Fever

Fever is an elevation of body temperature that can be associated with infection as well as dehydration and thyrotoxicosis. The development of fever appears to involve a resetting of the thermoregulatory set-point to a higher level, as shown in Fig. 5. When this occurs, the hypothalamic regulatory center responds as if the core temperature were too low—cutaneous vasoconstriction and shivering ensue, leading to the feeling of chill that precedes and accompanies fever. When the body core temperature rises to the higher set-point, a new balance of heat loss and heat production is achieved but at a higher body temperature. When a fever "breaks," the set-point falls toward the normal level and the hypothalamic integrative center causes cutaneous vasodilation and sweating, leading to a fall in body temperature to the new set-point. During the course of an infection, the set-point can oscillate up and down, leading to cycles of shivering and sweating.

The fever with infection occurs when the immune system reacts to components of the infecting organism— for example, to lipopolysaccharides of the bacterial cell wall, especially from Gram-negative bacteria. Such substances are called exogenous pyrogens. They cause mono-cytes and macrophages to release cytokines such as interleukins (especially IL-1B and IL-6) and tumor necrosis factor (TNF). These cytokines are referred to as endogenous pyrogens, and they cause the production of

Exogenous pyrogens such as lipopolysacchrides from infecting organisms

Local release of Jt prostaglandin E2 and thromboxanes

^ Endogenous pyrogens ,such as IL-1 p, IL-6 and TNF are released by leukocytes

A Body heat content

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