High fever and cough

Most diseases that occur in a person in one or another period of life, accompanied by the appearance of a symptom complex of one or more signs that allow you to make a preliminary diagnosis. With the appearance of symptoms such as fever and cough, the thought immediately comes to mind about colds, which are often combined by physicians with a single term - acute respiratory illness (ARI). These are symptoms that signal the development of inflammation in the upper or lower respiratory tract. But the exact diagnosis of the specialist can put only taking into account the causes and localization of inflammation, the age of the patient, individual characteristics of the body.

Epidemiology

According to statistics, about 90% of people get colds at least once a year. They can occur with or without a cough, with hyperthermia or against a background of normal temperature. The combination of both symptoms is most characteristic of ARVI (influenza) and pneumonia (inflammation of the lungs), which more often affect children with their incompletely formed immune system. In this population, diseases are more severe, and there are also children's diseases that start with a cough and fever, such as whooping cough, croup, scarlet fever and chickenpox (more often affecting children than adults).

Causes of the fever and cough

The appearance of a cough without fever can cause many reasons, which to the unsophisticated reader may seem unrelated to each other. At first glance, what can be common between infectious-inflammatory processes in the respiratory system and allergic reactions, the influence of dry air and cigarette smoke, inhalation of aggressive chemicals and stressful situations? The appearance of a cough may be common, but a rise in temperature is not necessary.

Allergies and stress are unlikely to cause hyperthermia. If there is an increase in temperature, it will be insignificant. Smoker's cough, the same symptom when taking some antihypertensive drugs and inhalation of polluted air is usually not accompanied by temperature changes, except for drug intoxication. The same can be said about small and large particles entering the respiratory tract, exposure to dry air, cough accompanying diseases of the heart, digestive and nervous system.

A marked increase in temperature combined with a cough is noted mainly in colds affecting the upper and lower respiratory tract. More often, fever and cough occur in infectious diseases of the respiratory system, called acute respiratory infections, including influenza. Although a protective reaction in the form of a marked increase in temperature may be noted in more rare bacterial infections of the same localization.

Risk factors

Risk factors for these symptoms are:

• hypothermia, which reduces the body's defenses,
• Consumption of cold beverages that pump up local immunity,
• exposure to drafts,
• contact with an infected person (respiratory infections are mainly airborne),
• Care of the patient without following infection prevention methods,
• weakened immune system,
• Having chronic diseases that increase the risk of infectious diseases due to decreased immunity,
• immunodeficiency, avitaminosis, etc.
• childhood.

Cough with fever can be caused by inflammation of the respiratory tract, nose or throat infections, and adenoid overgrowth. Sore throat, flu, bronchitis, tracheitis, pneumonia, sinusitis, laryngitis, pharyngitis and other respiratory diseases can run with fever. Sometimes these symptoms also occur in middle ear inflammation.

Pathogenesis

Cough and fever are nonspecific symptoms that can appear in a variety of diseases. They are not associated with a specific diagnosis, but can be of great help in making a preliminary medical judgment.

Individually, these symptoms may be evidence of unrelated pathologies. For example, a cough can be a manifestation of both respiratory diseases and disorders of the cardiovascular or digestive systems. It is also evidence of an inadequate response of the immune system (allergies) or a manifestation of bronchial overreactivity (bronchial asthma).

Coughing can occur in the absence of disease, for example, when foreign objects get into the airways, which irritate the mucous membrane and prevent the passage of air. The same symptom occurs when the inner lining of the pharynx, larynx, trachea and bronchi is irritated by chemical or thermal irritants.

In any case, coughing is seen as a protective reaction, aimed at freeing the airways from the source of irritation or obstruction to the passage of air flow. A dry cough occurs with minor irritation, and a wet cough occurs with the development of inflammation or lung stasis.

Temperature is also an indication of inflammation. Many have noted that the focus of inflammation is always warmer than the surrounding tissues, which is the result of changes in the nature of metabolic processes and blood circulation in it.

Generalized fever is a response to the generalization of the pathological process. Body temperature rises more strongly in infectious inflammation, especially of viral origin. This is how our body fights pathogens and signals us about their presence and increased activity.

The combination of fever and cough indicates the generalization of the inflammatory process and the involvement of the respiratory system. Inflammation increases the sensitivity of the mucosa to various irritants, stimulates the production of bronchial gland secretion, which is designed to moisturize the inner surface of the respiratory organs and promote the removal of foreign elements from the respiratory system.

Both cough and fever are considered in this regard as a protective reaction of the body. Coughing helps to remove pathogenic bacteria together with accumulated phlegm, and fever creates unsuitable conditions for the reproduction of pathogens. This is all very useful, until it begins to act on the body exhausting and does not become dangerous in terms of violation of the rheological properties of the blood.

Violation of thermoregulation in the disease leads to the fact that the body temperature continues to rise, which becomes dangerous, because it is a matter of blood clotting, which increases the load on the cardiovascular system, contributes to the formation of blood clots.

Although not considered a life-threatening symptom, coughing can also be a significant problem, especially if you are prone to bronchospasm. An exhausting dry cough wastes the patient's energy, while a wet cough with increased sputum production is a risk factor for bronchial obstruction.

Symptoms of the fever and cough

Cough and fever in such a combination can not be indicators of human health. This symptom complex itself indicates certain disorders in the body, which are reflected in the state of the nervous and respiratory system. But it rarely appears alone, usually we are talking about a more extensive and diverse clinical picture, which allows you to differentiate one disease from another.

In addition, the word "cough" itself can not tell a specialist much. After all, in the diagnosis of diseases, a major role is played not so much by the presence of this symptom as its nature: wet or dry, constant or episodic, as well as its combination with other manifestations of the disease state.

Cough, runny nose and fever are considered the first signs of acute respiratory infections and influenza. In this case, the cough may appear not on the first day of the disease, but much later, manifesting itself more strongly in the morning hours due to the need to expectorate sputum accumulated overnight in the bronchi with attached nasal discharge.

But the temperature in viral diseases in the acute period rises quite quickly and can be held for several days.

Symptoms such as headache, tearing and pain in the eyes that increases when looking at bright light, lacrimation, pain or soreness in the throat, unusual lethargy and apathy will also help to suspect acute respiratory infections. Incidentally, headache and weakness throughout the body, to the point of muscle pain when trying to move, are more characteristic of a viral infection.

The rate at which symptoms increase depends on the type of infection. Thus, in influenza, the body's reaction is almost instantaneous, and high fever along with headache is among the first symptoms of the acute period, but dry and wet cough, runny nose can appear much later.

Dry (non-productive) cough is the result of irritation of the mucosa of the respiratory tract. It appears before a serious inflammatory reaction develops. But wet cough can be considered as a consequence of inflammation or the result of increased productivity of bronchial secretion production and attachment of inflammatory exudate to it.

When microbes have already become active in the throat and upper respiratory tract and swelling of tissues has begun, a change in the voice is noted. From a ringing voice it turns into a muffled, hoarse, hoarse. Before the appearance of edema, the cough may be non-productive, but without peculiarities. With the emergence of edema and voice timbre changes and audible signs of cough. It increasingly resembles intermittent muffled dog barking, so it is called barking.

The combination of a barking cough and fever indicates that the inflammation is localized in the throat, larynx or trachea. Usually there is heavy breathing, pain in the throat that increases with swallowing, swelling of the larynx, and lymph nodes may be enlarged in bacterial infections. Such symptoms are more typical for acute respiratory viral infections, influenza, laryngitis and pharyngitis, less so for tracheitis and bronchitis.

We've already mentioned the symptoms of acute respiratory viral infections and influenza. But what are laryngitis and pharyngitis? Laryngitis is called an inflammatory process in the larynx, which is most often a consequence of a cold or infectious disease. This nature of the disease will be indicated by an elevated temperature. Other symptoms of laryngitis are considered: a red, swollen throat at the entrance to the larynx, painful when swallowing, frequent dry cough, which later becomes productive, a burning sensation and drying of the throat. With infection, plaque may appear on the mucous membranes of the pharynx.

Laryngitis can be caused by both viruses, bacteria and fungi of the genus Candida. In the first case, it is categorized as an acute respiratory infection with a specific localization, so all the symptoms of a viral infection (pain in the head, muscles and eyes, severe weakness) can take place.

The same applies to pharyngitis - inflammatory with localization in the pharynx. Inflammation covers the mucous membrane of the throat and the lymphoid tissue of the adenoids. The temperature in this case rises to subfebrile, and the patient complains of parching and pain in the throat, dry excruciating cough and other symptoms characteristic of infectious respiratory diseases. The person starts coughing to reduce the throat's soreness and tingling, but once he starts coughing, he can no longer stop. Examination of the throat shows that it is deep red, as in sore throat, and there may also be some ulcers.

Red throat, discomfort, fever, pain in the throat, noticeably increasing when swallowing and high fever - symptoms characteristic of sore throat, but the cough in this disease usually does not appear or occurs later (in this case, we are talking about a productive symptom). In addition, not in favor of the diagnosis of "sore throat" speaks and the spilt nature of inflammation in the pharynx.

Red throat in viral and bacterial respiratory diseases is observed in 90% of cases, but usually the redness is not localized only in the tonsils, but spreads further to the pharynx, upper and lower palate, uvula. If the hyperemia is predominantly in the tonsils, angina is diagnosed.

High fever, cough and vomiting - a symptom complex characteristic of the influenza virus, especially when it comes to a sick child. Vomiting is a consequence of intoxication and throat irritation. But in children with their lower weight compared to adults and not fully formed central regulation of many processes intoxication grows faster, and the gag reflex is triggered more often. Moreover, the occurrence of vomiting against the background of the clinical picture of respiratory infection, is noted not only in influenza, but also in many other diseases (eg, bronchitis or pneumonia).

However, such a combination of symptoms can not be called specific, characterizing only respiratory diseases. Such a clinical picture may be evidence of poisoning. Vomiting can be considered a consequence of intoxication. But what does this have to do with cough and fever?

Temperature in poisoning can both rise and fall. In infectious intoxication, it usually rises, which is explained by the development of an acute inflammatory process in the gastrointestinal tract. The effect of toxins on the CNS is such that the functionality of various brain structures can be impaired, including the thermoregulation center in the hypothalamus and cerebral cortex. This causes the temperature to continue to rise more than is necessary for defense against microorganisms.

Coughing in poisoning usually occurs after vomiting. Vomit masses begin to irritate the mucosa of the throat, causing a dry cough. Coughing fits can also be provoked by elements of the vomit masses entering the respiratory tract.

We have looked mainly at the reasons that can cause a cough and a temperature of 37-39, or even higher, in an adult. When it comes to children, however, there may be many more causes.

Complications and consequences

Cough and fever are symptoms that the body has begun to fight infection, and this process is accompanied by the development of an inflammatory response. Inflammation itself can be considered both as a physiological and pathological process. Yes, a local increase in temperature reduces the activity of pathogens in this area, and in general and in the whole body, but if inflammation is not treated, there is a possibility of destructive changes in tissues, disruption of the functionality of the bronchial mucous epithelium, the transition of the disease into a chronic form.

Another danger is the result of incorrect self-diagnosis or unprofessional diagnosis in a health care facility. The combination of cough and fever is usually associated with colds, i.e. Inflammation of the throat and respiratory tract, and other symptoms of a cold are expected: runny nose, red throat, headache, although they may not be present if it is a different inflammatory process.

For example, a fever of up to 38 degrees and a dry cough may be a symptom of infectious inflammation of the cardiac membranes. These symptoms often occur in patients with myocarditis and endocarditis.

Low-productive cough can also be a symptom of coronary heart disease. This is worth thinking about if there are no other symptoms of a cold, but there is shortness of breath, heavy breathing, discomfort in the heart area. Temperature rise in this case will be a bad prognostic sign, most often indicating myocardial infarction.

It is equally dangerous to underestimate the severity of the disease. You may think that it is just a cold and treat it with warm tea and gargle, but in fact it turns out that you are sick with pneumonia, which requires qualified treatment in the pulmonology department.

It is even worse when parents diagnose their child based on their meager knowledge of medicine. But many children's diseases, given the unformed immunity of the baby, are potentially life-threatening. Yes, medicine has gone far ahead and is now armed with such a serious weapon as vaccines against pathogens of childhood and adult diseases, but many parents are wary of vaccinating children, given the possible complications, and rarely agree to such prevention. And when a child gets sick, it is too late to beat the drums, every minute is precious, which can save a child's life.

Diagnostics of the fever and cough

Doctors with their professional training take symptoms such as cough and fever more seriously. Although in most cases it is really just a common cold, they consider all possible scenarios, from acute respiratory infections to myocardial infarction, which may have a hidden course.

Studying the patient's medical history is the first thing that an experienced doctor does. In this case, he is interested not in the fact of the presence of cough, but its nature: constant or attack-like, painful dry or wet, the amount of sputum secreted and its characteristics. The same applies to temperature, here are important and specific numbers and the time of temperature rise. The presence of any other symptoms helps to shed light on the diagnosis of the disease.

Information from the patient's medical record helps to suggest a chronic course or relapse of the disease, if there have been previous mentions. If the person is a heart patient, it makes sense to pay attention to the state of the cardiovascular system at the moment.

Appeal to the therapist or pediatrician with complaints of cough and fever initially involves physical examination. The doctor assesses the condition of the mucous membranes of the throat and oral cavity, listens to the patient's breathing for wheezing, and at the same time assesses the work of the heart. Wheezing and whistling in the chest indicate severe inflammation in the bronchi and lungs, which requires additional examination.

Such tests can be blood tests and sputum of the patient. Blood tests will show an increase in white blood cells as an indicator of inflammation, and often the presence of antibodies (after all, the immune system fights the infectious agent, and by the type of antibodies can be calculated). Sputum analysis gives more information about the severity of inflammation and its cause. It determines not only the presence of pus and blood in the sputum, but also identifies the infection that caused the disease. Urinalysis in this situation is rarely prescribed in order to assess the kidneys, which are responsible for the excretion of most drugs.

Instrumental diagnostics is performed mainly when serious diseases are suspected. In acute respiratory viral infections and influenza, there is usually no need for it, unless we are talking about possible complications in the form of bronchitis, pneumonia, pleurisy. Methods of instrumental diagnosis of cough and fever can be considered a chest X-ray, bronchoscopy, spirography (assessment of the functional activity of the respiratory organs), ultrasound of the pleural cavity, etc.

If heart disease is suspected, in addition, blood pressure, pulse, electrocardiogram, Holter heart monitoring, echocardiogram, MRI or ultrasound of the heart and some other special studies are also performed.

All basic and additional studies, the doctor prescribes, based on the preliminary diagnosis, which is made during the study of anamnesis and physical examination. In controversial situations, the patient may be sent for consultation to an otolaryngologist or cardiologist. A slight increase in temperature and coughing is also possible with reflux disease. If this is suspected, endoscopic examination of the esophagus and stomach is performed.

Differential diagnosis

Differential diagnosis in this situation helps to systematize the information obtained and determine the final diagnosis. Despite the fact that cough and fever in most cases are symptoms of viral diseases, their occurrence cannot be ruled out in bacterial infections of the respiratory and cardiac organs, myocardial infarction, refluxysophagitis, and sometimes in exacerbation of gastric ulcers or severe allergies with swelling of the larynx.

The treatment scheme largely depends on the causative agent of the disease, so it is very important to call it by name, in order to subsequently select the most effective drugs to combat the pathogen.

Treatment of the fever and cough

To begin with, it is illogical and dangerous to treat cough and fever without determining the causes of such symptoms, because there is a great risk that the disease lurks and will go into a chronic form or worse give severe complications. For example, the flu is happy to give complications to the heart and lungs, provokes the development of chronic diseases of the ear, throat, nose, can cause inflammation of the brain and its membranes. By the way, pneumonia, bronchitis, endo-, myo- and pericarditis, meningitis and encephalitis, sciatica, otitis media and even neuralgia in most cases are consequences of the common cold.

Since usually cough and fever are still symptoms of diseases of the upper and lower respiratory tract, we will pay more attention to the treatment of these diseases. As for infectious inflammation of the heart membranes, its treatment is not much different from that of severe pneumonia: eradication of the causative agent (depending on the type of infection, antibiotics, antimycotics, antiviral agents are prescribed) and control of inflammation with corticosteroids with medication support of immunity (immunostimulants, vitamins).

Treatment of any infectious disease is the competence of a specialized doctor. Even if we take into account the fact that many people know the basic rule: bacterial infections are treated with antibiotics, fungal infections are treated with antifungal agents or antimycotics, viral infections are treated with antiviral drugs and immunostimulants, not everyone is able to choose the right drug. After all, it is necessary to take into account not only the nature of the infection, but also its type. Drugs for the treatment of staphylococcus and the causative agent of tuberculosis may be completely different, and the flu virus can not be destroyed by drugs against herpes, although both the disease is a viral infection. Antiviral drugs, antimycotics and antibiotics for fever and cough should be prescribed by a doctor after the nature of the causative agent of the disease (ideally also its type) has been determined.

The biggest mistake many patients make is treating the symptoms when we should be treating the disease and its cause. Yes, changing a cough from non-productive to productive certainly plays a big role in the case of respiratory tract infection. But this measure is usually not enough to remove all units of the pathogen from the body. Even worse, when the cough is tried to strangle, ie, weaken the cough reflex at the level of the CNS. Such an approach to treatment is not scientific, rather the opposite, it will be anti-treatment.

As for fever, its treatment is generally doubtful until it reaches critical values. Up to 38 degrees Celsius temperature can not be knocked down, no matter what infection they were caused by. This you only prevent the body to fight. Knocking down the temperature before the doctor and forgetting to mention its rise, you can only confuse the specialist, because coughing with fever is a symptom of some diseases, and without fever may be signs of completely different pathologies.

In any case, treatment of the infection should not be limited to taking antipyretics and cough medicines (expectorants and mucolytics). If the causative agent of the disease is bacteria or fungi, then the use of means to increase immunity, effective for viral etiology of the disease, is likely to be insufficient. Antifungal and antibiotic therapy to date are considered the best option to combat the corresponding pathogens, despite all the disadvantages of these methods. But without them, there is a high risk of developing dangerous complications.

In the treatment of infectious diseases, a great role is played not only by prescribed medications, but also by the use of non-medication methods of treatment. First of all, it is rest and bed rest, which are mandatory in the acute period of the disease. Keep the temperature within safe limits without medication helps to drink plenty of water. It also facilitates the expectoration of sputum when coughing. Diet helps to reduce the load on the organs during the disease and save energy to fight the infection.

Prevention

Both cough and fever are not inherently a disease. They are just a reaction of the body trying to fight pathogens in every possible way. Yes symptoms affect our well-being, and there is a great desire to get rid of them, but this is wrong. If there were no cough, which helps to remove germs from the respiratory tract, and temperature, which is a killer on pathogens, the disease would be much more severe and with serious complications.

Speaking of prevention, we should understand that we should prevent not a protective reaction, but the possible cause of the disease, i.e. Infection and its activity due to weakened immunity. Often the causative agent of the disease sits for years in the body, and we do not even suspect it, until our immune system does not give slack. And to avoid this it is necessary to take care of a rational diet with sufficient vitamins, regular physical activity, and in the fall-winter and spring period on the preventive reception of multivitamin complexes and immunostimulants of plant origin (echinacea, Rhodiola rosea, lemongrass, eleutherococcus).

Our immunity and susceptibility to infectious diseases are affected by: hypothermia, chronic and autoimmune diseases and bad habits. Something for preventive purposes can be removed from your life: take care of hypothermia and draughts, give up alcohol and smoking, do not allow the transition of acute pathologies in chronic. And the prevention of autoimmune diseases - is the timely treatment of infections, because they are often responsible for the disorder of the immune system, which begins to react inadequately to their cells, but ignores foreign cells.

Forecast

The prognosis of diseases with cough and fever depends on the timeliness and relevance of the treatment carried out. The worst it happens. If a person ignores the symptoms for a long time and gets to the hospital in a serious condition.

High fever and cough cannot be considered as a normal variant. Therefore, these symptoms must be paid attention to, and the earlier it is done, the lower the risk of complications.