Temperature above 39 in an adult: how to bring it down

Temperatures with fluctuations from 37 to 38 degrees without obvious signs of illness are usually designated as low-grade fever of unknown etiology. This condition can last for weeks or months. This condition can be observed in many patients who seek help from a therapist.

To find out the cause of the elevated level, the patient is subjected to numerous studies. Unfortunately, the original source of the disease is not always found. The patient is diagnosed with various diseases and syndromes and is prescribed ineffective treatment.

It is possible that our patient's difficult life situation became a chronic stressor, which led to her sharp increase in axillary temperature as an acute stress load. In this patient, we found that the magnitude of the stress-induced increase in axillary temperature was greater than the increase in tympanic membrane temperature. Animal studies have shown that non-shivering thermogenesis occurring in brown adipose tissue plays a critical role in the development of stress-induced hyperthermia.

If a stress interview activates brown fat thermogenesis, resulting in hyperthermia, it is reasonable to assume that the increase in temperature would be more evident in the axillary region, which is closer to the brown fat tissue than the eardrum. Peripheral cytokines may not be involved in this process.

More than 70% of cases of low-grade fever are observed in young women with asthenic syndrome.

This is manifested in the physiological features of the female body system: urogenital infections and disorders in the psycho-vegetative apparatus.

Low-grade fever according to its causes is divided into two groups: non-infectious and infectious.

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. This study was supported in part by grants for scientific research from the Japan Society for the Promotion of Science and Scientific Grants for Health and Occupational Research in Integrative Medicine.

Authors original submitted files for images

The authors declare that they have no competing interests. All authors read and approved the final manuscript. Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University. Section of Psychosomatic Medicine, Department of General Medicine, Fukuoka College of Dentistry.

Infectious

• In case of low-grade fever of unknown etiology, the possibility of the disease is excluded. To find out, the patient will have to undergo a thorough interview and examination by specialists. Significant aspects from the anamnesis for identifying tuberculosis. Personal and prolonged contact with carriers of various forms of tuberculosis. Staying with a patient with tuberculosis in an open area (apartment, store or entrance) or living in close proximity can become a direct cause of the disease. Previous tuberculosis or consequences of changes in the lungs (presumably caused by Koch's bacillus). Moreover, such conditions were diagnosed after fluorography. Any illness that was treated with ineffective methods (lasting about 3 months).
• Focal infection. It is believed that diseases with a chronic focus of pathogens occur with low-grade fever and changes in the blood. However, this can only be proven by completely removing the infected organ, for example, the tonsils. After the source of infection disappears, the patient's condition quickly improves and the low-grade fever decreases. About 90% of cases of toxoplasmosis are manifested by low-grade fever. Chronic brucellosis proceeds according to the same principle.
• Rheumatic fever in the acute period. It is characterized by the involvement in the pathological process of such organs as connective tissue, cardiac and (against the background of the causative agent beta-hemolytic streptococcus group A). These conditions occur with an increase in temperature to 38 degrees and weakening of the body.
• "Temperature tail". It appears after the underlying disease has passed. The fever can last for several months. This condition goes away on its own. The exception is typhoid fever, in which the temperature does not decrease, there are signs of liver enlargement and adynamic fever.

Not infectious

Department of Psychosomatic Medicine, Department of Neurology, University of Occupational and Environmental Health. Department of Pediatrics and Child Health, Kuryume Medical School. Fever is actually a very complex and uncertain problem. A better description is probably the statement that a fever is “a body temperature that is above normal in a particular person.” Our body temperature is controlled by the center of the brain and is strictly individual. A person's fever may be completely normal in others.

Elevated body temperature can be considered a protective reaction of our body to an external or internal stimulus that causes an inflammatory response. Chemicals resulting from the inflammatory response affect the brain. There is a special zone that controls body temperature like a thermostat. The chemicals irritate this center of the brain and cause the thermostat to increase the body's desired temperature.

Low-grade fever of a non-infectious nature manifests itself as a result of somatic diseases, physiological processes or disorders of the psycho-vegetative apparatus.

• There are two psychosomatic diseases with increased temperature: thyrotoxicosis and.
• Thyrotoxicosis. Excess of thyroid hormones leads to inevitable low-grade fever. At the same time, the patient experiences fatigue, weight loss, and signs of emotional instability. For diagnosis, specialists check the level of thyroid-stimulating hormone.
• Physiological features. Low-grade fever in adults also depends on the constitutional characteristics of the body. This is a normal manifestation of the body. A slight increase in temperature also depends on stress: emotional (nervousness, excitability) and physical (activity in sports). External factors also influence the presence of low-grade fever: a stuffy and hot room, sunbathing. In women, low-grade fever is observed during the second half of the menstrual cycle.
• Psychovegetative features. The main manifestation of low-grade fever in this disorder is observed in patients with vegetative-vascular dystonia.

The non-infectious nature of low-grade fever can characterize both the physiological characteristics of patients and the manifestation of diseases.

What is the meaning of fever?

Fever is an important factor in the fight against infectious diseases.
Higher temperatures facilitate white blood cell function, help activate the immune system, and weakly inhibit bacterial proliferation. Therefore, we must view fever as a positive natural process that should not be aggressively reduced at any cost. Note: This article focuses on febrile conditions in adults; elevated body temperature in children is a special and slightly different problem. This is by far the most common cause of fever. Doctors commonly see upper respiratory tract infections, bronchitis, pneumonia, and urinary tract infections. High fever accompanied by headache is usually present in bacterial meningitis and kidney infections.

Learn about the reasons for a prolonged increase in temperature from the video.

Jump

In what cases does the temperature rise in an adult? It is generally believed that there is a bacterial or viral infection. However, the list of reasons does not end there. The source of the increase can be injuries, chronic diseases, allergic reactions, bleeding, heart attacks, and so on. That is, a reaction such as fever is not always an immune response only to bacteria or viruses. This is a general defense, a signal that something is threatening the normal functioning of the body.

The generally accepted opinion of medical workers is that it is not worth reducing the fever to 38.5. This is the optimal temperature for the death of certain types of bacteria and viruses. So it can be considered an alarming symptom when the thermometer does not fall below 39 degrees.

When is urgent medical attention needed?

In any case, when the temperature rises, you should consult a doctor. Urgent medical attention is required in several situations:

• Body temperature is not reduced by improvised means.
• The temperature continues to rise.
• Convulsions are observed.
• There are breathing problems.
• The temperature rises to 39-40 degrees.
• Stiffness of the neck muscles began.

In all other cases, self-help is possible (but not self-medication, this is a big difference).

First aid to a patient

First aid is required only when the hyperthermia level exceeds 38 degrees. There is no need to reduce the temperature below (as a rule).

1. It is necessary to ensure a flow of fresh air into the room.
2. The patient should be given plenty of warm drinks (fruit drinks, compotes, teas, clean water without gases).
3. Give the patient an antipyretic drug. Ibuprofen, Nurofen, etc. They should be taken with caution and only before consulting a doctor, no longer.

If the thermometer is above 39, the most reasonable thing to do is call an ambulance.

Causes

What reasons can cause a jump to 39 degrees or higher in an adult:

1. Overheating in the sun.
2. Prolonged physical activity.
3. Stress, nervous shock.
4. Reaction to any allergen - from an insect bite to medicinal substances.
5. Bacterial or viral infection.
6. Acute food poisoning caused by various factors - bacteria, toxins.
7. Endocrine diseases. A temperature of 39 degrees can be caused by inflammatory diseases of the thyroid gland.
8. Septic wounds, necrosis, purulent processes.
9. Collagenoses.
10. In some cases, a temperature of 39 and above, which lasts for a long time, indicates oncological changes in the body.

There are several ways to bring down a fever in an adult. They are quite effective and help, but only in cases where the cause is truly an infection. If the cause of the fever is different, antipyretic drugs can only do harm. Therefore, it is better to consult a doctor by calling an ambulance. After all, sometimes even a simple flu can result in serious complications.

Other infectious diseases

This includes otitis media, sinusitis, etc. Any severe infectious disease is characterized by hyperthermia, and we can talk not only about febrile temperature, but also about values ​​of 39.9 or more.

This can be deadly: when the thermometer readings become too high, the blood cells begin to clot, resulting in death.

Advanced forms of cancer

Characterized by general and focal symptoms. General symptoms include hyperthermia, headache, weakness, weakness.

In some cases, nausea and vomiting are observed. Focal manifestations depend on the localization of the neoplastic process.

Thus, stomach cancer is manifested by dyspeptic symptoms, lung cancer by impaired gas exchange, etc.

As a result of excessive proliferative activity of malignant cells, they die: atypical anatomical structures simply do not have enough nutrition.

At stages 3-4 of the disease, massive metastasis is observed with the formation of secondary foci.

Dying cells begin to decay, poisoning the body with toxins. Irritation of special centers of the brain leads to an increase in body temperature, since the body accepts toxins as the result of the vital activity of bacterial microflora.

Usually we have to talk about relatively small thermometer values. The temperature is constant at 38.4 -38.5 and is not relieved by typical antipyretics.

Hypothalamic lesions

United by the common name hypothalamic syndrome. The essence of the pathological process is the destruction of the nuclei of this brain structure (it is known that the hypothalamus is responsible for normal thermoregulation).

Destruction can be caused by tumors (glial origin: astrocytomas, oligodendrogliomas, ependymomas), compression of the organ as a result of increased cerebrospinal fluid pressure, etc. Pathognomonic headaches, body temperature 38.3-38.7, mental and behavioral disorders.

Childhood diseases

In adulthood, childhood diseases are especially difficult to tolerate (chickenpox, measles, etc.).

The cause of their occurrence in adults is an old infectious focus.

Sometimes it is impossible to identify the source of the lesion at first glance.

In this case, you need to look for the cause in the infectious focus (carious teeth, chronic diseases of the nasopharynx, etc.).

Hyperthyroidism

The thyroid gland is a kind of heating boiler of the body. If we carry the analogy further, at a certain point in time the heating boiler may begin to work too intensely.

In this case, the body temperature rises to 38.5 degrees. The disease is characterized by changes in the structure of the neck, protrusion of the eyeballs (exophthalmos), and disturbances in thermoregulation.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune inflammatory disease in which the destruction of joint and musculoskeletal structures occurs.

Persons of young, working age are most susceptible to the disease. In this case, the observed temperature is 38.4 - 38.8 degrees.

The main signs: pain in the area of ​​the affected joint (pain is intense, intensifies at night and in the morning, weakens by midday), a feeling of squeezing of the limb (tight glove or sock), impaired motor activity of the musculoskeletal structure susceptible to the pathogenic process.

How to fight on your own

Flu or a cold in an adult is accompanied by the following symptoms:

1. Weakness, lethargy, malaise, drowsiness.
2. Feverish blush on the cheeks.
3. Aches in bones and muscles.
4. Headache.
5. Heartbeat.
6. Nasal and nasopharyngeal congestion, runny nose, cough.
7. Sore throat and sore throat.

If you are sure that you have the flu or a cold, you can try to reduce the fever yourself, at home.

Important tip! In an attempt to bring down the temperature, do not use means that will increase it - hot water for drinking, hot water to steam your feet, inhalations over steam, mustard plasters, vodka or alcohol compresses, alcohol, caffeine, spicy foods.

Household auxiliary

First of all, it’s good to remember: the fever can be brought down within 24 hours. If during this time you have not achieved results, the temperature has risen above 39 degrees - call a doctor. Wherein:

1. Drink water or tea constantly. You should not drink hot drinks, they can raise the temperature by a couple of degrees. The drink should be warm, it will help prevent dehydration.
2. You can use a compress on the forehead and legs. It is made from a towel soaked in diluted vinegar (dilute 9% vinegar with water 1:1).
3. Immersing your feet in a basin of cool water can relieve the condition for a while.
4. The body can be wiped with a damp sponge or towel dipped in water or vinegar solution. Rapid evaporation of moisture from the surface of the skin will help reduce fever. Some recommend wiping the skin with alcohol: this method is allowed, but the patient may inhale alcohol fumes.

In febrile conditions, these methods greatly alleviate the general condition for some time. If significant improvement does not occur, medications will have to be used.

Medicines

Medicines are called antipyretics and come in several forms:

1. Complex powders for flu and colds. They contain paracetamol and vitamin C.
2. Coated or water-soluble tablets.
3. Syrups.
4. Suppositories.
5. Injections.

The most common and effective remedies include Paracetamol, Nise, Panadol, Nurofen, Ibuprofen. All these drugs are usually easily tolerated, but when taking any medicine, you need to remember its effect on the gastric mucosa, especially Aspirin.

A mixture of suprastin and analgin, taken 1:1, is used as an injection solution. Or another composition of analgin, papaverine and diphenhydramine, also in a 1:1:1 ratio.

We must not forget about the individual reaction to the active ingredient of the drug. For some, Paracetamol will remarkably reduce the fever, but for others it will not work at all. Look for your remedy for fever.

In addition, the following rule will not be superfluous: if the drug does not improve the condition within the time specified in the instructions, then you need to call a doctor, and not take the next pill in the hope that it will bring down your fever.

What to do in case of high fever in adults?

1. Observe bed rest, any stress can lead to deplorable maltings and adversely affect your health!
2. Drink more liquid, give preference to still mineral water, compotes, berry juices, cranberry juice.
3. High temperature can lead to dehydration, and therefore it is necessary to promptly replenish the water balance in the body.
4. Wet rubbing will also be useful; just soak a towel in cold water and apply it to the body; it is advisable to add yarrow infusion to the water. Compresses should be changed as the tissue warms up.
5. Wiping with a vinegar solution can be done every 2-3 hours, just mix a spoonful of vinegar and mix with 5 tablespoons of water, wipe your stomach, back, arms and legs.
6. Prepare a decoction of peppermint, cool, wet a cloth and apply to the temples, neck, armpits, elbows, renew the compress every 10 minutes.
7. Take an antipyretic; preference is given to instant tablets and powders. Suspensions have a good antipyretic effect; the substance is quickly absorbed into the blood and provides minimal contact with the gastric mucosa.
8. An enema with chamomile decoction will help cleanse the intestinal tract, remove harmful toxins from the body, stabilize the temperature and improve the patient’s overall well-being.
9. If vomiting and nausea are still observed at a high temperature, then it is better not to take medications orally; it is better to use rectal suppositories; one or two are enough to normalize the temperature.

Attention! Before bringing down the temperature, you need to identify the source of its appearance, seek qualified help and not self-medicate. This is especially true for small children and pregnant women. Only immediate emergency care and further actions under the supervision of a doctor.

Take care of yourself and your family, be healthy and happy!

Other types of fever

A sharp increase in temperature without cold symptoms is possible. In what cases does this happen?

1. A prolonged temperature of 39, without cold symptoms, may be a sign of thyroid disease.
2. Fever without symptoms can be the first sign of systemic lupus erythematosus.
3. Rheumatoid joint lesions are accompanied by fever and joint pain.
4. In acute food poisoning, the main symptoms are fever, vomiting, diarrhea, general intoxication and weakness.

In addition to the above diseases, a temperature of 39 and above can also accompany:

1. Tropical form of malaria.
2. Infectious diseases (typhoid fever).
3. Oncological diseases.
4. Pneumonia.