The Clinical Significance of Fever Patterns

Fever patterns have been appreciated for centuries by clinicians as important diagnostic signs.When methods for diagnosing infectious diseases were primitive or nonexistent, analysis of fever curves often provided the only way to differentiate acute febrile illnesses.Magnitude and frequency of fever spikes, as well as the fever's characteristic fever curves, were associated with a variety of infectious disorders.Although fever curves were helpful in only a relatively few infectious diseases, it was noted that certain infections regularly and reproducibly were associated with a particular fever pattern.To this day, in spite of extensive research in chemical mediators of the febrile response (e.g., cytokines), it is not understood why certain fever patterns are characteristic of certain infectious diseases.It is remarkable and somewhat amazing that typhoid fever still is accompanied by a stepwise increase in temperature with a sustained fever pattern.Why this or any other fever pattern is associated with particular infectious diseases remains a mystery.2*7, lo, l2The classical fever patterns were regarded as a key diagnostic sign by clinicians, but their usefulness has been questioned by some in the past few decades?Fever curves have limited diagnostic usefulness in hospital-acquired infections?In community-acquired infections, characteristic fever curves are more important, but are a function of geographic location.For example, the double quotidian fever curve seen with visceral leishmaniasis (kala-azar) is only useful to clinicians in those parts of the world where the disease is prevalent.Reassessment of the usefulness of fever curves for diagnostic purposes is related to the ratio of