- this is a temperature at the level of 37-37.5 ° C for a long time. At the same time, a person may have no symptoms of any disease at all, or malaise may appear. We are not talking about subfebrile temperature when isolated cases of an increase in temperature are recorded: this may be due to individual characteristics organism and the above factors, and if the subfebrile condition is fixed in the temperature curve with measurements taken for many days in a row.

A true temperature rise is considered to be a temperature above 38.3 degrees.... This temperature is accompanied by very specific symptoms that correspond to a very specific disease. But a prolonged subfebrile condition is often the only sign, in order to find out the cause of which you will have to run to the doctors.

The normal temperature of the human body is recognized as a temperature of 36.6 ° C, although for many, 37 ° C is fixed as a normal temperature. It is this temperature that is observed in a healthy organism: child or adult, male or female - it does not matter. It is not a stable, static, unchanged temperature; during the day it fluctuates in both directions, depending on overheating, hypothermia, stress, time of day and biological rhythms. Therefore, temperatures from 35.5 to 37.4 ° C are considered the normal range.

The body temperature is regulated by the endocrine glands - the thyroid gland and the hypothalamus... The receptors of the nerve cells of the hypothalamus respond to body temperature by altering the secretion of TSH, which regulates the activity of the thyroid gland. Thyroid hormones T3 and T4 regulate the metabolic rate, which determines the temperature. In women, the hormone estradiol is involved in temperature regulation. With an increase in its level, the basal temperature decreases - this process depends on the menstrual cycle. In women, body temperature changes by 0.3-0.5 ° C during the menstrual cycle. The highest rates up to 38 degrees are observed between 15 and 25 days of a standard 28-day menstrual cycle.

In addition to the hormonal background, temperature indicators are slightly affected by:

• physical exercise;
• food intake;
• in children: severe prolonged crying and active games;
• time of day: in the morning the temperature is usually lower (the most low temperature observed between 4-6 o'clock in the morning), and in the evening reaches a maximum (from 18 to 24 o'clock at night - the period of maximum temperature);
• in the elderly, the temperature decreases.

Physiological fluctuations in thermometry during the day within the range of 0.5-1 degrees are considered the norm.

Subfebrile condition does not apply to normal state organism and therefore the main question that is posed to the doctor is to identify the causes of pathology. If the patient has recently been ill and has been treated for a long time, it is believed that the increase in temperature is associated with the healing process. If nothing of the kind happened, then you have to look for the dysfunction that caused this symptom. For a more accurate detection of pathology, it is recommended to draw up a temperature curve, an analysis of well-being, and laboratory diagnostics.

Diseases characterized by subfebrile condition

Infectious causes of diseases

Infections are the most common reason subfebrile condition. With the long-term existence of the disease, the symptoms are usually erased and only subfebrile condition remains. The main causes of infectious subfebrile condition are:

• ENT diseases - sinusitis, tonsillitis, otitis media, pharyngitis, etc.
• Dental diseases and carious teeth as well.
• Diseases of the gastrointestinal tract - gastritis, pancreatitis, colitis, cholecystitis, etc.
• Diseases of the urinary tract - pyelonephritis, cystitis, urethritis, etc.
• Diseases of the genitals - inflammation of the appendages and prostatitis.
• Abscesses from injections.
• Non-healing ulcers of patients with diabetes mellitus.

Autoimmune diseases

In autoimmune diseases, the body's immune system begins to attack its own cells, which causes chronic inflammation with periods of exacerbation. For this reason, the body temperature also changes. The most common autoimmune pathologies are:

• rheumatoid arthritis;
• systemic lupus erythematosus;
• Hashimoto's thyroiditis;
• Crohn's disease;
• diffuse toxic goiter.

To identify autoimmune diseases, tests for ESR, C-reactive protein, rheumatoid factor and some other examinations are prescribed.

Oncological diseases

At malignant tumors subfebrile condition can be an early manifestation of the disease, 6 to 8 months ahead of its symptoms. In the development of subfebrile condition, the formation of immune complexes that trigger an immune response plays a role. However, an early rise in temperature is associated with the onset of the production of a specific protein by the tumor tissue. This protein is found in blood, urine, and tumor tissue. If the tumor has not yet shown itself in any way, the combination of subfebrile condition with specific changes in the blood is of diagnostic value. Often subfebrile condition accompanies chronic myeloid leukemia, lymphocytic leukemia, lymphoma, lymphosarcoma.

Other diseases

They can cause subfebrile condition and other diseases:

• autonomic dysfunction: disruption of the heart and cardiovascular system;
• dysfunction of the endocrine glands: hyperthyroidism and thyrotoxicosis (ultrasound of the thyroid gland and a blood test for hormones T3, T4, TSH, antibodies to TSH are detected);
• hormonal disorders;
• latent infection: Epstein-Barr virus, cytomegalovirus infection, herpes infection;
• HIV infection (detected by ELISA and PCR);
• helminthiasis (detected by analysis of feces for worm eggs);
• toxoplasmosis (detected by ELISA);
• brucellosis (detected by PCR);
• tuberculosis (detected by Mantoux tests and fluorography);
• hepatitis (detected by ELISA and PCR);
• Iron-deficiency anemia;
• allergic reactions;
• thermoneurosis.

An infectious subfebrile condition is characterized by:

1. decrease in temperature under the influence of antipyretic;
2. poor temperature tolerance;
3. daily physiological temperature fluctuations.

Non-infectious subfebrile conditions are characterized by:

1. imperceptible flow;
2. lack of response to antipyretic;
3. lack of daily changes.

Safe subfebrile condition

1. Low-grade fever is completely safe during pregnancy, menopause and breastfeeding, which is simply a symptom of hormonal changes.
2. A temperature tail can persist for up to two months or even six months after suffering infectious diseases.
3. Neurosis and stress may well provide a rise in temperature in the evenings. Subfebrile condition in this case will be accompanied by a feeling of chronic fatigue and general weakness.

Psychogenic subfebrile condition

The subfebrile condition, like any other processes in the body, is influenced by the psyche. Under stress and neuroses, metabolic processes are disturbed in the first place. Therefore, women often experience unmotivated low-grade fever. Stress and neuroses provoke a rise in temperature, and excessive suggestibility (for example, about a disease) can affect the actual rise in temperature. In young women of the asthenic type, prone to frequent headaches and VSD, hyperthermia is accompanied by insomnia, weakness, shortness of breath, chest and abdominal pain.

To diagnose the condition, tests are prescribed to assess psychological stability:

• tests to detect panic attacks;
• scale of depression and anxiety;
• Beck's scale;
• scale of emotional excitability,
• Toronto Alexithymic Scale.

Based on the results of the tests carried out, the patient is given a referral to a psychotherapist.

Medicinal subfebrile condition

Long-term use of some drugs can also cause subfebrile fever: adrenaline, ephedrine, atropine, antidepressants, antihistamines, neuroleptics, some antibiotics (ampicillin, penicillin, isoniazid, lincomycin), chemotherapy, narcotic pain relievers, thyroxin preparations. Cancellation of therapy also relieves obsessive subfebrile condition.

Subfebrile condition in children

Of course, any parent will start to worry if their child has a fever every day towards the evening. And this is correct, because in babies, an increase in temperature in some cases is the only symptom of the disease. The norm for subfebrile condition in children is:

• age up to a year (reaction to the BCG vaccine or unsteady thermoregulation processes);
• teething period when elevated temperature can be observed for several months;
• in children from 8 to 14 years old, due to the critical phases of growth.

Long-term subfebrile condition, which occurs due to a violation of thermoregulation, is said if a child lasts 37.0–38.0 ° for more than 2 weeks, and the child:

• does not lose weight;
• the examination shows the absence of diseases;
• all analyzes are normal;
• heart rate is normal;
• antibiotics do not reduce the temperature;
• the temperature is not reduced by antipyretics.

Often in children, the endocrine system is to blame for the increase in temperature. Quite often it happens that feverish children have impaired functionality of the adrenal cortex, and the immune system is weakened. If you draw a psychological portrait of children with fever for no reason, you get a portrait of an uncommunicative, suspicious, withdrawn, easily annoyed child, who can be unsettled by any event.

Treatment and a correct lifestyle bring children's heat exchange back to normal. As a rule, after 15 years, few people have this temperature. Parents must organize the correct routine for the child. Children suffering from subfebrile condition should get enough sleep, walk and sit at the computer less often. Hardening trains thermoregulatory mechanisms well.

In older children, low-grade fever accompanies such frequent diseases as adenoiditis, helminthiasis, and allergic reactions. But subfebrile condition may indicate the development of more dangerous diseases: cancer, tuberculosis, asthma, blood diseases.

Therefore, you should definitely consult a doctor if your child has a temperature of 37-38 ° C for more than three weeks. To diagnose and find out the causes of subfebrile condition, the following studies will be assigned:

• blood biochemistry;
• OAM, study of daily urine;
• feces on the eggs of the worm;
• X-ray of the sinuses of the nose;
• X-ray of the lungs;
• electrocardiography;
• tuberculin tests;
• Ultrasound of internal organs.

If deviations are found in the analyzes, this will be a reason for referral to consultations of narrow specialists.

How to correctly measure temperature in children

The temperature in children should not be measured immediately after waking up, after lunch, vigorous physical activity, in an agitated state. At this time, the temperature may rise by physiological reasons... If the baby is asleep, resting, or hungry, the temperature may drop.

When measuring the temperature, you need to wipe the armpit dry and hold the thermometer for at least 10 minutes. Change thermometers periodically.

How to deal with subfebrile condition

To begin with, you should diagnose subfebrile condition, because not every increase in temperature in the specified range is just subfebrile condition. The conclusion about subfebrile condition is made on the basis of the analysis of the temperature curve, for the compilation of which temperature measurements are used 2 times a day at the same time - in the morning and in the evening. The measurements are taken within three weeks, the results of the measurements are analyzed by the attending physician.

If the doctor diagnoses subfebrile condition, the patient will have to visit the following narrow specialists:

• otolaryngologist;
• cardiologist;
• infectious disease specialist;
• phthisiatrician;
• endocrinologist;
• dentist;
• oncologist.

The tests that will need to be passed to identify hidden current diseases:

• UAC and OAM;
• blood biochemistry;
• cumulative urine samples and study of daily urine;
• feces on the eggs of the worm;
• blood for HIV;
• blood for hepatitis B and C;
• blood on RW;
• X-ray of the sinuses of the nose;
• X-ray of the lungs;
• otolaryngoscopy;
• tuberculin tests;
• blood for hormones;
• Ultrasound of internal organs.

The identification of deviations in any analysis becomes the reason for the appointment of a more in-depth examination.

Prevention measures

If the pathology in the body has not been identified, you should pay close attention to the health of your body. To gradually bring thermoregulatory processes back to normal, you need:

• promptly treat all foci of infection and emerging diseases;
• avoid stress;
• minimize the number of bad habits;
• observe the daily routine;
• get enough sleep in accordance with the needs of your body;
• exercise regularly;
• harden;
• walk more on fresh air.

All these methods help to strengthen immunity, train heat transfer processes.

About methods of measuring body temperature

It would seem that there is nothing difficult in measuring body temperature. If there is no thermometer at hand, then you can touch the patient's forehead with your lips, but errors often occur here, this method will not allow you to accurately determine the temperature.

Another more accurate method is heart rate counting. An increase in temperature by 1 degree leads to an increase in heart rate by 10 beats per minute. Thus, you can roughly calculate how much the temperature has increased, knowing your normal heart rate. An increase in the frequency of respiratory movements also indicates a fever. Normally, children take about 25 breaths per minute, while adults take up to 15 breaths.

Measurement of body temperature with a thermometer is carried out not only in the armpit, but also orally or rectally (holding the thermometer in oral cavity or in the anus). For young children, a thermometer is sometimes placed in the groin fold. There are a number of rules that must be followed when measuring temperature in order not to get a false result.

• The skin at the measurement site must be dry.
• During the measurement, you cannot make movements, it is advisable not to talk.
• When measuring the temperature in the armpit, the thermometer should be held for about 3 minutes (the norm is 36.2 - 37.0 degrees).
• If you use the oral method, then the thermometer should be kept for 1.5 minutes (the normal indicator is 36.6 - 37.2 degrees).
• When measuring the temperature in the anus, it is enough to hold the thermometer for one minute (the norm with this method is 36.8 - 37.6 degrees)

Norm and pathology: when is it time to "bring down" the temperature?

It is generally accepted that the normal body temperature is 36.6 degrees, however, as you can see, this is quite relative. The temperature can reach 37.0 degrees and is considered normal; it usually rises to such indicators in the evening or in the hot season, after physical activity. Therefore, if you saw the figure 37.0 on the thermometer before going to bed, then there is nothing to worry about yet. When the temperature exceeds this limit, we can already talk about a fever. It is also characterized by a feeling of heat or chills, redness skin.

When should the temperature be brought down?

The doctors of our clinic recommend using antipyretics when the body temperature in children reaches 38.5 degrees, and in adults - 39.0 degrees. But even in these cases, you should not take a large dose of antipyretic, it is enough to lower the temperature by 1.0 - 1.5 degrees to effective fight with the infection continued without a threat to the body.

A dangerous sign in fever is the paleness of the skin, their "marbling", while the skin remains cold to the touch. This indicates a spasm of peripheral vessels. This is usually more common in children and is followed by seizures. In such cases, you need to urgently call an ambulance.

Infectious fever

With bacterial or viral infections, the temperature rises almost always. How much it increases depends, firstly, on the amount of the pathogen, and secondly, on the state of the human body. For example, in older people, even an acute infection may be accompanied by a mild fever.

It is curious that with various infectious diseases, the body temperature can behave differently: rise in the morning and fall in the evening, increase by a certain number of degrees and decrease after a few days. Depending on this, they singled out Various types fevers - perverted, recurrent and others. For doctors, this is a very valuable diagnostic criterion, since the type of fever makes it possible to narrow the range of suspected diseases. Therefore, in case of infection, the temperature should be measured in the morning and in the evening, preferably during the day.

What infections raise the temperature?

Usually, with an acute infection, a sharp temperature jump occurs, while there are general signs of intoxication: weakness, dizziness, or nausea.

1. If the fever is accompanied by a cough, sore throat, or chest, shortness of breath, hoarseness of voice, then it comes about a respiratory infectious disease.
2. If the body temperature increased, and with it diarrhea began, nausea or vomiting, abdominal pains, then there is practically no doubt that this is an intestinal infection.
3. A third option is also possible, when, against the background of fever, there is a sore throat, redness of the pharyngeal mucosa, sometimes there is a cough and a runny nose, as well as abdominal pain and diarrhea. In this case, you should suspect rotavirus infection or the so-called "intestinal flu". But for any symptoms, it is better to seek help from our doctors.
4. Sometimes a local infection anywhere on the body can cause the temperature to rise. For example, fever is often accompanied by carbuncles, abscesses, or cellulitis. It also occurs with (, kidney carbuncle). Only in the case of acute fever it almost never happens, because the absorption capacity of the bladder mucosa is minimal, and substances that cause an increase in temperature practically do not penetrate into the bloodstream.

Sluggish chronic infectious processes in the body can also cause fever, especially during an exacerbation. However, a slight increase in temperature is often observed at ordinary times, when there are practically no other obvious symptoms of the disease.

When does the temperature rise again?

1. An unexplained increase in body temperature is noted with oncological diseases... This usually becomes one of the first symptoms along with weakness, apathy, loss of appetite, dramatic weight loss and depressive mood. In such cases, the elevated temperature lasts for a long time, but at the same time it remains febrile, that is, does not exceed 38.5 degrees. As a rule, with tumors, the fever is wave-like. Body temperature rises slowly, and when it reaches its peak, it also slowly decreases. Then there comes a period when the normal temperature is maintained, and then it starts to rise again.
2. At lymphogranulomatosis or Hodgkin's disease wave-like fever is also common, although other types may also occur. An increase in temperature in this case is accompanied by chills, and when it decreases, pouring sweat occurs. Excessive sweating is usually observed at night. Along with this, Hodgkin's disease manifests itself as enlarged lymph nodes, sometimes itching is present.
3. The body temperature rises if acute leukemia... It is often confused with sore throat, as there is pain when swallowing, palpitations, increase The lymph nodes, there is often increased bleeding (hematomas appear on the skin). But even before the onset of these symptoms, patients note a sharp and unmotivated weakness. It is noteworthy that antibiotic therapy does not give positive results, that is, the temperature does not drop.
4. Fever may also indicate endocrine diseases... For example, it almost always appears with thyrotoxicosis. At the same time, the body temperature usually remains subfebrile, that is, it does not rise more than 37.5 degrees, however, during periods of exacerbations (crises), this limit can be significantly exceeded. In addition to fever with thyrotoxicosis, mood swings, tearfulness, increased excitability, insomnia, a sharp loss of body weight against a background of increased appetite, trembling of the tip of the tongue and fingers, and menstrual irregularities in women are disturbing. With hyperfunction of the parathyroid glands, the temperature can rise to 38 - 39 degrees. In the case of hyperparathyroidism, patients complain of intense thirst, frequent urge to urinate, nausea, drowsiness, and itching.
5. Special attention should be directed to a fever that appears a few weeks after suffering respiratory diseases (most often after a sore throat), since it can talk about the development rheumatic myocarditis... Usually, the body temperature rises slightly - up to 37.0 - 37.5 degrees, but such a fever is a very serious reason for contacting our doctor. In addition, the body temperature may rise with endocarditis or, but in this case, the main attention is not paid to the pain in the chest, which cannot be relieved by available analgesics.
6. It is curious that the temperature often rises when stomach ulcer or duodenum , though it also does not exceed 37.5 degrees. Fever gets worse if it occurs internal bleeding... Its symptoms are sharp dagger pains, vomiting of "coffee grounds" or tarry feces, as well as sharp and growing weakness.
7. Cerebral disorders(traumatic brain injury or brain tumors) provoke an increase in temperature, irritating the center of its regulation in the brain. Fever can be very different.
8. Drug fever most often occurs in response to the use of antibiotics and some other drugs, while it is part of allergic reaction, therefore, it is usually accompanied by itching of the skin and rashes.

What to do at elevated temperatures?

Many, having found in themselves an elevated temperature, immediately try to lower it, using antipyretic drugs available to everyone. However, their thoughtless use can harm even more than the fever itself, because fever is not a disease, but just a symptom, therefore, suppressing it without establishing the cause is not always correct.

This is especially true of infectious diseases, when pathogens must die in conditions of elevated temperature. If you try to lower the temperature at the same time, infectious agents will remain in the body alive and unharmed.

Therefore, do not rush to run for pills, but lower the temperature competently when the need arises, our specialists will help you with this. If fever bothers you for a long time, you should contact one of our doctors: as you can see, it can talk about many non-communicable diseases, so you cannot do without additional research.

Life "under the degree"

10 reasons why the temperature can rise

1. The disease begins suddenly, usually with chills, body aches, pain in the eyes. The temperature quickly rises to 38 - 39 degrees, its fluctuations are insignificant during the day. It can be kept for 4 - 5 days.

It looks like a flu, especially since the season is right. Other acute respiratory viral infections also occur with an increase in temperature, but more often not so high.

2. The temperature suddenly rises to 39 - 40 degrees, a strong headache, chest pain, worse with inspiration. On the face - a feverish blush, on the lips herpes may become active. A day later, brownish sputum begins to leave.

This is how pneumonia proceeds. It captures a segment or lobe of the lung (sometimes bilateral). True, now more and more often this disease proceeds in a blurred form.

3. During the day, the temperature jumps to 38 - 39 degrees. A rash appears all over the body. Before that, there may be weakness, a runny nose for several days. Adults are more ill than children.

It seems that you have contracted measles, or rubella, or scarlet fever - these infectious diseases are very similar in the initial stages. Help to make a correct diagnosis characteristic signs: with rubella, lymph nodes increase, with scarlet fever, the rash is small, there is no runny nose, unlike measles, but it is often accompanied by sore throat.

4. There is a periodic rise in temperature, more often subfebrile condition. In the blood, leukocytes may be increased.

It looks like there is a chronic illness, or there is a hidden source of infection in the body.

Fever is often the main or even the only symptom. inflammatory processes... For example, exacerbation of pyelonephritis, inflammation in the gallbladder, arthritic joints sometimes do not have obvious clinical manifestations, except for fever.

5. The temperature jumps up to 40 degrees with lightning speed in a few hours. There is a severe headache, vomiting, which does not bring relief. The patient cannot tilt his head forward, straighten his legs. A rash appears. Strabismus, nervous tics in the eye area may occur.

It looks like infectious meningitis - an inflammation of the lining of the brain. It is necessary to immediately call an ambulance and hospitalize the patient.

6. Prolonged (longer than a month) unreasonable increase in temperature is combined with general malaise, weakness, loss of appetite and weight. Lymph nodes enlarge, blood appears in the urine, etc.

An increase in body temperature almost always occurs with tumors. It is especially typical for tumors of the kidneys, liver, lung cancer, leukemia. There is no need to panic right away, but in some cases, especially the elderly, it is necessary to be examined by an oncologist without wasting time.

7. Increased body temperature, more often about 37 - 38 degrees, is combined with weight loss, irritability, tearfulness, fatigue, and a feeling of fear. Appetite increases, but weight is lost.

Thyroid hormones need to be checked. A similar picture occurs with diffuse toxic goiter.

In case of thyroid dysfunction - hyperthyroidism - there is a disorder of the body's thermoregulation.

An increase in temperature is combined with damage to the joints, kidneys, pain in the heart.

Fever almost always occurs with rheumatism and rheumatism-like diseases. These are autoimmune diseases - they disrupt the general immune status of the body, and leapfrog begins, including with a temperature.

Low-grade fever, mainly in young women, is combined with pressure drops, there may be redness of the face, neck, chest.

This is constitutional hyperthermia - it is more often observed in young people with nervous and physical strain, for example, during exams. Of course, this diagnosis can be made by excluding other causes of the rise in temperature.

Even after a thorough examination, it is not possible to identify the cause of the fever. Nevertheless, an elevated temperature (38 and above) or its periodic rises for 3 weeks is recorded.

Such cases are called "fever of unknown origin" by doctors. We must look more carefully, using special methods research: test for immune status, endocrinological examination. Sometimes a rise in temperature can provoke the use of certain antibiotics, analgesics - this is a drug fever.

BY THE WAY
The normal human body temperature - 36 to 36.9 degrees - is regulated by a region of the brain called the hypothalamus.
Most often, an increase in temperature is a protective and adaptive factor of the body.

ON A NOTE
What will help bring down the temperature without medication:
Rubbing the body with a weak solution of vinegar.
Warm green tea or black with raspberries.
Citrus. In order for the temperature to drop by 0.3 - 0.5 degrees for a cold, you need to eat 1 grapefruit, 2 oranges or half a lemon.
Cranberry juice.

FACT
It is believed that in case of colds, temperatures up to 38 degrees should not be brought down with the help of drugs.

TYPES OF TEMPERATURE
37 - 38 degrees - subfebrile,
38 - 38.9 - moderate
39 - 40 - high,
41 - 42 - extra high.