LESSON 3

FEVER OR PYREXIA

Elevation of body temperature above normal

(37.5°C) resulting from an imbalance between heat

produced in the body and the heat eliminated from it

• Not a disease in itself but a symptom, usually of infection

Infection

invasion and multiplication of bacteria, fungi, viruses

and parasites in the body, causing damaging to the tissues, usually accompanies by fever

ACUTE, CHRONIC

2 classification of fever

acute

fevers of short duration

chronic

Fever lasts for weeks; may be longstanding or intermittent

1)Increased BMR

2) Increased tissue catabolism - increased glycogenolysis, ketogenesis, and lipolysis

3) Increased fluid and electrolyte (e.g. sodium and potassium losses)

4) Decreased glycogen and adipose tissue stores

5) Decreased activity of the digestive system - decreased GIT motility

6) Poorer appetite with feelings of nausea and sometimes vomiting

7) General weakness and prostration in serious cases

8) Muscle and joint pains may be present

METABOLIC EFFECTS OF FEVER

ACUTE, CHRONIC, RECURRENT

CLASSIFICATIONS OF INFECTIONS

ACUTE INFECTION

Short duration, sudden onset, rapid progression

CHRONIC INFECTION

last weeks, months or years

RECURRENT INFECTION

occur in periodic intervals

High kcal

diet for:

13% increase in BMR per °C rise in body temperature

7% increase in BMR per °F rise in body temperature

High protein

DIET FOR ; To replace losses: 10% increase in BMR per ° C in body temperature 5% increase in BMR per ° F in body temperature

high carbohydrate, easily digested

diet for: to spare protein, provide quick energy and replenish depleted glycogen stores

increases fat in emulsifies form

to supply additional calories

high fluids

DIET FOR: TO REPLENISH LOSSES

MINERALS

DIET FOR: ELECTROLYTE IMBALANCE

vitamins

diet for: For energy metabolism, wound healing

PROGRESSIVE DIET FROM CLEAR TO NORMAL

DIET FOR: GRADUAL ADJUSTMENT TO PERISTALTIC CHANGES

SALMONELLA TYPHOSA

CAUSATIVE AGENT OF TYPHOID FEVER

TYPHOID FEVER

Causative agent:

Salmonella typhosa

• Characteristics:

• anorexia, fevers, weakness, stomach pains,headache; constipation and rash for some patients; internal bleeding and death can occur but are rare

antibiotics to arrest infection

medical management for typhoid fever

high kcal, high chon - presence of fever

low fiber - to prevent irritation of the GIT bleeding

dietary management for typhoid fever

rheumatic fever

An inflammatory disease which is a complication

of inadequately treated strep throat or scarlet

fever. It can cause permanent damage to the heart

Streptococcal Infection

rheumatic fever causative agent

RHEUMATIC FEVER

characteristics of——

 Fever

 painful and tender joints

 red, hot or swollen joints

 Small, painless bumps beneath the skin

 Chest pain

 Heart murmur

 Fatigue

 Flat or slightly raised, painless rash with a

ragged edge

 Jerky, uncontrollable body movements – most

often in the hands, feet and face

 Outbursts of unusual behavior, such as crying

or inappropriate laughing,

antibiotics, pain relivers, corticosteroids, prophylaxis

medical management for rheumatic fever:

pulmonary tubercolosis

A contagious bacterial infection that affects the lungs. It may spread to other organs

Mycobacterium

tuberculosis, tubercle bacilli

causative agent for pulmonary tubercolosis

ca and fe

replace losses

vit k

prevent hemorrhage

vit b6 and b12

Some anti-tuberculosis drugs (isoniazid) displace these

cholera

An acute diarrheal infection caused by ingestion of contaminated food or water; disease is known as El tor

vibrio vholerae

causative agent of cholera

meningitis

inflammation of the lining around the spinal

cord and the brain, called the meninges

• Characteristics: inflammation of the

meninges; muscle pains and lesions,

headache and weakness and hyperirritability

encephalitis

Inflammation of the brain

• Characteristics: Infection of the brain, congenital

malformations, seizures, stupor, coma,

delirium

whooping cough

also known as PERTUSSIS a respiratory tract infection that is highly contagious

Bordetella pertussis

causative agent of whooping cough

diptheria

infectious disease affecting the throat and

upper airways; produce a toxin that affects

other organs

cornybacterium diptheriae

causative agent of diptheria

erysipelas

An intradermal infection that produces local inflammation and toxemia

streptococcal infection

causative agent of erysipelas

scarlet fever

A bacterial illness that develops in some people who

have strep throat

erythrogenic

causative agent of scarlet fever

adentitis, sinusitis, nephritis, rheumatism

characteristics of scarlet fever

polyomyelitis

inflammation and destruction of the gray matter of

the spinal cord

spinal, bulbar

types of poliomyelitis

spinal

poliomyelitis that muscles are affected

bulbar

poliomyelitis: swallowing is affected

AIDS

refers to the most advanced stages of HIV infection. It is an HIV infection along with a CD4 cell count of 200 or less, dementia,wasting syndrome, cancers such as Kaposi’ sarcoma or non-Hodgkin’s lymphoma, or one

of 20 other opportunistic conditions

aids

a retrovirus that can destroy the helper T cells, making the patient prone to Opportunistic infections (infections arising from immune system highly compromised)

weight loss, cough, prolonged fever and diarrhea, thrush in mouth, repeated infections, mental regression, lipodystrophy (altered distribution of fat), and lipoma (benign tumors of fat)

signs of AIDS

dengue fever

mosquito-borne disease

flavivirus

causative agent of dengue fever

dengue fever

• acute febrile illness with sudden onset of fever, followed by generalized symptoms and sometimes a macular skin rash

• known as “breakbone fever”: severe muscle, joint and bone pains; pain behind the eyes (retro-orbital pain) may be

present

• fever may be biphasic (i.e. two separate episodes or waves of fever). Most patients recover after a few days.

dengue hemorrhagic fever

• has an acute onset of fever followed by other symptoms resulting from thrombocytopenia, increased vascular permeability and hemorrhagic manifestations.

dengue shock syndrome

• supervenes in a small proportion of cases.

• Severe hypotension develops, requiring urgent medical treatment to correct hypovolaemia.

• Without appropriate hospital care, 40–50% of cases can be fatal; with timely medical care by experienced physicians and nurses the mortality rate can be decreased to 1% or less.

measles

contagious and serious disease caused by a virus. It is spread through direct contact and through the air

RNA virus

causative agent of measles

mumps

A viral infection that primarily affects the parotid glands, predilection of glandular and nervous tissues; stiffness of the jaw, mandible tenderness, pain when swallowing

chicken pox

Causative agent: herpes virus Varicella zoster

 Characteristics: invades the respiratory tract, which

can cause scattered skin lesions, appendicitis,

pneumonia, myocarditis, encephalitis

small pox

Serious infectious disease that is highly

contagious

 Causative agent: variola manor, variola

major

 Characteristics: invades the respiratory

tract with a high or mild degree of

virulence, fever, headaches, pain in the

limbs, vomiting, rashes, lesions

pneumonia

An infection that causes inflammation of the air sacs in one or both lungs

 Causative agent: Mycobacterium

pneumoniae, viruses

 Characteristics: patchy inflammatory

changes in the lungs; starts as a

common cold, malaise, production of sputum, fever and cough

malaria

Caused by parasites that are spread

to people through the bites of

infected female mosquito

 Causative agent: protozoa of genus

plasmodium, transmitted by

Anopheles mosquitoes

 Characteristics: chills and high

fever, anemia

amoebiasis

Cause by parasites that are usually transmitted

through fecal contamination of food or hands

 Causative agent:

Entamoeba

hystolytica

hookworm infestation

Causative agents: primarily Ancylostoma

duodenale

 Characteristics: attacks and damages the small

intestines; malnutrition, anemia, edema and

dilatation of the heart

ascariasis

A roundworm infection that attacks and damages the

small intestines

 Causative agent: Ascaris

lumbricoides