Fever, Friend or Foe?
The audio and slides for this SMACC talk are at the bottom of this blog post
Fever is so hot right now…
‘Humanity has but three great enemies: fever, famine and war; of these by far the greatest, by far the most terrible, is fever’
— William Osler1
Fever is one of the cardinal signs of infection and — nearly 120 years after William Osler’s statement in his address to the 47th annual meeting of the American Medical Association on The Study of the Fevers of the South1 — infectious diseases remain a major cause of morbidity and mortality2. Despite this, it is unclear whether fever itself is truly the enemy or whether, in fact, the febrile response represents an important means to help the body fight infection. Furthermore, it is unclear whether the administration of antipyretic medications to patients with fever and infection is beneficial or harmful3,4.
The febrile response to infection is seen in a range of animal species including not only endotherms like mammals5-8 and birds9 but also ectotherms including reptiles10, amphibians11, and fish12. The febrile response in desert iguanas13 and bluegill sunfish14, like the response seen in humans, can be blocked by inhibition of cyclooxygenase (COX). As COX catalyses the generation of prostaglandins from arachidonic acid, this suggests that the pivotal role of PGE2 in the regulation of the thermostatic set point may be preserved in these species as well as in higher animals. A common biochemical mechanism regulating...
Source: Life in the Fast Lane - Category: Emergency Medicine Doctors Authors: Paul Young Tags: Emergency Medicine Featured Infectious Disease Intensive Care critical care Fever Friend or Foe ICU paul young SEPSIS SMACC Source Type: blogs
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