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What causes a febrile-intoxication syndrome?
Last reviewed: 19.10.2021
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Fever, accompanied by intoxication, is typical for most bacterial, viral and protozoal infectious diseases, generalized mycoses. It is possible in helminthic invasions (opisthorchiasis, trichinosis, schistosomiasis). Feverish-intoxication syndrome is not typical for cholera, botulism, hepatitis B virus and viral hepatitis C, uncomplicated amoebiasis. Cutaneous leishmaniasis, giardiasis, localized mycoses and many helminthic invasions.
The level of fever reflects the severity of the course of the disease as a whole. Fever may be absent or be subfebrile in the presence of many diarrheal and acute respiratory infections.
In most cases, febrile-intoxication syndrome accompanies the specific symptoms of a certain nosoform (rash, polyadenitis, arthritis, catarrhal respiratory, hepatolien, meningeal, dyspeptic syndromes, etc.). In the absence of these symptom complexes, patients are hospitalized and examined in a diagnostic department. Clarify the anamnesis of the disease, epidemiological history (contact with febrile patients, travel to regions where malaria is widespread, tropical fever, typhoid paratyphoid diseases). The following studies are carried out: three-hour thermometry to clarify the type of temperature curve, a general blood test, urine, chest X-ray. A study for malaria (smear, a "thick drop" of blood), blood culture for "sugar broth" and Rappoport. In the absence of positive results, in the next stage an in-depth examination is conducted to exclude tuberculosis (Mantoux reaction, phthisiatric consultation), sepsis (resuspension of blood). Infectious endocarditis (ultrasound of the heart), severe local suppuration (ultrasound of the abdominal cavity, pelvis and kidneys), nonspecific connective tissue diseases (large collagenoses) - blood on LE cells. Antinuclear antibodies, C-reactive protein (SRB), oncological diseases (oncohematology, lymphoma, myeloma) - protein and protein fractions, sternal puncture, radiography of flat bones, central thermoregulation disorder (EEG, neurologist consultation), hyperthyroidism (thyroid hormones, consultation endocrinologist). The results of the three-hour thermometry allow us to clarify the time of the minimum and maximum body temperature levels and to determine the remitting, hectic, intermittent or incorrect types of the temperature curve, repeated body temperature increases during the day, peculiar to brucellosis and sepsis.