~Teachingcenter的醫學筆記~

主要有五種1.Intermittent 2.Remittent 3.Continuous or Sustained 4.Hetic 5.Relapsing or Periodic

1. Remittent fever and Intermittent fever

(rf: http://drrajivdesaimd.com/?p=3311)

Intermittent就是有時候燒，有時候不燒，燒可以超過39度，又可以自己退燒到正常溫度(defervescence)，感染為最常見的成因(pyaemia(膿血症)、septicemia(敗血症)、結核病、malaria、kala-azar(黑熱病-利什曼原蟲))，另外如lymphoma、juvenile rheumatoid/idiopathic arthritis也是可能成因

Remittent就是一直都超過38度，在39度的地方擺盪(範圍超過1度)，病毒性感染為最常見的原因(如登革熱病毒)、細菌性感染又以infective carditis, Salmonella typhi, Brucellosis常見(布魯氏菌病,也有可能是constant fever)，另外如lymphoma、sarcoidosis、atrial myxoma也是可能成因

2. Continuous, Constant or Sustained fever

(rf: https://publish.get.com.tw)

一直燒，且擺動小於1度，child TB、lobar pneumonia、Brucellosis等很嚴重的感染，嚴重的connective tissue diseases也會

Typoid fever (Wunderlich curve of typhoid fever): 階梯狀、逐步上升，high plateau

3. Hectic fever (Spiking fever)

(rf:www.studyblue.com)

短時內上下擺盪超過1.4度，嚴重感染、lymphoma...，有時會當作是一種intermittent fever

4. Relapsing(回歸熱) or Periodic

A.回歸熱疏螺旋體(Borrelia recurrentis(由louse(蝨) and tick傳染))
B.體溫升降反反覆覆，正常體溫及異常體溫反覆出現，其體溫可能是在一、二天內恢復正常，又再上升，術後傷口感染、登革熱、rat-bite fever (Spirillum mimus)、Pel-Ebstein fever、malaria、lymphoma

Pel-Ebstin fever: Cyclic fever in Hodgkin's disease

Jarisch–Herxheimer reaction: The Jarisch–Herxheimer reaction is classically associated with penicillin treatment of syphilis. The reaction to endotoxin-like product.
Borreliosis (Lyme disease and tick-borne relapsing fever) and leptospirosis, and in Q fever.
Similar reactions have also been reported to occur in bartonellosis (including cat scratch disease), brucellosis, typhoid fever, trichinosis, and cerebral trypanosomiasis.

Charcot triad: fever, jaundice, RUQ abdominal pain

(RF: https://www.researchgate.net/figure/268878020_fig4_Figure-4-Clinical-fever-patterns-Clinical-fever-patterns-and-examples-of-diseases-that)

5. Recurrent

反反覆覆發燒超過六個月，可能成因為metabolic defects、CNS dysregulation of temperature control、cyclic neutropenia、hyperimmunoglobulin D syndrome、periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA)、deficiency of IL-1 or IL-36 recteptor antagonist、immunodeficiency

過年十大常見疾病-不明熱 Fever of Unknown Origin (FUO)
http://teachingcenter1.pixnet.net/blog/post/352657529 (1)
http://teachingcenter1.pixnet.net/blog/post/352684238 (2)
http://teachingcenter1.pixnet.net/blog/post/352712312 (3)
http://teachingcenter1.pixnet.net/blog/post/352714538 (4)