Chapter 30: Fever, Hyperthermia, and Rash


  • Temperature: The hypothalamic thermoregulatory center balances excess heat production from metabolic activity in muscle and liver with heat dissipation from the skin and lungs to maintain a normal body temperature of 36.8° ± 0.4°C (98.2° ± 0.7°F), with diurnal variation (lower in A.M., higher in P.M.)
  • Fever: An elevation of body temperature (>37.2°C/98.9°F in the morning and >37.7°C/99.9°F in the evening) in conjunction with an increase in the hypothalamic set point
  • Fever of unknown origin (FUO) : Temperatures >38.3°C (>101°F) on two or more occasions and an illness duration of ≥3 weeks, with no known immunocompromised state and unrevealing laboratory and radiologic investigations into the cause
  • Hyperpyrexia: Temperatures >41.5°C (>106.7°F) that can occur with severe infections but more commonly occur with CNS hemorrhages
  • Hyperthermia: An uncontrolled increase in body temperature that exceeds the body’s ability to lose heat without a change in the hypothalamic set point. Hyperthermia does not involve pyrogenic molecules.
  • Pyrogen: Any fever-causing substance, including exogenous pyrogens (e.g., microbial toxins, lipopolysaccharide, superantigens) and pyrogenic cytokines (e.g., IL-1, IL-6, TNF)

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