Further discussion on the treatment of “fever”

  Most of the so-called fever patients, whose body temperature is completely normal, think they are high or feel higher than before, are actually just a self-conscious symptom, and the real presence of fever must be confirmed by objective temperature measurement. In addition, from the consultation, most of them are young people or students aged 15 to 17 years old, most of them did not find any abnormality in the hospital after various examinations, some of them do any large examination such as CT at any time, and some of them hang water and take medicine every day, in addition to western medicine and Chinese medicine. Here I have to say, health awareness has increased, of course, is a good thing, but the phenomenon of small treatment of no disease, small disease is also becoming more and more serious, especially parents, their children are more so, the mood is understandable. But this is undoubtedly a waste of resources, but also increases the family’s unnecessary expenditure, more importantly, inappropriate treatment will be counterproductive.  Now the people are not saying that it is expensive to see a doctor, it is difficult to see a doctor, but there are still a small number of people who have fever and other uncomfortable symptoms to the hospital, must send money to the hospital, the author is not saying that there is a disease do not see, but that there is a disease how to see? I often encounter “fever” patients in the clinic, some parents came all the way here with their children to see the so-called fever, in fact, the child can eat, sleep, what much good, after the enlightenment, of course, but also inevitably a few “scolding” after the family happily left. The family left happily. There are also patients in the primary hospital was diagnosed as “sepsis”, because of the active anti-infection treatment temperature does not go down referred to hospital, the results of the hospital after the discontinuation of all antibiotics, including drugs suspected of causing metabolic reactions, the temperature gradually returned to normal, almost no money to go home safe and sound. The author once went to a larger general tertiary hospital in the field to consult a fever patient, because the patient is a famous local entrepreneur, really is “not bad money”, a variety of good drugs on, but the result is getting worse, and appear oliguria, renal impairment, the local doctors believe that the patient is a serious infection, and the complication of Infectious shock, before also invited many consultations, but none of them dare to say that it is not an infection. The author went to the ward to see the patient, found that the patient’s face and neck red and congested, although hyperthermia, but the general condition is still good, before the spirit, appetite are good, only with the escalation of antibiotics and a variety of antibiotics in combination, the body temperature is getting higher and higher, after a comprehensive analysis concluded that the patient fever cause and drug-related, that is, the body is in a state of high inflammatory response to a variety of antibiotics there is a high The patient’s fever was related to the medication, that is, the organism was in a high inflammatory reaction state, with a high degree of metaplasia to various antibiotics, and vasculitis, plasma extravasation, transient hypotension, prerenal oliguria with elevated blood urea nitrogen and creatinine levels. The patient recovered quickly after discontinuing all antibiotics and promptly applying glucocorticoids and intravenous propecia to suppress the inflammatory response in the body.  The patient recovered very quickly. The purpose of citing so many cases is to show that antibiotics can “treat” fever and may also cause fever, we call the drug-induced fever as “drug fever”, in fact, drug fever is only one of the adverse drug reactions, other adverse reactions are Drug-related liver damage, serious liver failure and death, drug-induced rash (i.e. drug rash), serious life-threatening epidermolysis bullosa can occur. It can be said that the side effects or adverse reactions of drugs can involve all systems of the body, and their symptoms vary in severity, with the milder ones not being taken seriously by patients and the more serious ones being life-threatening.  As there are many consultations, there is no shortage of patients taking herbal medicines. Chinese medicine is the medicine of the motherland and should be thoroughly researched, developed and scientifically applied in clinical practice. However, herbal medicines, especially unprocessed, untreated, and unextracted herbs, should be extra vigilant about their side effects. Due to individual differences, the tolerance of Chinese medicine varies, and some people are fine with taking it for a long time, while others may experience certain uncomfortable symptoms even after taking it for a short time. Even so, the people especially like Chinese medicine and believe that Chinese medicine has no side effects, I often encounter patients ask such a question when prescribing to them: is it Chinese medicine or Western medicine? In fact, as the ancients say, medicine is poisonous in three parts, whether it is western medicine or traditional Chinese medicine, first, to master and understand the characteristics of the drug, its possible side effects; second, to master the indications, to achieve reasonable application, including dose, duration of treatment, drug compatibility, etc.; third, to master the age of certain drugs, different physiological periods, for example, some drugs can not be used by children, some drugs are prohibited in women during pregnancy, etc.; finally, how to avoid adverse reactions to drugs, to avoid the adverse reactions to drugs, to avoid the adverse reactions to drugs. Finally, how to avoid adverse drug reactions, from two levels, doctors should continue to read and learn, master new knowledge, new technology, in order to improve the quality of medical care, to ensure medical safety; patients should not take drugs on their own initiative, especially do not have a “fever” on the rush to take drugs, hanging water, and do not listen to the so-called prescriptions, secret recipes. In order to deepen the impression of “fever”, the basic concept of fever is introduced here, and we hope it will be helpful to you.  The normal body temperature range of healthy adults is: oral temperature is 36.3~37.2℃, rectal temperature is 0.3~0.5℃ higher than oral temperature, axillary temperature is 0.2~0.4℃ lower than oral temperature. The body temperature of healthy adults fluctuates slightly throughout the day and night, with the lowest from 2:00 a.m. to 6:00 a.m. and the highest from 1:00 p.m. to 6:00 p.m., but the range of fluctuation does not exceed 1°C during the day. The body temperature of children is slightly higher than that of adults. A fever is considered when the body temperature rises above 0.5°C of normal.