What is the pathophysiological mechanism by which infections cause pyrexia (fever)?

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From the Research

Infections cause fever as part of the body's immune response to pathogens, with the most recent and highest quality study suggesting that fever is a regulated increase in body temperature, resulting from an upward shift in the thermoregulatory set point, mediated by pyrogenic cytokines released from monocytes/macrophages in response to infection or trauma 1. When bacteria, viruses, or other microorganisms invade the body, immune cells detect their presence and release chemicals called pyrogens, particularly cytokines like interleukin-1, interleukin-6, and tumor necrosis factor. These pyrogens travel through the bloodstream to the hypothalamus in the brain, which functions as the body's thermostat. The pyrogens reset this thermostat to a higher temperature, triggering the body to increase heat production and reduce heat loss. This happens through mechanisms like shivering (to generate heat), blood vessel constriction (to reduce heat loss through the skin), and increased metabolic rate. The elevated body temperature serves several protective functions: it can directly inhibit the growth of some pathogens, enhance immune cell function, and speed up bodily reactions that help fight infection. Some key points to consider include:

  • Fever is a complex physiological response that is aimed at facilitating survival of the host 2
  • The causes, types, clinical management, and postoperative consequences of fever are important to understand 3
  • Fever is part of an integrated host defense system, and that failure to generate a fever in response to infection is generally associated with a poorer prognosis 1 While fever is generally a helpful defense mechanism, extremely high fevers (above 103°F or 39.4°C) may require treatment with fever-reducing medications like acetaminophen or ibuprofen to prevent complications, as suggested by earlier studies 4, 5.

References

Research

Perspective on fever: the basic science and conventional medicine.

Complementary therapies in medicine, 2013

Research

[The pathogenesis and the adaptive value of fever].

Postepy higieny i medycyny doswiadczalnej, 2003

Research

Fever--an update.

Journal of the American Podiatric Medical Association, 2010

Research

Fever as an important resource for infectious diseases research.

Intractable & rare diseases research, 2016

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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