Intermittent fever
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Intermittent fever is a type or pattern of
fever Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using val ...
in which there is an interval where
temperature Temperature is a physical quantity that expresses quantitatively the perceptions of hotness and coldness. Temperature is measurement, measured with a thermometer. Thermometers are calibrated in various Conversion of units of temperature, temp ...
is elevated for several hours followed by an interval when temperature drops back to normal. This type of fever usually occurs during the course of an
infectious disease An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable di ...
.
Diagnosis Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
of intermittent fever is frequently based on the clinical history but some biological tests like
complete blood count A complete blood count (CBC), also known as a full blood count (FBC), is a set of medical laboratory tests that provide information about the cells in a person's blood. The CBC indicates the counts of white blood cells, red blood cells and pl ...
and
blood culture A blood culture is a medical laboratory test used to detect bacteria or fungi in a person's blood. Under normal conditions, the blood does not contain microorganisms: their presence can indicate a bloodstream infection such as bacteremia or ...
are also used. In addition radiological investigations like chest
X-ray An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10  picometers to 10  nanometers, corresponding to frequencies in the range 30&nb ...
, abdominal
ultrasonography Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies fr ...
can also be used in establishing diagnosis.


Intermittent fever in malaria

Malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...
is a common cause of intermittent fever and it has following types.


Quotidian fever

Bouts of fever occurring daily (24-hour periodicity) for a few hours, typical of
Plasmodium knowlesi ''Plasmodium knowlesi'' is a parasite that causes malaria in humans and other primates. It is found throughout Southeast Asia, and is the most common cause of human malaria in Malaysia. Like other ''Plasmodium'' species, ''P. knowlesi'' has a li ...
.


Tertian fever

Fever occurs after an interval of two days (48-hour periodicity), typical of
Plasmodium vivax ''Plasmodium vivax'' is a protozoal parasite and a human pathogen. This parasite is the most frequent and widely distributed cause of recurring malaria. Although it is less virulent than ''Plasmodium falciparum'', the deadliest of the five huma ...
and
Plasmodium ovale ''Plasmodium ovale'' is a species of parasitic protozoon that causes tertian malaria in humans. It is one of several species of ''Plasmodium'' parasites that infect humans, including ''Plasmodium falciparum'' and ''Plasmodium vivax'' which are ...
.


Quartan fever

Fever occurs after an interval of three days (72-hour periodicity), typical of
Plasmodium malariae ''Plasmodium malariae'' is a parasitic protozoan that causes malaria in humans. It is one of several species of ''Plasmodium'' parasites that infect other organisms as pathogens, also including ''Plasmodium falciparum'' and ''Plasmodium vivax'' ...
.


Examples


Infectious causes of intermittent fever

The following are examples of infectious diseases that may feature intermittent fever. *
Malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...
*
Tuberculosis Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, i ...
*
Sepsis Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is follo ...
*
Kala azar Visceral leishmaniasis (VL), also known as kala-azar (Hindi: kālā āzār, "black sickness") or "black fever", is the most severe form of leishmaniasis and, without proper diagnosis and treatment, is associated with high fatality. Leishmaniasi ...
*
Borreliosis Lyme disease, also known as Lyme borreliosis, is a vector-borne disease caused by the ''Borrelia'' bacterium, which is spread by ticks in the genus ''Ixodes''. The most common sign of infection is an expanding red rash, known as erythema migran ...
(Lyme disease) *
Rat-bite fever Rat-bite fever (RBF) is an acute, febrile human illness caused by bacteria transmitted by rodents, in most cases, which is passed from rodent to human by the rodent's urine or mucous secretions. Alternative names for rat-bite fever include stre ...
* Epstein-barr virus * Chronic
meningococcemia Meningococcal disease describes infections caused by the bacterium ''Neisseria meningitidis'' (also termed meningococcus). It has a high mortality rate if untreated but is vaccine-preventable. While best known as a cause of meningitis, it can a ...
.


Inflammatory causes of intermittent fever

Adult-onset Still's disease Adult-onset Still's disease (AOSD) is a form of Still's disease, a rare systemic autoinflammatory disease characterized by the classic triad of fevers, joint pain, and a distinctive salmon-colored bumpy rash. The disease is considered a diagno ...
is an inflammatory disease that may cause intermittent fever, characteristically a quotidian fever that spikes once or twice in the late afternoon to evening.


Management

Antipyretics like ibuprofen and paracetamol are used for fever and body aches.
Antibiotics An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention o ...
are also used for any underlying infection. For treating malaria, anti-malarial drugs like
quinine Quinine is a medication used to treat malaria and babesiosis. This includes the treatment of malaria due to '' Plasmodium falciparum'' that is resistant to chloroquine when artesunate is not available. While sometimes used for nocturnal le ...
,
chloroquine Chloroquine is a medication primarily used to prevent and treat malaria in areas where malaria remains sensitive to its effects. Certain types of malaria, resistant strains, and complicated cases typically require different or additional medi ...
and
primaquine Primaquine is a medication used to treat and prevent malaria and to treat ''Pneumocystis'' pneumonia. Specifically it is used for malaria due to ''Plasmodium vivax'' and '' Plasmodium ovale'' along with other medications and for prevention if oth ...
are given.


See also

* Continuous fever *
Relapsing fever Relapsing fever is a vector-borne disease caused by infection with certain bacteria in the genus '' Borrelia'', which is transmitted through the bites of lice or soft-bodied ticks (genus ''Ornithodoros''). Signs and symptoms Most people who ar ...
* Undulant fever *
Remittent fever Remittent fever is a type or pattern of fever in which temperature does not touch the baseline and remains above normal throughout the day. Daily variation in temperature is more than 1°C in 24 hours, which is also the main difference as compared ...
* Neutropenic fever * Cyclic fever; called
Pel–Ebstein fever Pel–Ebstein fever is a rarely seen condition noted in patients with Hodgkin's lymphoma Hodgkin lymphoma (HL) is a type of lymphoma, in which cancer originates from a specific type of white blood cell called lymphocytes, where multinucleated R ...
in
Hodgkin's lymphoma Hodgkin lymphoma (HL) is a type of lymphoma, in which cancer originates from a specific type of white blood cell called lymphocytes, where multinucleated Reed–Sternberg cells (RS cells) are present in the patient's lymph nodes. The condition w ...


References

{{reflist Fever Malaria Tuberculosis