Questions to prepare for classes and examination
• Definition of fever. Differences between fever and hyperthermia.
• Types of pyrogens.
• Pathogenesis of fever. Features of thermoregulation at different stages of fever.
• The biological significance of fever.
• Symptoms accompanying fever and their mechanisms.
• Types of fever:
— based on the extent of temperature rise;
— based on the circadian temperature fluctuations.
• Types of hyperthermia: exertional, nonexertional, drug-induced, neurogenic, endocrinopathic.
• Principles of treatment of fever.
• The concept of infectious process. Three stages of infectious process.
• Entry and colonization of the host.
• The host defence mechanisms against the entry of infectious agent.
• Invasion and growth of parasitic organisms in host tissues.
• The host response.
• Pathological components of infectious process.
N 38
A 39-year-old patient Z. had been surgically treated eight days before in the surgical department for perforating duodenal ulcer. In the morning he has presented with progressive weakness, dizziness, nausea, complained of fullness in the epigastrium. The body temperature 39.2 °C. Ultrasonic studies of the abdomen showed collection of fluid, 4x4x8 cm of size, on the left of the umbilicus. Bacteriological analysis of the fluid, removed by the needle aspiration, revealed the presence of anaerobic organisms. The patient received the appropriate antibiotic therapy. Three days later the patient's body temperature decreased to 37.4 °C and persisted at this level.
Questions
• What factor caused an increase of the patient's body temperature eight days after the surgery? Substantiate your opinion.
• What are the specific mechanisms of fever in this case? Use the given data to substantiate your answer.
• Why was the administration of antibiotics for three days ineffective to bring the patient's body temperature to normal values?