Pyrexia (or fever) is a clinical sign, indicated by an abnormally elevated core body temperature, which is defined by several medical societies as ≥38.3°C (≥101°F). The temperature elevation may be persistent or episodic. If the body temperature is greater than 41.5°C - a rare phenomenon - it is known as hyperpyrexia.
The commonest cause of fever is infection, in one study of hospital inpatients accounting for ~70% cases 1. Other frequent causes are inflammatory disease, malignancies and medication-related fevers. Pyrogenic is the term used for anything that causes pyrexia. When the cause of a fever remains unexplained it is termed a pyrexia of unknown origin (PUO).
- infection (~70% cases)
- medication: drug fever
- inflammatory disease: many diseases, including granulomatous (e.g. sarcoidosis), vasculitides, and autoimmune (e.g. hepatitis)
- recreational drugs, e.g. MDMA (ecstasy), cocaine, amphetamines, LSD, mephedrone
- brain insult: trauma, ischemia, cerebral hemorrhage
- endocrine (rare): thyrotoxicosis, pheochromocytoma, hypoadrenalism
- 1. Walter EJ, Hanna-Jumma S, Carraretto M, Forni L. The pathophysiological basis and consequences of fever. (2016) Critical care (London, England). 20 (1): 200. doi:10.1186/s13054-016-1375-5 - Pubmed
- 2. Toussaint E, Bahel-Ball E, Vekemans M, Georgala A, Al-Hakak L, Paesmans M, Aoun M. Causes of fever in cancer patients (prospective study over 477 episodes). (2006) Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 14 (7): 763-9. doi:10.1007/s00520-005-0898-0 - Pubmed
- 3. Launey Y, Nesseler N, Mallédant Y, Seguin P. Clinical review: fever in septic ICU patients--friend or foe?. (2011) Critical care (London, England). 15 (3): 222. doi:10.1186/cc10097 - Pubmed