Different types of fever and thier diagnosis
The nature of the type of the fever and the duration should be considered as there are many types which could help narrow down the differential diagnosis you are considering.
Continuous fever: Where the temperature remains above normal throughout a 24-hour period and does not fluctuate more than 1 degree Celsius in 24 hours. This type of fever occurs in lobar pneumonia, typhoid, urinary tract infection, infective endocarditis, brucellosis, and typhus.
Remittent fever: The temperature remains above normal throughout the day and fluctuates more than 2 degree Celsius in 24 hours. This type is seen in patients with typhoid fever and infective endocarditis.
Pel-Ebstein fever: There is a regular alternation of recurrent bouts of fever and febrile periods. The temperature may take 3 days to rise, remain high for 3 days and then remits over 3 days. The patient could then be apyrexial for 9 days.
Intermittent fever: In a 24 hour period the temperature is only present for some hours of the day and the rest of the time is normal. The spike can occur same time each day, every other day or every few days but is normally in a repetitive pattern. Examples of some diseases which have an intermittent fever are malaria, pyemia, and septicemia.
Septic fever: A very high temperature which doesn't improve with antipyretics can indicate a septic fever and the patient should be seen quickly and reviewed to prevent any further deterioration in their state of health.
Cyclical recurrent fevers or periodic fevers: These are recurrences of fever which last from a few days to a few weeks and are separated by symptom-free intervals. This pattern of fever can be caused by recurrent infection, malignancy or non-infectious inflammatory diseases. Attacks of fever which follow the same course normally have a non-infectious cause like Still's disease, Rheumatoid arthritis, Crohn's disease and Bechet's syndrome. A family history of periodic fever could indicate Familial Mediterranean Fever or Hyper-IgD syndrome.
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