High Fever: What To Do?

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in healthy adults it can be considered superfluous when the fever does not reach 38-38.5 ° C. Furthermore, symptomatic treatment is of secondary importance with respect to ascertaining the causes; for example, if the fever is caused by inflammation of the membranes that cover the brain (meninges), the risk of permanent and irreversible neurological lesions is concrete. even for temperatures below 39-40 ° C.

The patient should therefore not be frightened by the high fever itself, but by the concomitant onset of specific symptoms such as (in the case of meningitis) drowsiness, irritability, headache, muscle stiffness, hypersensitivity to light, rash (in bacterial forms) and possible convulsions (children).

In pneumonia, fever is continuous-remitting and accompanied by cough, shortness of breath and polypnea (increased respiratory rate with short breaths).

In the face of a high fever we shouldn't ask ourselves the question "how to lower it?", but ask us rather"what caused it?'

All this to remember that high fever is not a disease, but a defensive reaction of the body to the attack of bacteria or viruses. Not surprisingly, a consistent local or systemic increase in body temperature is also used for therapeutic purposes, in an attempt to destroy tumors (especially superficial ones such as melanoma); it has long been known, in fact, that hyperthermia enhances the activation of immune mechanisms, including those directed against cancer cells. For this purpose, specific machinery capable of overheating, up to 42-43 degrees centigrade, parts of the organism or the whole body for an average time of 90 minutes.

Fever is not a disease in itself, but a powerful means by which the body reacts to the disease.

, diabetics, debilitated patients or with respiratory or renal insufficiency, for whom it is good to limit excessive rises in body temperature.

Treatment with antipyretics (or febrifuges) in healthy adults should be considered mandatory only for severe hyperpyrexia (> 40 ° C)

37,5 - 37,9 moderate fever 38 - 38,9 high fever 39 - 39,9 hyperpyrexia >40

Paracetamol or acetominophen (Efferalgan, Tachipirina) is the drug of choice, as it has a strong antipyretic and analgesic power (painkiller); however, at high doses it can damage the liver. The dosage, in adults, is 300 / 500 mg every 4/6 hours; paracetamol can become dangerous at doses higher than four grams per day (in general, however, it is generally recommended not to exceed 2.6 g / day); in the presence of liver diseases it is preferable to resort to aspirin.

Aspirin and other NSAIDs - such as oxicams (eg naproxen, Momendol), ibuprofen (eg Moment, Nurofen) and diclofenac - exhibit a powerful anti-inflammatory and antipyretic effect. The dosage of aspirin as a febrifuge in adults is 1.5-2 grams per day, divided into four doses; that of ibuprofen is instead 400-600 mg every six hours. Aspirin should not be administered to children under the age of 14 (for whom paracetamol or alternatively ibuprofen is more suitable); like all NSAIDs, these medicines should not be used in the presence of gastritis, peptic ulcer, asthma, bleeding disorders, severe chronic heart or kidney diseases. Further contraindications and drug interactions are reported in the respective package leaflets.

For all these reasons, these NSAIDs are considered second choice antipyretics, therefore to be used only in cases where paracetamol is not well tolerated.

• For the treatment of fever in children consult the specific article within the site.
• For general information on antipyretic drugs consult the specific article within the site.

, to be avoided in the presence of concomitant diarrhea), and abstention from smoking and alcohol.