Fever And Chills (Ague)

Fever, an abnormal rise in body temperature, is sometimes accompanied by chills. With flu, malaria, and certain other diseases, even may occur or alternate with sweating and chills.

The hypothalamus, which is part of the brain, controls the body's thermostat. It sets the body's temperature normally at about 98.6°F (37°C) when taken orally or about 99.6°F (37.5°C) when taken rectally. Your temperature is slightly lower when you first awake in the morning; this is referred to as the body's basal temperature.

Body temperature rises for a number of reasons, but the most common is the invasion of infectious organisms, which induce the bloods disease-fighting white cells to release pyrogen, a chemical that travels to the brain and prompts the hypothalamus to reset the body's thermostat at a higher level. The reaction is part of the body's effort to kill the organisms, which often cannot survive a high body temperature.

Diagnostic Studies and Procedures

Because fever is a symptom of a wide range of disorders and not an illness in itself, diagnosis focuses on finding the cause. Diagnostic studies may consist of blood tests, various cultures, X-rays, and possibly a biopsy.

Medical Treatments

The cause of a fever determines whether or not treatment is necessary. Many doctors feel that if a fever does not exceed 102°F (39°C), it is best to leave it alone. However, a prolonged high fever or one above 103°F (39.5°C) can bring on dehydration, headache, nausea, and convulsions, especially in young children. In the frail elderly, an extremely high fever may be life threatening.

In such cases, aspirin and acetaminophen are the most effective drugs for lowering a fever. For very young children -- and for anyone with a swallowing problem -- pills can be pulverized and mixed with mashed banana or applesauce. Be sure to consult a doctor before giving aspirin to anyone under age 18. In this age group, aspirin given during a viral infection increases the risk of Reye's syndrome, a potentially fatal disorder.

Alternative Therapies

Several alternative therapies can lower a fever. Such approaches may be useful adjuncts to medical treatment.

Aromatherapy. Aromatic oils, said to reduce a fever when massaged into the skin or converted to vapor for inhalation, include camphor, eucalyptus, lemon, and hyssop.

Herbal Medicine. Tea made with the dried bupleurum root can be effective, as can tea made from boncset, or ague-weed, a remedy favored by Native Americans to treat high fevers.

Homeopathy. Numerous remedies are recommended, including aconite, arnica, arsenicum, Pulsatilla, pyrogen, and hyoscyamus. The cause and nature of the fever determines what to use.

Hydrotherapy. Applying a cold compress to the forehead and sponging the body with cool or tepid water can quickly reduce a high fever. Do not sponge a baby with alcohol, however; the fumes can be dangerous.

Self-Treatment

Drink extra fluids to replace those lost through sweating. Good choices are water, fruit juice, lemonade, herbal teas, and clear broth. Avoid alcohol and beverages containing caffeine, which have a diuretic effect that can cause additional fluid loss.

Extra sleep is also important. Stay in bed as much as possible. If chills accompany the fever, use a light blanket that can be removed during periods of fever and sweating.

Other Causes of Fever

A continuing low-grade fever may be a warning sign of tuberculosis and of some types of cancer, especially leukemia and Hodgkin's disease. Fever is also a symptom of mononucleosis, rheumatoid arthritis, and lupus. A sudden high temperature may indicate an acute infection, such as appendicitis. In women, pelvic inflammatory disease or toxic shock syndrome can bring on a high fever, while in children, middle ear infections are a common cause.