Fever Clinical Pathophysiology

Posted by e-Medical PPT
Body Temperature
“Core Temperature”
Aortic blood temperature
Esophageal temperature
Tympanic membrane temperature

Normal Thermoregulation
Afferent Sensing
Cold receptors –> A delta fibers
Warm receptors –> C fibers
Integrated in spinal cord and CNS –> hypothalamus
Central Integration
20% each contribution from: skin, deep chest and abdomen, spinal cord, CNS, hypothalamus
Skin input predominates behavioral responses
Cold and warm response thresholds only 0.4º apart
Efferent Responses
Behavioral (clothing, adjusting environment)
Response to heat: sweat, cutaneous dilation
Response to cold: digital vasoconstriction
Nonshivering thermogenesis
Shivering

Endogenous Pyrogens
Interleukin–1 (alpha*, beta)
Interleukin–6
Interleukin–11
Tumor necrosis factor (alpha)
Interferon (alpha, beta, gamma)
Prostaglandin–E2
Platelet activating factor
Ciliary neurotropic factor (CNTF)
Oncostatin M
Cardiotropin–1
Leukemic inhibitory factor

Fever and Host Defense Enhancement
Neutrophil function
Enhanced migration
Enhanced superoxide production
Mononuclear function
Enhanced interferon production
Enhanced interferon tumor and viral activity
T–cell proliferation

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