliferation "Cell proliferation") of [T cells](https://en.wikipedia.org/wiki/T_cells "T cells").[\[105\]](https://en.wikipedia.org/wiki/Fever#cite_note-Craven2003-105): 1030 [\[106\]](https://en.wikipedia.org/wiki/Fever#cite_note-LewisDirksenHeitkemper2005-106): 212
### Advantages and disadvantages
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=16 "Edit section: Advantages and disadvantages")\]
A fever response to an infectious disease is generally regarded as protective, whereas fever in non-infections may be maladaptive.[\[107\]](https://en.wikipedia.org/wiki/Fever#cite_note-kiek-107)[\[108\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid9917881-108) Studies have not been consistent on whether treating fever generally worsens or improves mortality risk.[\[109\]](https://en.wikipedia.org/wiki/Fever#cite_note-SepticReview2017-109) Benefits or harms may depend on the type of infection, health status of the patient and other factors.[\[107\]](https://en.wikipedia.org/wiki/Fever#cite_note-kiek-107) Studies using [warm-blooded](https://en.wikipedia.org/wiki/Warm-blooded "Warm-blooded") [vertebrates](https://en.wikipedia.org/wiki/Vertebrates "Vertebrates") suggest that they recover more rapidly from infections or critical illness due to fever.[\[110\]](https://en.wikipedia.org/wiki/Fever#cite_note-VUB-110) In [sepsis](https://en.wikipedia.org/wiki/Sepsis "Sepsis"), fever is associated with reduced mortality.[\[111\]](https://en.wikipedia.org/wiki/Fever#cite_note-111)\[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
Fever does not necessarily need to be treated,[\[112\]](https://en.wikipedia.org/wiki/Fever#cite_note-112) and most people with a fever recover without specific medical attention.[\[113\]](https://en.wikipedia.org/wiki/Fever#cite_note-CDC_symptoms-113) Although it is unpleasant, fever rarely rises to a dangerous level even if untreated.[\[114\]](https://en.wikipedia.org/wiki/Fever#cite_note-114) Damage to the brain generally does not occur until temperatures reach 40.0 °C (104.0 °F), and it is rare for an untreated fever to exceed 40.6 °C (105.1 °F).[\[115\]](https://en.wikipedia.org/wiki/Fever#cite_note-revben-115) Treating fever in people with [sepsis](https://en.wikipedia.org/wiki/Sepsis "Sepsis") does not affect outcomes.[\[116\]](https://en.wikipedia.org/wiki/Fever#cite_note-116) Small trials have shown no benefit of treating fevers of 38.5 °C (101.3 °F) or higher of critically ill patients in ICUs, and one trial was terminated early because patients receiving aggressive fever treatment were dying more often.[\[19\]](https://en.wikipedia.org/wiki/Fever#cite_note-:0-19)
According to the NIH, the two assumptions which are generally used to argue in favor of treating fevers have not been experimentally validated. These are that (1) a fever is noxious, and (2) suppression of a fever will reduce its noxious effect. Most of the other studies supporting the association of fever with poorer outcomes have been observational in nature. In theory, these critically ill patients and those faced with additional physiologic stress may benefit from fever reduction, but the evidence on both sides of the argument appears to be mostly equivocal.[\[19\]](https://en.wikipedia.org/wiki/Fever#cite_note-:0-19)
### Conservative measures
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=18 "Edit section: Conservative measures")\]
Limited evidence supports sponging or bathing feverish children with tepid water.[\[117\]](https://en.wikipedia.org/wiki/Fever#cite_note-117) The use of a [fan](https://en.wikipedia.org/wiki/Mechanical_fan "Mechanical fan") or air conditioning may somewhat reduce the temperature and increase comfort. If the temperature reaches the extremely high level of [hyperpyrexia](https://en.wikipedia.org/wiki/Hyperpyrexia "Hyperpyrexia"), aggressive cooling is required (generally produced mechanically via [conduction](https://en.wikipedia.org/wiki/Conduction_\(heat\) "Conduction (heat)") by applying numerous ice packs across most of the body or direct submersion in [ice water](https://en.wikipedia.org/wiki/Ice_bath "Ice bath")).[\[102\]](https://en.wikipedia.org/wiki/Fever#cite_note-EM01-102) In general, people are advised to keep adequately hydrated.[\[118\]](https://en.wikipedia.org/wiki/Fever#cite_note-118) Whether increased fluid intake improves symptoms or shortens respiratory illnesses such as the [common cold](https://en.wikipedia.org/wiki/Common_cold "Common cold") is not known.[\[119\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid21328268-119)
Medications that lower fevers are called *[antipyretics](https://en.wikipedia.org/wiki/Antipyretic "Antipyretic")*.[\[120\]](https://en.wikipedia.org/wiki/Fever#cite_note-120) The antipyretic [ibuprofen](https://en.wikipedia.org/wiki/Ibuprofen "Ibuprofen") is effective in reducing fevers in children.[\[121\]](https://en.wikipedia.org/wiki/Fever#cite_note-Per2004-121) It is more effective than [acetaminophen](https://en.wikipedia.org/wiki/Acetaminophen "Acetaminophen") (paracetamol) in children.[\[121\]](https://en.wikipedia.org/wiki/Fever#cite_note-Per2004-121) Ibuprofen and acetaminophen may safely be used together in children with fevers.[\[122\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid19454182-122)[\[123\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid19606950-123) The efficacy of acetaminophen by itself in children with fevers has been questioned.[\[124\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid12076499-124) Ibuprofen is also superior to [aspirin](https://en.wikipedia.org/wiki/Aspirin "Aspirin") in children with fevers.[\[125\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid9049576-125) Additionally, [aspirin](https://en.wikipedia.org/wiki/Aspirin "Aspirin") is not recommended in those under the age of 18 due to the risk of [Reye's syndrome](https://en.wikipedia.org/wiki/Reye%27s_syndrome "Reye's syndrome").[\[126\]](https://en.wikipedia.org/wiki/Fever#cite_note-126)
Using both paracetamol and ibuprofen at the same time or alternating between the two is more effective at decreasing fever than using only paracetamol or ibuprofen.[\[127\]](https://en.wikipedia.org/wiki/Fever#cite_note-Wong2013-127) It is not clear if it increases child comfort.[\[127\]](https://en.wikipedia.org/wiki/Fever#cite_note-Wong2013-127) Response or nonresponse to medications does not predict whether or not a child has a serious illness.[\[128\]](https://en.wikipedia.org/wiki/Fever#cite_note-pmid23846358-128)
With respect to the effect of antipyretics on the risk of death in those with infection, studies have found mixed results, as of 2019.[\[129\]](https://en.wikipedia.org/wiki/Fever#cite_note-129)
Fever is one of the most common [medical signs](https://en.wikipedia.org/wiki/Medical_signs "Medical signs").[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2) It is part of about 30% of healthcare visits by children,[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2) and occurs in up to 75% of adults who are seriously sick.[\[11\]](https://en.wikipedia.org/wiki/Fever#cite_note-Ki2013-11) About 5% of people who go to an emergency room have a fever.[\[130\]](https://en.wikipedia.org/wiki/Fever#cite_note-EMP2012-130)
A number of types of fever were known as early as 460 BC to 370 BC when [Hippocrates](https://en.wikipedia.org/wiki/Hippocrates "Hippocrates") was practicing medicine including that due to [malaria](https://en.wikipedia.org/wiki/Malaria "Malaria") (tertian or every 2 days and quartan or every 3 days).[\[131\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sajadi2012-131) It also became clear around this time that fever was a symptom of disease rather than a disease in and of itself.[\[131\]](https://en.wikipedia.org/wiki/Fever#cite_note-Sajadi2012-131)
Infections presenting with fever were a major source of mortality in humans for about 200,000 years. Until the late nineteenth century, approximately half of all humans died from infections before the age of fifteen.[\[132\]](https://en.wikipedia.org/wiki/Fever#cite_note-132)
An older term, [febricula](https://en.wiktionary.org/wiki/febricula "wikt:febricula") (a [diminutive](https://en.wikipedia.org/wiki/Diminutive "Diminutive") form of the [Latin](https://en.wikipedia.org/wiki/Latin_language "Latin language") word for fever), was once used to refer to a low-grade fever lasting only a few days. This term fell out of use in the early 20th century, and the symptoms it referred to are now thought to have been caused mainly by various minor [viral](https://en.wikipedia.org/wiki/Virus "Virus") [respiratory infections](https://en.wikipedia.org/wiki/Respiratory_infection "Respiratory infection").[\[133\]](https://en.wikipedia.org/wiki/Fever#cite_note-133)
## Society and culture
\[[edit](https://en.wikipedia.org/w/index.php?title=Fever&action=edit§ion=22 "Edit section: Society and culture")\]
[](https://en.wikipedia.org/wiki/File:Virgil_Solis_Febris.jpg)
Febris
- [Febris](https://en.wikipedia.org/wiki/Febris "Febris") (*fever* in [Latin](https://en.wikipedia.org/wiki/Latin "Latin")) is the goddess of fever in [Roman mythology](https://en.wikipedia.org/wiki/Roman_mythology "Roman mythology"). People with fevers would visit her temples.
- Tertiana and Quartana are the goddesses of tertian and quartan fevers of malaria in Roman mythology.[\[134\]](https://en.wikipedia.org/wiki/Fever#cite_note-134)
- [Jvarasura](https://en.wikipedia.org/wiki/Jvarasura "Jvarasura") (*fever-demon* in [Hindi](https://en.wikipedia.org/wiki/Hindi "Hindi")) is the personification of fever and disease in [Hindu](https://en.wikipedia.org/wiki/Hindu_mythology "Hindu mythology") and [Buddhist mythology](https://en.wikipedia.org/wiki/Buddhist_mythology "Buddhist mythology").
Fever is often viewed with greater concern by parents and healthcare professionals than might be deserved, a phenomenon known as fever phobia,[\[2\]](https://en.wikipedia.org/wiki/Fever#cite_note-Peds2011-2)[\[135\]](https://en.wikipedia.org/wiki/Fever#cite_note-Crocetti2001-135) which is based in both caregiver's and parents' misconceptions about fever in children. Among them, many parents incorrectly believe that fever is a [disease](https://en.wikipedia.org/wiki/Disease "Disease") rather than a [medical sign](https://en.wikipedia.org/wiki/Medical_sign "Medical sign"), that even low fevers are harmful, and that any temperature even briefly or slightly above the oversimplified "normal" number marked on a thermometer is a clinically significant fever.[\[135\]](https://en.wikipedia.org/wiki/Fever#cite_note-Crocetti2001-135) They are also afraid of harmless side effects like [febrile seizures](https://en.wikipedia.org/wiki/Febrile_seizure "Febrile seizure") and dramatically overestimate the likelihood of permanent damage from typical fevers.[\[135\]](https://en.wikipedia.org/wiki/Fever#cite_note-Crocetti2001-135) The underlying problem, according to professor of pediatrics Barton D. Schmitt, is that "as parents we tend to suspect that our children's brains may melt."[\[136\]](https://en.wikipedia.org/wiki/Fever#cite_note-136) As a result of these misconceptions parents are anxious, give the child fever-reducing medicine when the temperature is technically normal or only slightly elevated, and interfere with the child's sleep to give the child more medicine.[\[135\]](https://en.wikipedia.org/wiki/Fever#cite_note-Crocetti2001-135)
Fever is an important metric for the [diagnosis](https://en.wikipedia.org/wiki/Medical_diagnosis "Medical diagnosis") of [disease in domestic animals](https://en.wikipedia.org/wiki/Livestock_disease "Livestock disease"). The body temperature of animals, which is taken rectally, is different from one species to another. For example, a [horse](https://en.wikipedia.org/wiki/Horse "Horse") is said to have a fever above 101 °F (38\.3 °C).[\[137\]](https://en.wikipedia.org/wiki/Fever#cite_note-137) In species that allow the body to have a wide range of "normal" temperatures, such as [camels](https://en.wikipedia.org/wiki/Camel "Camel"),[\[138\]](https://en.wikipedia.org/wiki/Fever#cite_note-138) whose body temperature varies as the environmental temperature varies,[\[139\]](https://en.wikipedia.org/wiki/Fever#cite_note-139) the body temperature which constitutes a febrile state differs depending on the environmental temperature.[\[140\]](https://en.wikipedia.org/wiki/Fever#cite_note-140) Fever can also be behaviorally induced by invertebrates that do not have immune-system based fever. For instance, some species of grasshopper will thermoregulate to achieve body temperatures that are 2–5 °C higher than normal in order to inhibit the growth of fungal pathogens such as *[Beauveria bassiana](https://en.wikipedia.org/wiki/Beauveria_bassiana "Beauveria bassiana")* and *[Metarhizium acridum](https://en.wikipedia.org/wiki/Metarhizium_acridum "Metarhizium acridum")*.[\[141\]](https://en.wikipedia.org/wiki/Fever#cite_note-Thomas2003-141) Honeybee colonies are also able to induce a fever in response to a fungal parasite *Ascosphaera apis*.[\[141\]](https://en.wikipedia.org/wiki/Fever#cite_note-Thomas2003-141)
1. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-2) [***d***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-3) [***e***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-4) [***f***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-5) [***g***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-6) [***h***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-7) [***i***](https://en.wikipedia.org/wiki/Fever#cite_ref-NC08_1-8)
Axelrod YK, Diringer MN (May 2008). "Temperature management in acute neurologic disorders". *Neurologic Clinics*. **26** (2): 585–603, xi. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.ncl.2008.02.005](https://doi.org/10.1016%2Fj.ncl.2008.02.005). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [18514828](https://pubmed.ncbi.nlm.nih.gov/18514828).
2. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-2) [***d***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-3) [***e***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-4) [***f***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-5) [***g***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-6) [***h***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-7) [***i***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-8) [***j***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-9) [***k***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-10) [***l***](https://en.wikipedia.org/wiki/Fever#cite_ref-Peds2011_2-11)
Sullivan JE, Farrar HC (March 2011). ["Fever and antipyretic use in children"](https://doi.org/10.1542%2Fpeds.2010-3852). *Pediatrics*. **127** (3) e20103852: 580–587\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1542/peds.2010-3852](https://doi.org/10.1542%2Fpeds.2010-3852). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [21357332](https://pubmed.ncbi.nlm.nih.gov/21357332).
3. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Sue2014_3-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Sue2014_3-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Sue2014_3-2)
Huether, Sue E. (2014). [*Pathophysiology: The Biologic Basis for Disease in Adults and Children*](https://books.google.com/books?id=l9XsAwAAQBAJ&pg=PA498) (7th ed.). Elsevier Health Sciences. p. 498. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-0-323-29375-4](https://en.wikipedia.org/wiki/Special:BookSources/978-0-323-29375-4 "Special:BookSources/978-0-323-29375-4")
.
4. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-CDC2010_4-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-CDC2010_4-1)
CDC Staff (31 March 2020). ["Taking Care of Someone Who is Sick: Caring for Someone Sick at Home"](https://web.archive.org/web/20150324084355/http://www.cdc.gov/flu/homecare/treatfever.htm). Archived from [the original](https://www.cdc.gov/flu/homecare/treatfever.htm) on 24 March 2015. Retrieved 8 May 2015.
5. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Kl2015_5-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Kl2015_5-1)
Kluger MJ (2015). [*Fever: Its Biology, Evolution, and Function*](https://books.google.com/books?id=gIF9BgAAQBAJ&pg=PA57). Princeton University Press. p. 57. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-1-4008-6983-1](https://en.wikipedia.org/wiki/Special:BookSources/978-1-4008-6983-1 "Special:BookSources/978-1-4008-6983-1")
.
6. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Gar2012p375_6-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Gar2012p375_6-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Gar2012p375_6-2)
Garmel GM, Mahadevan SV, eds. (2012). ["Fever in adults"](https://books.google.com/books?id=pyAlcOfBhjIC&q=An%20Introduction%20to%20Clinical%20Emergency%20Medicine&pg=PA375). *An introduction to clinical emergency medicine* (2nd ed.). Cambridge: Cambridge University Press. p. 375. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-0-521-74776-9](https://en.wikipedia.org/wiki/Special:BookSources/978-0-521-74776-9 "Special:BookSources/978-0-521-74776-9")
.
7. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-2) [***d***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-3) [***e***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-4) [***f***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-5) [***g***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-6) [***h***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-7) [***i***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-8) [***j***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-9) [***k***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-10) [***l***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-11) [***m***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-12) [***n***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-13) [***o***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-14) [***p***](https://en.wikipedia.org/wiki/Fever#cite_ref-Harrisons20th_7-15)
Dinarello CA, Porat R (2018). "Chapter 15: Fever". In Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo, J (eds.). [*Harrison's Principles of Internal Medicine*](https://books.google.com/books?id=XGQntQEACAAJ&q=9781259644030). Vol. 1–2 (20th ed.). New York: McGraw-Hill. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-1-259-64403-0](https://en.wikipedia.org/wiki/Special:BookSources/978-1-259-64403-0 "Special:BookSources/978-1-259-64403-0")
. Retrieved 31 March 2020.
8. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-CC09_8-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-CC09_8-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-CC09_8-2) [***d***](https://en.wikipedia.org/wiki/Fever#cite_ref-CC09_8-3) [***e***](https://en.wikipedia.org/wiki/Fever#cite_ref-CC09_8-4) [***f***](https://en.wikipedia.org/wiki/Fever#cite_ref-CC09_8-5)
Laupland KB (July 2009). "Fever in the critically ill medical patient". *Critical Care Medicine*. **37** (7 Suppl): S273-8. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1097/CCM.0b013e3181aa6117](https://doi.org/10.1097%2FCCM.0b013e3181aa6117). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [19535958](https://pubmed.ncbi.nlm.nih.gov/19535958).
9. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ric2015_9-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ric2015_9-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ric2015_9-2) [***d***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ric2015_9-3) [***e***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ric2015_9-4)
10. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Gar2012_10-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Gar2012_10-1)
Garmel GM, Mahadevan SV, eds. (2012). *An introduction to clinical emergency medicine* (2nd ed.). Cambridge: Cambridge University Press. p. 401. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-0-521-74776-9](https://en.wikipedia.org/wiki/Special:BookSources/978-0-521-74776-9 "Special:BookSources/978-0-521-74776-9")
.
11. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ki2013_11-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ki2013_11-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Ki2013_11-2)
Kiekkas P, Aretha D, Bakalis N, Karpouhtsi I, Marneras C, Baltopoulos GI (August 2013). "Fever effects and treatment in critical care: literature review". *Australian Critical Care*. **26** (3): 130–135\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.aucc.2012.10.004](https://doi.org/10.1016%2Fj.aucc.2012.10.004). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [23199670](https://pubmed.ncbi.nlm.nih.gov/23199670).
12. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-12)**
Franjić, Siniša (31 March 2019). ["Fever Can Be A Symptom of Many Diseases"](https://doi.org/10.47363%2Fjmhc%2F2021%283%29146). *Journal of Medicine and HealthCare*: 1–3\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.47363/jmhc/2021(3)146](https://doi.org/10.47363%2Fjmhc%2F2021%283%29146). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [243837498](https://api.semanticscholar.org/CorpusID:243837498).
13. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Gar2012p5_13-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Gar2012p5_13-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Gar2012p5_13-2)
Garmel GM, Mahadevan SV, eds. (2012). *An introduction to clinical emergency medicine* (2nd ed.). Cambridge: Cambridge University Press. p. 5. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
[978-0-521-74776-9](https://en.wikipedia.org/wiki/Special:BookSources/978-0-521-74776-9 "Special:BookSources/978-0-521-74776-9")
.
14. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Rod2020_14-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Rod2020_14-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Rod2020_14-2)
Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, Alvarado-Arnez LE, Bonilla-Aldana DK, Franco-Paredes C (13 March 2020). ["Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102608). *Travel Medicine and Infectious Disease*. **34** 101623. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.tmaid.2020.101623](https://doi.org/10.1016%2Fj.tmaid.2020.101623). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [7102608](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102608). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [32179124](https://pubmed.ncbi.nlm.nih.gov/32179124).
15. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-15)**
Dayal R, Agarwal D (January 2016). "Fever in Children and Fever of Unknown Origin". *Indian Journal of Pediatrics*. **83** (1): 38–43\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1007/s12098-015-1724-4](https://doi.org/10.1007%2Fs12098-015-1724-4). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [25724501](https://pubmed.ncbi.nlm.nih.gov/25724501). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [34481402](https://api.semanticscholar.org/CorpusID:34481402).
16. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-16)**
["Fever"](https://www.medlineplus.gov/ency/article/003090.htm). *MedlinePlus*. 30 August 2014. [Archived](https://web.archive.org/web/20090511181606/http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm) from the original on 11 May 2009.
17. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Sch2006_17-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Sch2006_17-1)
Schaffner A (March 2006). "Fieber – nützliches oder schädliches, zu behandelndes Symptom?" \[Fever–useful or noxious symptom that should be treated?\]. *Therapeutische Umschau* (in German). **63** (3): 185–188\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1024/0040-5930.63.3.185](https://doi.org/10.1024%2F0040-5930.63.3.185). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [16613288](https://pubmed.ncbi.nlm.nih.gov/16613288).
Abstract alone is in German and in English.
18. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-Antipyretic_therapy_in_febrile_crit_18-0)**
Niven DJ, Stelfox HT, Laupland KB (June 2013). "Antipyretic therapy in febrile critically ill adults: A systematic review and meta-analysis". *Journal of Critical Care*. **28** (3): 303–310\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.jcrc.2012.09.009](https://doi.org/10.1016%2Fj.jcrc.2012.09.009). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [23159136](https://pubmed.ncbi.nlm.nih.gov/23159136).
19. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-:0_19-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-:0_19-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-:0_19-2)
Ray, Juliet J. (December 2015). ["Fever: suppress or let it ride?"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4703655). *Journal of Thoracic Disease*. **7** (12): E633–E636. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.3978/j.issn.2072-1439.2015.12.28](https://doi.org/10.3978%2Fj.issn.2072-1439.2015.12.28). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [4703655](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4703655). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [26793378](https://pubmed.ncbi.nlm.nih.gov/26793378).
20. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-20)**
Crocetti M, Moghbeli N, Serwint J (June 2001). "Fever Phobia Revisited: Have Parental Misconceptions About Fever Changed in 20 Years?". *Pediatrics*. **107** (6): 1241–1246\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1542/peds.107.6.1241](https://doi.org/10.1542%2Fpeds.107.6.1241). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [11389237](https://pubmed.ncbi.nlm.nih.gov/11389237).
21. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-21)**
["Fever: Symptoms, treatments, types, and causes"](https://www.medicalnewstoday.com/articles/168266). *www.medicalnewstoday.com*. 5 May 2020. Retrieved 22 April 2022.
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Harden, L. M.; Kent, S.; Pittman, Q. J.; Roth, J. (1 November 2015). ["Fever and sickness behavior: Friend or foe?"](https://www.sciencedirect.com/science/article/pii/S0889159115004079). *Brain, Behavior, and Immunity*. **50**: 322–333\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.bbi.2015.07.012](https://doi.org/10.1016%2Fj.bbi.2015.07.012). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0889-1591](https://search.worldcat.org/issn/0889-1591). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [26187566](https://pubmed.ncbi.nlm.nih.gov/26187566). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [19396134](https://api.semanticscholar.org/CorpusID:19396134).
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Kelley KW, Bluthé RM, Dantzer R, Zhou JH, Shen WH, Johnson RW, Broussard SR (February 2003). "Cytokine-induced sickness behavior". *Brain, Behavior, and Immunity*. 17 Suppl 1 (1): S112–S118. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/S0889-1591(02)00077-6](https://doi.org/10.1016%2FS0889-1591%2802%2900077-6). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [12615196](https://pubmed.ncbi.nlm.nih.gov/12615196). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [25400611](https://api.semanticscholar.org/CorpusID:25400611).
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Adamis D, Treloar A, Martin FC, Macdonald AJ (December 2007). ["A brief review of the history of delirium as a mental disorder"](https://hal.archives-ouvertes.fr/hal-00570887/document). *History of Psychiatry*. **18** (72 Pt 4): 459–469\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1177/0957154X07076467](https://doi.org/10.1177%2F0957154X07076467). [hdl](https://en.wikipedia.org/wiki/Hdl_\(identifier\) "Hdl (identifier)"):[2262/51619](https://hdl.handle.net/2262%2F51619). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [18590023](https://pubmed.ncbi.nlm.nih.gov/18590023). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [24424207](https://api.semanticscholar.org/CorpusID:24424207).
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Beard, Robin M.; Day, Michael W. (June 2008). ["Fever and Hyperthermia"](https://doi.org/10.1097%2F01.NURSE.0000320353.79079.a5). *Nursing2022*. **38** (6): 28–31\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1097/01.NURSE.0000320353.79079.a5](https://doi.org/10.1097%2F01.NURSE.0000320353.79079.a5). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0360-4039](https://search.worldcat.org/issn/0360-4039). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [18497656](https://pubmed.ncbi.nlm.nih.gov/18497656).
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Ushikubi F, et al. (September 1998). "Impaired febrile response in mice lacking the prostaglandin E receptor subtype EP3". *Nature*. **395** (6699): 281–284\. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[1998Natur.395..281U](https://ui.adsabs.harvard.edu/abs/1998Natur.395..281U). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1038/26233](https://doi.org/10.1038%2F26233). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [9751056](https://pubmed.ncbi.nlm.nih.gov/9751056). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [4420632](https://api.semanticscholar.org/CorpusID:4420632).
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Evans SS, Repasky EA, Fisher DT (June 2015). ["Fever and the thermal regulation of immunity: the immune system feels the heat"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4786079). *Nature Reviews. Immunology*. **15** (6): 335–349\. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[2015NatRI..15..335E](https://ui.adsabs.harvard.edu/abs/2015NatRI..15..335E). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1038/nri3843](https://doi.org/10.1038%2Fnri3843). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [4786079](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4786079). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [25976513](https://pubmed.ncbi.nlm.nih.gov/25976513).
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Nakamura, Kazuhiro (November 2011). ["Central circuitries for body temperature regulation and fever"](https://www.physiology.org/doi/10.1152/ajpregu.00109.2011). *American Journal of Physiology. Regulatory, Integrative and Comparative Physiology*. **301** (5): R1207–R1228. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[2011AJPRI.301R1207N](https://ui.adsabs.harvard.edu/abs/2011AJPRI.301R1207N). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1152/ajpregu.00109.2011](https://doi.org/10.1152%2Fajpregu.00109.2011). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0363-6119](https://search.worldcat.org/issn/0363-6119). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [21900642](https://pubmed.ncbi.nlm.nih.gov/21900642).
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Morrison, S.F.; Nakamura, K. (10 February 2019). ["Central Mechanisms for Thermoregulation"](https://www.annualreviews.org/doi/10.1146/annurev-physiol-020518-114546). *Annual Review of Physiology*. **81** (1): 285–308\. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[2019ARPhy..81..285M](https://ui.adsabs.harvard.edu/abs/2019ARPhy..81..285M). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1146/annurev-physiol-020518-114546](https://doi.org/10.1146%2Fannurev-physiol-020518-114546). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0066-4278](https://search.worldcat.org/issn/0066-4278). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [30256726](https://pubmed.ncbi.nlm.nih.gov/30256726).
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Nakamura, Kazuhiro; Nakamura, Yoshiko; Kataoka, Naoya (January 2022). ["A hypothalamomedullary network for physiological responses to environmental stresses"](https://www.nature.com/articles/s41583-021-00532-x). *Nature Reviews Neuroscience*. **23** (1): 35–52\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1038/s41583-021-00532-x](https://doi.org/10.1038%2Fs41583-021-00532-x). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [1471-003X](https://search.worldcat.org/issn/1471-003X). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [34728833](https://pubmed.ncbi.nlm.nih.gov/34728833).
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Nowack, Julia; Giroud, Sylvain; Arnold, Walter; Ruf, Thomas (9 November 2017). ["Muscle Non-shivering Thermogenesis and Its Role in the Evolution of Endothermy"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684175). *Frontiers in Physiology*. **8** 889. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.3389/fphys.2017.00889](https://doi.org/10.3389%2Ffphys.2017.00889). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [1664-042X](https://search.worldcat.org/issn/1664-042X). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [5684175](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684175). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [29170642](https://pubmed.ncbi.nlm.nih.gov/29170642).
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Deussen, A. (September 2007). "\[Hyperthermia and hypothermia. Effects on the cardiovascular system\]". *Der Anaesthesist*. **56** (9): 907–911\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1007/s00101-007-1219-4](https://doi.org/10.1007%2Fs00101-007-1219-4). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0003-2417](https://search.worldcat.org/issn/0003-2417). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [17554514](https://pubmed.ncbi.nlm.nih.gov/17554514).
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Hagel L, Jagschies G, Sofer G (1 January 2008). "5 – Analysis". [*Handbook of Process Chromatography*](https://archive.org/details/handbookprocessc00hage) (2nd ed.). Academic Press. pp. [127](https://archive.org/details/handbookprocessc00hage/page/n145)–145. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/b978-012374023-6.50007-5](https://doi.org/10.1016%2Fb978-012374023-6.50007-5). [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
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Kojima K (1 January 2012). "17 – Biological evaluation and regulation of medical devices in Japan". In Boutrand JP (ed.). [*Biocompatibility and Performance of Medical Devices*](https://archive.org/details/biocompatibility00bout). Woodhead Publishing Series in Biomaterials. Woodhead Publishing. pp. [404](https://archive.org/details/biocompatibility00bout/page/n434)–448. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1533/9780857096456.4.404](https://doi.org/10.1533%2F9780857096456.4.404). [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
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Pecoraro, Valentina; Petri, Davide; Costantino, Giorgio; Squizzato, Alessandro; Moja, Lorenzo; Virgili, Gianni; Lucenteforte, Ersilia (25 November 2020). ["The diagnostic accuracy of digital, infrared and mercury-in-glass thermometers in measuring body temperature: a systematic review and network meta-analysis"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7686821). *Internal and Emergency Medicine*. **16** (4). Springer Science and Business Media LLC: 1071–1083\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1007/s11739-020-02556-0](https://doi.org/10.1007%2Fs11739-020-02556-0). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [1828-0447](https://search.worldcat.org/issn/1828-0447). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [7686821](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7686821). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [33237494](https://pubmed.ncbi.nlm.nih.gov/33237494).
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Geneva, Ivayla I.; Cuzzo, Brian; Fazili, Tasaduq; Javaid, Waleed (2019). ["Normal Body Temperature: A Systematic Review"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456186). *Open Forum Infectious Diseases*. **6** (4) ofz032. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1093/ofid/ofz032](https://doi.org/10.1093%2Fofid%2Fofz032). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [6456186](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456186). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [30976605](https://pubmed.ncbi.nlm.nih.gov/30976605).
67. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Garami_67-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Garami_67-1) [***c***](https://en.wikipedia.org/wiki/Fever#cite_ref-Garami_67-2) [***d***](https://en.wikipedia.org/wiki/Fever#cite_ref-Garami_67-3)
Garami, András; Székely, Miklós (6 May 2014). ["Body temperature"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972507). *Temperature: Multidisciplinary Biomedical Journal*. **1** (1): 28–29\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.4161/temp.29060](https://doi.org/10.4161%2Ftemp.29060). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [2332-8940](https://search.worldcat.org/issn/2332-8940). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [4972507](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972507). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [27583277](https://pubmed.ncbi.nlm.nih.gov/27583277).
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Alsalamah, M; Alrehaili, B; Almoamary, A; Al-Juad, A; Badri, M; El-Metwally, A (July 2022). ["The optimal oral body temperature cutoff and other factors predictive of sepsis diagnosis in elderly patients"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9374123). *Annals of Thoracic Medicine*. **17** (3): 159–165\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.4103/atm.atm\_52\_22](https://doi.org/10.4103%2Fatm.atm_52_22). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [9374123](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9374123). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [35968398](https://pubmed.ncbi.nlm.nih.gov/35968398).
70. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-70)**
Raoult, Didier; Levy, Pierre-Yves; Dupont, Hervé Tissot; Chicheportiche, Colette; Tamalet, Catherine; Gastaut, Jean-Albert; Salducci, Jacques (January 1993). ["Q fever and HIV infection"](http://journals.lww.com/00002030-199301000-00012). *AIDS*. **7** (1): 81–86\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1097/00002030-199301000-00012](https://doi.org/10.1097%2F00002030-199301000-00012). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0269-9370](https://search.worldcat.org/issn/0269-9370). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [8442921](https://pubmed.ncbi.nlm.nih.gov/8442921).
71. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-71)**
French, Neil; Nakiyingi, Jessica; Lugada, Eric; Watera, Christine; Whitworth, James A. G.; Gilks, Charles F. (May 2001). ["Increasing rates of malarial fever with deteriorating immune status in HIV-1-infected Ugandan adults"](https://journals.lww.com/aidsonline/Fulltext/2001/05040/Increasing_rates_of_malarial_fever_with.10.aspx). *AIDS*. **15** (7): 899–906\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1097/00002030-200105040-00010](https://doi.org/10.1097%2F00002030-200105040-00010). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0269-9370](https://search.worldcat.org/issn/0269-9370). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [11399962](https://pubmed.ncbi.nlm.nih.gov/11399962). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [25470703](https://api.semanticscholar.org/CorpusID:25470703). [Archived](https://web.archive.org/web/20220222192422/https://journals.lww.com/aidsonline/Fulltext/2001/05040/Increasing_rates_of_malarial_fever_with.10.aspx) from the original on 22 February 2022.
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Heymann, D. L.; Weisfeld, J. S.; Webb, P. A.; Johnson, K. M.; Cairns, T.; Berquist, H. (1 September 1980). "Ebola Hemorrhagic Fever: Tandala, Zaire, 1977–1978". *Journal of Infectious Diseases*. **142** (3): 372–376\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1093/infdis/142.3.372](https://doi.org/10.1093%2Finfdis%2F142.3.372). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0022-1899](https://search.worldcat.org/issn/0022-1899). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [7441008](https://pubmed.ncbi.nlm.nih.gov/7441008).
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Feldmann, Heinz; Geisbert, Thomas W (March 2011). ["Ebola haemorrhagic fever"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406178). *The Lancet*. **377** (9768): 849–862\. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[2011Lanc..377..849F](https://ui.adsabs.harvard.edu/abs/2011Lanc..377..849F). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/s0140-6736(10)60667-8](https://doi.org/10.1016%2Fs0140-6736%2810%2960667-8). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [0140-6736](https://search.worldcat.org/issn/0140-6736). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [3406178](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406178). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [21084112](https://pubmed.ncbi.nlm.nih.gov/21084112).
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Colunga-Salas, Pablo; Sánchez-Montes, Sokani; Volkow, Patricia; Ruíz-Remigio, Adriana; Becker, Ingeborg (17 September 2020). ["Lyme disease and relapsing fever in Mexico: An overview of human and wildlife infections"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7497999). *PLOS ONE*. **15** (9) e0238496. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[2020PLoSO..1538496C](https://ui.adsabs.harvard.edu/abs/2020PLoSO..1538496C). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1371/journal.pone.0238496](https://doi.org/10.1371%2Fjournal.pone.0238496). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [1932-6203](https://search.worldcat.org/issn/1932-6203). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [7497999](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7497999). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [32941463](https://pubmed.ncbi.nlm.nih.gov/32941463).
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Arnhold, Jürgen (2019). *Cell and tissue destruction: mechanisms, protection, disorders*. Elsevier Science. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
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83. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-83)** Typhoid fever may show a specific fever pattern, with a slow stepwise increase and a high plateau (drops due to fever-reducing drugs are excluded).\[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
84. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-84)**
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91. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-91)**
Singh, B.; Daneshvar, C. (1 April 2013). ["Human Infections and Detection of Plasmodium knowlesi"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623376). *Clinical Microbiology Reviews*. **26** (2): 165–184\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1128/CMR.00079-12](https://doi.org/10.1128%2FCMR.00079-12). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [3623376](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623376). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [23554413](https://pubmed.ncbi.nlm.nih.gov/23554413).
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Chin, W.; Contacos, P. G.; Coatney, G. R.; Kimball, H. R. (20 August 1965). "A Naturally Acquired Quotidian-Type Malaria in Man Transferable to Monkeys". *Science*. **149** (3686): 865. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[1965Sci...149..865C](https://ui.adsabs.harvard.edu/abs/1965Sci...149..865C). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1126/science.149.3686.865](https://doi.org/10.1126%2Fscience.149.3686.865). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [14332847](https://pubmed.ncbi.nlm.nih.gov/14332847). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [27841173](https://api.semanticscholar.org/CorpusID:27841173).
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Hilson AJ (July 1995). "Pel-Ebstein fever". *The New England Journal of Medicine*. **333** (1): 66–67\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1056/NEJM199507063330118](https://doi.org/10.1056%2FNEJM199507063330118). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [7777006](https://pubmed.ncbi.nlm.nih.gov/7777006).
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Magrath, Melissa; Pearlman, Michelle; Peng, Lan; Lee, William (30 June 2018). ["Granulomatous Hepatitis and Persistent Fever of Unknown Origin: A Case Report"](https://doi.org/10.33425%2F2639-9334.1009). *Gastroenterology, Hepatology & Digestive Disorders*. **1** (2): 1–2\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.33425/2639-9334.1009](https://doi.org/10.33425%2F2639-9334.1009). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [2639-9334](https://search.worldcat.org/issn/2639-9334). [S2CID](https://en.wikipedia.org/wiki/S2CID_\(identifier\) "S2CID (identifier)") [86786427](https://api.semanticscholar.org/CorpusID:86786427).
96. ^ [***a***](https://en.wikipedia.org/wiki/Fever#cite_ref-Klastersky_2014_13%E2%80%9326_96-0) [***b***](https://en.wikipedia.org/wiki/Fever#cite_ref-Klastersky_2014_13%E2%80%9326_96-1)
Klastersky, Jean A. (2014), "Prevention of Febrile Neutropenia", *Febrile Neutropenia*, Tarporley: Springer Healthcare Ltd., pp. 13–26, [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1007/978-1-907673-70-2\_2](https://doi.org/10.1007%2F978-1-907673-70-2_2), [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
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`{{citation}}`: CS1 maint: work parameter with ISBN ([link](https://en.wikipedia.org/wiki/Category:CS1_maint:_work_parameter_with_ISBN "Category:CS1 maint: work parameter with ISBN"))
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White, Lindsey; Ybarra, Michael (1 December 2017). ["Neutropenic Fever"](https://linkinghub.elsevier.com/retrieve/pii/S0889858817301284). *Hematology/Oncology Clinics of North America*. **31** (6): 981–993\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.hoc.2017.08.004](https://doi.org/10.1016%2Fj.hoc.2017.08.004). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [29078933](https://pubmed.ncbi.nlm.nih.gov/29078933) – via ClinicalKey.
98. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-98)**
Rolston, Kenneth VI; Rubenstein, Edward B., eds. (2001). *Textbook of febrile neutropenia*. Martin Dunitz. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
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Sharma HS, ed. (2007). [*Neurobiology of Hyperthermia*](https://books.google.com/books?id=Vk1UTlmEwrQC&pg=485) (1st ed.). Elsevier. pp. 175–177, 485. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
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. [Archived](https://web.archive.org/web/20170908174330/https://books.google.com/books?id=Vk1UTlmEwrQC&pg=485#v=onepage&q=hyperpyrexia%20core%20temperature&f=false) from the original on 8 September 2017. Retrieved 19 November 2016. "Despite the myriad of complications associated with heat illness, an elevation of core temperature above 41.0 °C (often referred to as fever or hyperpyrexia) is the most widely recognized symptom of this syndrome."
101. **[^](https://en.wikipedia.org/wiki/Fever#cite_ref-101)** See section in Chapter 15 therein, the section on "Fever versus hyperthermia".
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McGugan EA (March 2001). "Hyperpyrexia in the emergency department". *Emergency Medicine*. **13** (1): 116–120\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1046/j.1442-2026.2001.00189.x](https://doi.org/10.1046%2Fj.1442-2026.2001.00189.x). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [11476402](https://pubmed.ncbi.nlm.nih.gov/11476402).
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Craven RF, Hirnle CJ (2003). [*Fundamentals of Nursing: Human Health and Function*](https://archive.org/details/fundamentalsofnu0000unse_c8z5) (4th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. [ISBN](https://en.wikipedia.org/wiki/ISBN_\(identifier\) "ISBN (identifier)")
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Kiekkas P, Aretha D, Bakalis N, Karpouhtsi I, Marneras C, Baltopoulos GI (August 2013). "Fever effects and treatment in critical care: literature review". *Australian Critical Care*. **26** (3): 130–135\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.aucc.2012.10.004](https://doi.org/10.1016%2Fj.aucc.2012.10.004). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [23199670](https://pubmed.ncbi.nlm.nih.gov/23199670).
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Drewry, Anne M.; Ablordeppey, Enyo A.; Murray, Ellen T.; Stoll, Carolyn R. T.; Izadi, Sonya R.; Dalton, Catherine M.; Hardi, Angela C.; Fowler, Susan A.; Fuller, Brian M.; Colditz, Graham A. (2017). ["Antipyretic Therapy in Critically Ill Septic Patients"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389594). *Critical Care Medicine*. **45** (5): 806–813\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1097/CCM.0000000000002285](https://doi.org/10.1097%2FCCM.0000000000002285). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [5389594](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389594). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [28221185](https://pubmed.ncbi.nlm.nih.gov/28221185).
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Rumbus, Z; Matics, R; Hegyi, P; et al. (2017). ["Fever Is Associated with Reduced, Hypothermia with Increased Mortality in Septic Patients: A Meta-Analysis of Clinical Trials"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5230786). *PLOS ONE*. **12** (1) e0170152. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[2017PLoSO..1270152R](https://ui.adsabs.harvard.edu/abs/2017PLoSO..1270152R). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1371/journal.pone.0170152](https://doi.org/10.1371%2Fjournal.pone.0170152). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [5230786](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5230786). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [28081244](https://pubmed.ncbi.nlm.nih.gov/28081244).
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Drewry AM, Ablordeppey EA, Murray ET, Stoll CR, Izadi SR, Dalton CM, Hardi AC, Fowler SA, Fuller BM, Colditz GA (May 2017). ["Antipyretic Therapy in Critically Ill Septic Patients: A Systematic Review and Meta-Analysis"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389594). *Critical Care Medicine*. **45** (5): 806–813\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1097/CCM.0000000000002285](https://doi.org/10.1097%2FCCM.0000000000002285). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [5389594](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389594). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [28221185](https://pubmed.ncbi.nlm.nih.gov/28221185).
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[](https://en.wikipedia.org/wiki/File:Commons-logo.svg)
Wikimedia Commons has media related to [Fever](https://commons.wikimedia.org/wiki/Category:Fever "commons:Category:Fever").
- [Fever and Taking Your Child's Temperature](http://kidshealth.org/parent/general/body/fever.html)
- [US National Institute of Health factsheet](https://www.medlineplus.gov/ency/article/003090.htm)
- [Drugs most commonly associated with the adverse event Pyrexia (Fever) as reported the FDA](http://www.drugcite.com/indi/?i=PYREXIA) [Archived](https://web.archive.org/web/20120309114919/http://www.drugcite.com/indi/?i=PYREXIA) 9 March 2012 at the [Wayback Machine](https://en.wikipedia.org/wiki/Wayback_Machine "Wayback Machine")
- [Fever](https://medlineplus.gov/fever.html) at MedlinePlus
- [Why are We So Afraid of Fevers?](https://www.nytimes.com/2021/01/11/well/live/fever-benefits.html) at *The New York Times* |
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