What is the reason why adults have a high fever that won't go away

A high fever that does not go away is a relatively dangerous situation for both adults and children, because fever affects not only body temperature and spirit, but can also affect the brain and lungs. For some patients with persistent high fever, it is necessary to find the cause and then treat the disease accordingly. So, what diseases cause high fever? The following will provide a detailed introduction.

1. Sepsis

Common ones are Staphylococcus aureus sepsis and Gram-negative bacterial sepsis. The former has an acute onset, sudden chills, high fever, and the fever type is mostly remittent fever. The main clinical manifestations are polymorphic rash, skin and mucous membrane hemorrhages, joint swelling and pain, endocarditis, and migratory purulent lesions. The peripheral blood leukocytes and neutrophils were significantly increased. Gram-negative sepsis is often characterized by remittent, intermittent, or bimodal fever, which may be accompanied by a relatively bradycardia, necrotic rash, hepatosplenomegaly, and septic shock. Some patients may not have high peripheral blood leukocytes.

2. Tuberculosis

(1) Miliary tuberculosis

There may be high fever, chills, shortness of breath and symptoms of systemic poisoning, and chest X-ray shows diffuse small nodular shadows.

(2) Infiltrative pulmonary tuberculosis

There may be fever, cough, hemoptysis, fatigue, loss of appetite, weight loss, night sweats, sputum tuberculosis culture may be positive, chest X-ray shows patchy or spotted shadows on one or both sides of the upper lung, and fibrosis and calcification may also be present.

(3) Extrapulmonary tuberculosis

Including tuberculous meningitis, tuberculous pleurisy, peritoneal tuberculosis, lymph node tuberculosis, renal tuberculosis, etc. Clinically, there are symptoms of systemic poisoning and associated symptoms. The white blood cell count is generally normal or slightly elevated, the erythrocyte sedimentation rate may be increased, and the tuberculin test is positive. Diagnostic treatment is effective.

3. Typhoid

The onset is slow, the body temperature rises in a trapezoidal pattern, and the fever persists, accompanied by apathy, relatively slow pulse, and roseola. In typical cases, splenomegaly and hepatomegaly may occur at the end of the first week of the disease course. The white blood cell count was decreased, the Widal reaction was positive, and Salmonella typhi was isolated from the blood culture. In recent years, due to the widespread use of antibiotics, atypical cases of typhoid fever have increased, and complications have increased and become more complex, which should be paid attention to.

4. Epidemic hemorrhagic fever

Rats are the source of infection and can be prevalent in spring and summer and autumn and winter. Clinically, it is divided into five stages: fever stage, hypotension stage, oliguria stage, polyuria stage, and recovery stage. The fever stage has an acute onset, with body temperature generally between 39°C and 40°C. The fever type is mostly remittent fever, accompanied by headache, eye pain, orbital pain, blurred vision, thirst, nausea, vomiting, abdominal pain, diarrhea, etc. The face and orbital areas are congested, the upper chest is flushed, and scattered bleeding spots can be seen in the armpits. The number of white blood cells increased, the number of lymphocytes increased, and the number of platelets decreased. Chest X-ray may show diffuse exudative changes.

5. Malaria

The incidence rate is high in summer and autumn. There is obvious chills before high fever, and the body temperature can reach above 40°C, accompanied by heavy sweating. There may be splenomegaly and anemia, and the white blood cell count is low. For patients suspected of malaria, if Plasmodium is not found in multiple blood smears or bone marrow smears, chloroquine can be tried as a diagnostic treatment.

6. Infective endocarditis

Patients with congenital heart disease or rheumatic valvular heart disease, or after heart surgery, may develop unexplained high fever accompanied by general fatigue, progressive anemia and embolism. Physical examination may reveal bleeding spots on the skin, mucous membranes, nail beds, etc., and a new murmur or a change in the nature of the original murmur may occur during heart auscultation, or the patient may have irregular heart rhythm. The possibility of this disease should be considered, and repeated blood cultures may help to confirm the diagnosis.