persistent relaxation fever
Introduction
Introduction Relaxation heat is also called septicemia. It means that the body temperature continues to be above 39 degrees, and the fluctuation range is large. The body temperature fluctuation range exceeds 2 degrees within 24 hours, but both are above the normal level. Common in sepsis, rheumatic fever, severe tuberculosis and suppurative inflammation. For active patients, nasal ulceration, systemic failure, persistent high fever, poor food intake, should be treated with high-dose corticosteroids assault treatment, until the nasal surface and systemic symptoms improve, then changed to a small dose to maintain clinical cure.
Cause
Cause
Relaxation heat, also known as septicemia, refers to body temperature often above 39 degrees, with large fluctuations, fluctuation range of more than 1 °C within 24 hours, but the minimum body temperature is still higher than normal body temperature. Common in sepsis, suppurative inflammation, severe tuberculosis, Kawasaki disease, advanced tumors, malignant histiocytosis. Persistent relaxation heat can be seen in malignant granuloma.
Examine
an examination
1. Blood: Half of the white blood cells are normal or slightly reduced, and the lymphocytes are relatively or absolutely increased, and the classification can reach more than 60%. ESR increased at all stages.
2. Bacteriological examination: the patient's blood, bone marrow, milk, uterine secretions can be used for bacterial culture. The positive rate in the acute phase is high and the chronic phase is low. Bone marrow specimens have a higher positive rate than blood specimens.
3. Immunological examination:
(1) Serum agglutination test.
(2) Complement binding test.
(3) Anti-human globulin test.
(4) Enzyme-linked immunosorbent assay.
Diagnosis
Differential diagnosis
Excessive heat: The body temperature is constantly maintained at a high level above 39-40 ° C for several days or weeks. The temperature fluctuation range does not exceed 1 °C within 24 hours. Common in pneumococcal pneumonia, typhus and typhoid fever.
Intermittent heat: After clinical occurrence of aversion to cold or chills, the body temperature rises sharply and can reach above 39 °C. After several hours, it drops to normal or below normal. It is repeated for several hours to several days, and it is called periodic fever. Found in malaria, such as vivax malaria or three-day malaria.
Irregular heat: The range of body temperature fluctuations during fever is extremely irregular, the duration is not necessarily, and the body temperature curve is irregular. The body temperature is usually around 38 ° C or fluctuates between 37 and 40 ° C. Clinically seen in a variety of diseases, such as respiratory infections, mycoplasmal pneumonia, tuberculosis, pleurisy, infective endocarditis, rheumatic fever, leukemia, etc., can also be seen in the interference of drugs or physical cooling.
Wave heat: The body temperature gradually rises, and then gradually drops to low heat or normal temperature after a few days. After a few days, it gradually rises again. This recurrence, the body temperature curve is wave-shaped, which is seen in brucellosis.
1 All cases of progressive granulogenous ulcer necrosis occurring in the nose and face should consider the disease first.
2 pathological examination: chronic non-specific granulomatous lesions, while seeing atypical reticulocytes or mitotic phase, you can diagnose the disease.
3 local damage is serious, but the whole body performance is still good.
4 local lymph nodes are generally not enlarged.
5 laboratory examination: white blood cell count is low, erythrocyte sedimentation rate is accelerated.
6 advanced patients often have persistent relaxation heat and progressive weight loss and systemic failure.
