fever and hyperthermia DIFFERENTIAL DIAGNOSIS AND TACTICS GENERAL PRACTITIONERS

FEVER: This increase in body temperature relative to normal daily values ​​due to changes in the thermoregulatory center.

hyperthermia This increase in body temperature without the participation of the hypothalamus , usually due to lack of heat ( such as during exercise , taking medicines that reduce sweating, and high ambient temperature )

frequency of occurrence

pyrogens Pyrogenic nazyvayutendogennye or exogenous substances that cause fever . Endogenous pyrogens are produced in the body otet to different stimuli ; most often it is an infection or inflammation. Exogenous pyrogens consist principally microorganisms and their toxins and waste products.

Prevalence

Statistics

Pathogenesis of fever Fever Fever heat production heat irradiation Жаропонижающи препараты organisms Toxins Mediators of inflammation Monocytes and macrophages endothelial cells other cells Fever pyrogenic cytokines (IL -1 , TNF α, IL -6 , interferons) heat production heat irradiation Anterior hypothalamic area Temperature setpoint Prostaglandin E2

Manifestations of febrile reactions Backache generalized myalgia Arthralgia Decreased appetite Drowsiness Chills Disorders of consciousness Febrile seizures

Diagnostics Diagnosis of diseases accompanied by fever requires general practitioner all his knowledge and skills , particularly in the collection of medical history . It is very important chronology of symptoms , their association with medication , surgery , and dentistry

Daily fluctuations to within 1 ° C Constant daily fluctuations in body within t 1.5 - 2 C remitting daily fluctuations of more than 1 t C Morning - the norm or below intermittent. hectic Daily fluctuations 3-5 C . Incorrect fever without a certain regularity

Contact with animals poisonous fumes When collecting medical history is necessary to pay attention to the following points Contact with animals poisonous fumes The sources of infection and allergens Contact with patients with fever or infectious diseases Culinary preferences Sexuality - Precautionary measures Bad habits Injuries Animal and insect bites Blood transfusion Vaccinations Allergic reactions

Diagnostics Physical examination : It is necessary to examine carefully and regularly Register all the physiological indicators The temperature measured is always in the same place Particular attention is paid to the skin . The lymph nodes , eyes, nail bed , ENT organs , the organs of the chest cavity and abdomen , musculoskeletal system , genitourinary system .

medical examination Stiff neck - meningitis Painful joints - septic arthritis or rheumatism Rapid breathing or chest indrawing - pneumonia Petechial rash - meningococcal disease or dengue fever Makulopapululeznaya rash - a viral infection or a reaction to drugs Полностью разденьте ребенка и тщательно осмотрите с целью возможного выявления следующих локальных признаков инфекции

medical examination Changes in the mucous membrane of the throat - an infection Soreness in the ear - otitis media Jaundice or external signs of anemia or sepsis - malyariya Changes in the spine and hip - septic arthritis Palpation of the abdomen - pain in the suprapubic region with urinary tract infections

medical examination Prolonged fever without local symptoms : Septicemia salmonellosis miliary tuberculosis HIV infection Urinary tract infection

laboratory and instrumental Clinical signs FEVER laboratory and instrumental Anamnesis external evidence fever type Specific indicators

Laboratory research Microscopic research methods Blood chemistry Bacteriological studies X-ray examination

Causes of hyperthermia Heatstroke Drug hyperthermia Neuroleptic malignant syndrome Malignant hyperthermia Diseases of the endocrine system

Diseases of the central nervous system Infection Autoimmune diseases Drugs tumors FEVER unknown origin Diseases of the central nervous system Simulation Internal illnesses acute viral infection vermin

Categories Infectious fever without local symptoms Infectious fever with local symptoms , but without rash Fever with a rash Случаи лихорадки у детей можно разделить на три основных категории Спросите курсантов какие заболевание входят в 1,2,3 категорию. Ответ в следующих слайдах.

The differential diagnosis of fever without local symptoms Malaria ( only if there is a risk of malaria transmission ) Septicemia Typhoid fever Urinary tract infection Fever associated with HIV infection

Skin and soft tissue infections Pneumonia Viral infection of the upper The differential diagnosis of fever with the presence of local symptoms Meningitis Otitis media Mastoiditis Osteomyelitis Septic arthritis Skin and soft tissue infections Pneumonia Viral infection of the upper respiratory tract throat abscess Sinusitis genyantritis

The differential diagnosis of fever with rash Measles Viral infections Meningococcal disease Hemorrhagic fever

Tactics OF GP In some cases, you have to rush to the hospital ? In some cases, you need to send to the expert? In some cases, you have to treat a patient on an outpatient basis ? Спросите курсантов задавая следующие вопросы. Ответы в следующем слайде

Referral to hospital It is a serious disease Acute laryngitis Acute epiglottitis Acute obstructive bronchitis Acute pneumonia ( severe) Acute mastoiditis And etc.