Canefield fever

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Related to Canefield fever: canicola fever, nanukayami fever, pretibial fever


(fe'ver) [L. febris]



Patient care

Patients with fever frequently seek professional medical attention. Fever is often an important indicator of infections or inflammations that may cause significant injury if left untreated. Diagnosing the cause of a fever may lead to specific therapies that limit the duration of an illness, prevent secondary organ damage or even death. The suppression of fever, however, is controversial. Some believe that fever helps to eradicate infecting organisms that cannot survive in a hot environment. Nonetheless, medications such as acetaminophen, aspirin, and other nonsteroidal anti-inflammatory drugs (NSAIDs) can lower body temperatures in febrile patients and are commonly used esp. if the body temperature exceeds 101°F (38.3°C). It is unknown whether using antipyretics results in improvements in survival or decreases in morbidity. In some settings (e.g., the care of the hospice patient with a fever) withholding an antipyretic drug is considered to be inadequate symptom management by most health care providers. In other settings (e.g., in patients with malignant hyperthermia or heatstroke), giving antipyretics represents a standard of care. To date, however, controlled trials of withholding antipyretics in many illnesses have not been performed.

Suppression of fever (by induced hypothermia) is recommended for those who have suffered sudden death, stroke, or persistent seizures; however, proof of the effectiveness of lowering the body temperature of stroke victims is based on laboratory data rather than clinical effectiveness. Suppression of fever in young children with viral and bacterial infections is often a comfort for them; yet some researchers have speculated about adverse effects of this common practice (e.g., whether there is a link suppression of fever and autistic disorders). When the choice is made to suppress a fever, it is probably most comfortable to give antipyretics on a regular basis (every 4 or 6 hr) rather than intermittently. Intermittent dosing of antipyretics may produce alternating bouts of chills and sweats, which most patients find unpleasant. Some patients may never mount a fever; this is particularly true of those over 65, who may have serious treatable infections without elevations of body temperature. In older patients, the first indication of inflammatory or infectious illnesses may be a cough, lethargy, anorexia, or alterations in mental status.


Aspirin and other salicylates are contraindicated as antipyretics or analgesics in children because of their association with an increased risk of Reye's syndrome. Public and parental education should be provided to make certain this knowledge is widely disseminated.
2. A disease characterized by fever.

acute pharyngoconjunctival fever

Abbreviation: APC

African tick bite fever

A disease transmitted to humans by ticks of the genus Amblyomma infected with Rickettsia africae. The disease is found in sub-Saharan Africa and the French West Indies and is characterized by fevers, headache, scabs that form at the site of tick inoculation, and localized lymph node swelling.

Alkhurma hemorrhagic fever

Abbreviation: AHFV

biphasic fever


blackwater fever

Bloody urine (hemoglobinuria) that occurs as a complication of falciparum malaria infection. It is the result of red blood cell destruction and the release of hemoglobin. It occurs most commonly in patients who have been treated with drugs derived from quinine. See: falciparum malaria



boutonneuse fever

Mediterranean spotted fever.

brain fever


breakbone fever


childbed fever

Puerperal sepsis.

Canefield fever


Congo-Crimean viral hemorrhagic fever

A frequently fatal viral infection found in the Middle East, Africa, and southwestern Asia, characterized by bleeding, diarrhea, hepatitis, high fevers, throat pain, and vomiting. The cause is the Congo-Crimean hemorrhagic fever virus, which is transmitted to humans by ticks or exposure to the blood of infected animals or patients. Ribavirin has been used to treat the disease in some patients.

continuous fever


dandy fever


deer fly fever


dengue fever


dengue hemorrhagic fever

Abbreviation: DHF

desert fever


drug fever

Fever caused by the administration of a drug. Because fevers are more often caused by infections, rheumatological illnesses, or malignancies, the diagnosis of drug fever may be overlooked initially.

Ebola virus hemorrhagic fever

An often fatal viral disease that appears in sporadic outbreaks in Africa. The clinical presentation of widespread bleeding into many organs and fever is similar to that seen in Lassa, Marburg, and Congo-Crimean viral hemorrhagic fevers.


The disease is caused by one of three species of Ebola virus, a Filoviridae virus distinguished by long threadlike strands of RNA. The animal host has not been identified, which limits study of the disease. In each outbreak, the first human infection is believed to be caused by a bite from an infected animal. Subsequent cases are the result of contact with blood or body secretions from an infected person or the reuse of contaminated needles and syringes.

Patient care




enteric fever

Typhoid fever.

epidemic hemorrhagic fever

Hemorrhagic nephrosonephritis.

factitious fever

Fever produced artificially by a patient. This is done by artificially heating the thermometer or by self-administered pyrogenic substances. An artificial fever may be suspected if the pulse rate is much less than expected for the degree of fever noted. This diagnosis should be considered in all patients in whom there is no other plausible explanation for the fever. Patients who pretend to have fevers may have serious psychiatric problems.
See: factitious disorder; malinger; Munchausen syndrome

familial Hibernian fever

Synonym: TNF receptor associated periodic syndrome

familial Mediterranean fever

Synonym: periodic fever; recurrent polyserositis

Flinders island spotted fever

Abbreviation: FISF
A spotted fever transmitted to humans by the bite of Ixodes ticks infected with Ricksettsia honei. It is found primarily in Victoria and Tasmania, Australia, and is similar to Rocky Mountain Spotted Fever in the U.S.

Fort Bragg fever

Pretibial fever.

Gibraltar fever


grain fever

Silo-filler's disease.

Guama fever

A mosquito-borne encephalitis, transmitted by a bunyavirus.

Haverhill fever

Rat-bite fever.

hay fever








humidifier fever

Allergic alveolitis caused by exposure to inhaled antigens and marked by flulike symptoms. See: alveolitis
Synonym: humidifier lung

induced fever

Fever produced artificially to treat certain diseases such as central nervous system syphilis. Sustained fever of 105°F (40.5°C), or even higher, maintained for 6 to 8 or 10 hr may be induced by medical diathermy or injection of malarial parasites.

inhalation fever


intermittent fever

Fever in which symptoms disappear completely between paroxysms.
See: malaria; undulant fever

Japanese spotted fever


Karelian fever

An infectious disease caused by the Sindbis virus and marked by influenza-like symptoms and rashes, esp. blistering rashes on the hands and feet. A postinfectious arthritis sometimes follows.

Katayama fever


Korean hemorrhagic fever

Hemorrhagic nephrosonephritis.

Lassa fever

A potentially lethal viral illness marked by hemorrhage, extreme muscle pain, and, in some cases, shock. It is contracted only in Africa. The responsible agent, an arenavirus, is spread to people after contact with infected rodents or their urine or feces. Each year, approx. 300,000 people are infected.


Patients have abrupt onset of high fever that is continuous or intermittent and spiking, with generalized myalgia, chest and abdominal pain, headache, sore throat, cough, dizziness with flushing of the face, conjunctival injection, nausea, diarrhea, and vomiting. Hemorrhagic areas of the skin and mucous membranes may appear on the fourth day. Mortality of those in Africa with this disease varies from 16% to 45%.



Malta fever


Mediterranean fever


Mediterranean spotted fever

Synonym: boutonneuse fever

metal fume fever

A syndrome resembling influenza, produced by inhalation of excessive concentrations of metallic oxide fumes such as zinc oxide or antimony, arsenic, brass, cadmium, cobalt, copper, iron, lead, magnesium, manganese, mercury, nickel, or tin. It occurs in those whose occupations lead to exposure to these metals. See: polymer fume fever


The onset of symptoms is usually delayed. There are chills, weakness, lassitude, and profound thirst, followed some hours later by sweating and anorexia. Occasionally, there is mild inflammation of the eyes and respiratory tract. The symptoms are more acute at the beginning of the work week than at the end. This is felt to be due to the individual's adapting to the fumes as exposure continues.

First Aid

Therapy includes analgesics, antipyretics, and rest.

milk fever

A veterinary term, no longer used in clinical medicine, for an elevation in body temperature and paralysis occurring after a cow gives birth. Synonym: paresis puerperalis

neutropenic fever


Oroya fever

See: bartonellosis

pappataci fever

Sandfly fever.

paratyphoid fever

A rare form of febrile gastroenteritis in Western societies, marked by fevers, abdominal pain, diarrhea, headache, and occasionally intestinal perforation. It is caused by Salmonella paratyphi (A and B strains) and related Salmonella species, typically contracted by travelers who have visited tropical countries. Antibiotic treatments include ciprofloxacin or chloramphenicol.

parrot fever


Pel-Ebstein fever

See: Pel-Ebstein fever

periodic fever

Familial Mediterranean fever.

phlebotomus fever

Sandfly fever.

polymer fume fever

A condition due to breathing fumes produced by certain polymers heated over 300°C (570°F). Symptoms include a tight gripping sensation of the chest, shivering, sore throat, fever, and weakness. Avoidance of the fumes is the treatment. See: metal fume fever

Pontiac fever

An infection with Legionella species that causes fevers, chills, headache, muscle aches, gastrointestinal upset, and prostration but not pneumonia.

pretibial fever

Synonym: Fort Bragg fever

puerperal fever

Puerperal sepsis.

Q fever

Synonym: Query fever

Query fever

Q fever.

rabbit fever


rat-bite fever




relapsing fever


remittent fever

See: malaria

rheumatic fever

A multisystem, febrile inflammatory disease that is a delayed complication of untreated group A streptococcal pharyngitis (strep throat). It is believed to be caused by an autoimmune response to bacterial antigens in the streptococci although the precise mechanism responsible for the illness has not been identified. Primarily seen in children between ages 5 and 15, the disease is now uncommon in Western societies because of effective and prompt treatment for strep throat, but it remains a major cause of morbidity in the developing world.



Rheumatic fever may occur without any sign or symptom of joint involvement. Two major manifestations (carditis, polyarthritis, chorea, erythema marginatum, subcutaneous nodules) or one major and two minor criteria (fever of at least 100.4°F [38°C], arthralgia, previous rheumatic fever, elevated erythrocyte sedimentation rate or positive C-reactive protein, prolonged P-R interval) are required to establish the diagnosis of acute rheumatic fever.





Salicylates, acetaminophen, and NSAIDs are used to lower fever, reduce inflammation, and alleviate pain. Corticosteroids may be needed if the salicylates, acetaminophen, and NSAIDs do not relieve inflammation in patients with carditis. Diuretics and other cardiac medications are prescribed as necessary to treat heart failure. Severe heart valve dysfunction requires surgical correction but usually not until late adolescence or adulthood. Patients known to have carditis who must undergo dental or surgical procedures, esp. those involving instrumentation of the urinary tract, rectum, or colon, should receive additional antibiotic coverage on the day of the procedure and for several days thereafter.

Patient care

During the acute phase, diversional activities that are not physically demanding are offered; family and friends are encouraged to visit; a tutor ought to be provided to help the child stay current with school work. The child and family are taught about the disease and treatment, and all diagnostic measures are described. The child and family are also taught about signs of recurrent streptococcal infection and of heart failure, which require immediate reporting and treatment. Health care professionals advise the patient about lifestyle and activity modifications, as well as the importance of taking prescribed antibiotics for the full course of treatment and prophylaxis. The child and family are informed about symptoms of hypersensitivity reaction to the antibiotic and are advised to stop the drug and immediately and to notify the primary care provider if a rash, fever, chills, or other signs of allergy develop anytime during the course of therapy. The importance of maintaining a salt-restricted diet and of adhering to treatment with diuretics, digoxin, or afterload-reducing drugs is emphasized for patients with congestive heart failure. The American Heart Association provides educational materials and current protocol for prevention of bacterial endocarditis, which is different from the RF regimen used to prevent recurrence. (800-AHA-USA1;

Rocky Mountain spotted fever

An infectious disease caused by the bacterium Rickettsia ricketsii and transmitted by the wood tick Dermacentor andersoni or D. variabilis. Originally thought to exist only in the western U.S., it can occur anywhere that the tick vector is present.

The organism causes fever, headache, myalgia, and a characteristic vasculitic rash. The rash appears several days after the other symptoms, first erupting on the wrists and ankles, then on the palms and soles. It is nonpruritic and macular and spreads to the legs, arms, trunk, and face. Disseminated intravascular coagulation or pneumonia may be serious complications. Tetracyclines are the drug of choice for treating this disease, but their use in pregnant women is not advised. Chloramphenicol may be substituted.

People living in areas with wood ticks should wear clothing that covers much of their bodies, including the neck, to prevent ticks from attaching to the skin. People who live in or travel to areas where ticks flourish should examine their scalps, skin, and clothing daily. Ticks should be grasped close to the mouthparts (not on the tick's body), as close to their point of attachment to their human host as possible. Pets should be examined regularly for ticks.

rose fever

Hay fever of early summer attributed to inhaling rose pollen.
See: hay fever

sandfly fever

A mild viral disease that clinically resembles influenza. The causative organism is any of several species of Bunyaviridae viruses and is transmitted by the common sandfly Phlebotomus papatasi. The disease occurs in tropical and subtropical areas that have long periods of hot, dry weather. Several antiviral drugs (e.g., alpha interferon and ribavirin) have some effect against the disease.
Synonym: pappataci fever; phlebotomus fever; three-day fever

San Joaquin valley fever


scarlet fever

An acute, contagious disease characterized by pharyngitis and a pimply red rash. It is caused by group A beta-hemolytic streptococcus and usually affects children between 3 and 15. Synonym: scarlatina; second disease








Scarlet fever is treated with 10 days of penicillin (or erythromycin for those allergic to penicillin). A full course of therapy is vital to decrease the risk of rheumatic fever or glomerulonephritis. In general, patients are taught to isolate the infected child from siblings until they have received penicillin for 24 hr.

Patient care


Sennetsu fever


Shanghai fever


snail fever


spotted fever

See: Rocky Mountain spotted fever

spring fever


three-day fever

Sandfly fever.

trench fever

Synonym: Wolhynia fever

typhoid fever

A severe infectious disease marked by fever and septicemia, caused by Salmonella typhi. The CDC reports 400 cases per year in the U.S., mostly among travelers. An estimated 21 million cases of typhoid fever and 200,000 deaths occur worldwide because it is endemic in areas of poor sanitation. Synonym: enteric fever See: typhoid vaccine


Gastrointestinal symptoms may develop within 1 hr of ingestion of S., but they usually subside before the onset of the typhoid fever symptoms. The disease is marked initially by a gradually increasing fever up to 104°F (40°C), anorexia, malaise, myalgia, headache, and slow pulse for about 7 days, followed by remittent fever up to 104°F (40°C) that usually occurs in the evening, a flat, rose-colored, fleeting rash (primarily on the abdomen), chills and sweating, increasing abdominal pain and distention, diarrhea or constipation, generalized lymphadenopathy, abdominal pain, anorexia, weakness, and exhaustion, cough and moist crackles, a tender abdomen with enlarged spleen, and delirium as the bacteria spread through the bloodstream. About 14 days after the infection begins, persistent fever and increased weakness and fatigue are present but usually subside by about 21 days into the illness although relapses may occur. Internal bleeding usually develops due to gastrointestinal ulcers, abscesses, and intestinal perforation; this may lead to hypovolemic shock. Damage to the liver and spleen is common. In approx. 10% of patients, typhoid fever is complicated by pneumonia, thrombophlebitis, osteomyelitis, septic arthritis, cerebral thrombosis, meningitis, myocarditis, or acute circulatory failure, which account for most of the deaths.



Differential Diagnosis



The disease is treated with ciprofloxacin or other antimicrobials based on organism sensitivity testing for 10 days. Dexamethasone is administered a few minutes before antibiotics are given in patients with shock or decreased levels of consciousness. Travelers should be aware that the most important safeguards are good food handling and water sanitation. The CDC recommends vaccination with typhoid vaccine, which is available in a live attenuated oral and parenteral form and intramuscular form for people traveling to developing countries in Africa, Asia, the Indian subcontinent, Central and South America, and the Caribbean. The oral vaccine is taken in multiple doses, with adults and children over 6 prescribed one capsule every other day for a total of four doses. Each dose should be taken 1 hr before a meal with cool water, and the capsules kept in the refrigerator. The one-dose parenteral vaccine may be used as an option for children 2 to 6, for the immunocompromised, and for those who might not adhere to the oral regimen. Vaccination protects only 50% to 80% of those vaccinated; therefore all travelers should protect themselves by following the adage, “boil it, cook it, peel it, or forget it.” The vaccinations should be completed at least 1 week before the trip; boosters are required every 2 to 5 yrs, depending on the type of vaccine. The vaccinations should not be given to patients who are taking mefloquine for malaria prophylaxis.

Patient care


If the patient’s stool cultures are still positive at the time of discharge, he should be careful to use good hand hygiene, esp. after defecating, and should avoid preparation of uncooked foods, e.g., salads, for family members. Those who retain positive cultures (asymptomatic carrier state) should not be employed as food handlers. All cases of typhoid fever should be reported to the state health department. While traveling in endemic areas, people should be careful to buy bottled water or boil tap water for 5 Min before drinking, cooking, or brushing teeth with it; they should avoid ice in beverages and desserts and treats containing ice; eat well-cooked foods that are still steaming hot; avoid raw food, including garden or fruit salads. Before eating fresh fruit, people should wash their hands vigorously, wash the outside of the fruit, then peel the fruit, and they should avoid food sold by street vendors.

undulant fever


fever of unknown origin

Abbreviation: FUO
An illness of at least 3 weeks' duration with fever exceeding 100.9°F (38.3°C) on several occasions and diagnosis not established after 1 week of hospital investigation. The main causes are systemic and localized infections, neoplasms, or collagen-vascular diseases (e.g., rheumatoid arthritis, disseminated lupus erythematosus, and polyarteritis nodosa). Less common causes are granulomatous disease, inflammatory disease of the bowel, pulmonary embolization, drug fever, cirrhosis, and rare conditions such as Whipple's disease. Diseases such as AIDS, chronic fatigue syndrome, or Lyme disease are occasionally the cause of FUO. Some cases remain undiagnosed.

valley fever


viral hemorrhagic fever

Abbreviation: VHF

Wolhynia fever

Trench fever.

yellow fever

Either of two forms of an acute, infectious disease caused by a flavivirus and transmitted by species of theAedes mosquito. It is endemic in Western Africa, Brazil, and the Amazon region of South America but is no longer present in the U.S.




The virus is carried most commonly by the Aedes aegypti mosquito, but the A. vittatus and A. taylori mosquitoes also are important vectors.


After an incubation period of 3 to 6 days, patients develop high fever, headache, muscle aches, nausea and vomiting, and gastrointestinal disturbances such as diarrhea or constipation. In most patients, the disease resolves in 2 or 3 days, but in about 20% the fever returns after a 1 to 2 day remission and is accompanied by abdominal pain, severe diarrhea, gastrointestinal bleeding (producing a characteristic black vomit), anuria, and jaundice (whence the nameyellow fever) caused by liver infection. Rarely, there is progressive liver failure, renal failure, and death.


Laboratory Findings







No antiviral agents are effective against the yellow fever virus. Fluids are given to maintain fluid and electrolyte balance, acetaminophen to reduce fever, and histamine blockers (e.g., ranitidine) or gastric acid pump inhibitors (e.g., omeprazole) to decrease the risk of gastrointestinal bleeding. Vitamin K is given if there is decreased production of prothrombin by the liver.


