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FEVER

The body regulates its temperature to maintain a steady state and when it becomes excessively cold or warm damage can occur. We associate fever with illness; usually the illness causing the raised temperature is short-lived and improves with or without medication. In the older individual especially, an elevated temperature may have a number of causes, but it is usually the result of an infection, as is the case in people of all ages. Infections from bacteria and viruses almost invariably cause fever.

In some older people, however, there is an abnormality in the temperature-regulating mechanism. This may lead to an excessive rise of temperature with an infection, or it can occur if you have spent too much time in the sun or in an extremely warm environment. The opposite also occurs. A severe infection may be present without causing an elevation in your temperature.

Whenever you have a fever from an infection, other symptoms usually point to the source of the illness. Bacterial infections of the urinary tract usually cause burning when you pass urine and an urgency to urinate frequently. A lung infection often leads to coughing and the production of phlegm. We usually recognize the muscle aches and pains of a cold or influenza, and the fever usually subsides by itself within a few days. Fever caused by bacterial infections usually decreases after treatment with antibiotics has begun to be effective.

Some unusual illnesses in older people can cause fever that is not the result of infections. These ailments often lead to the great confusion in diagnosis and treatment. Unlike most infectious causes of temperature elevation, despite treatment with a few days of aspirin or an antibiotic, the elevated temperature does not return to normal. Sometimes the temperature goes up and down, either daily or weekly. At times it may even stay up for a week or two and then fall to normal for a few weeks and then go up again.

Various types of inflammation and certain tumors, especially of the blood or lymph glands, can cause fever. The temperature can also be elevated during unusual infections, such as bacterial endocarditis or tuberculosis. In these circumstances the temperature will not decrease with the usual fever-lowering medications such as aspirin, or if it does, the fever soon returns. Antibiotics may not lower the temperature, or do so only temporarily, and the fever may return after the medication is stopped.

An illness accompanied by fever should be carefully evaluated. Most of us recognize such simple causes of temperature elevation as a cold or influenza. If you have a fever that does not fall within a few days, or it if returns time after time, whether or not you have taken medications such as antibiotics, you should have a full examination and explanation from your physician. It is very dangerous for you to treat yourself with antibiotics repeatedly, especially if after a course of treatment your fever returns.

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