Fever: Complications

The following are the most important diseases or complications that can be co-morbid with fever:

Respiratory system (J00-J99)

• Aggravation of existing conditions such as pulmonary insufficiency (limitation of lung function).

Endocrine, nutritional, and metabolic diseases (E00-E90).

• Oxygen supply/consumption mismatch (“metabolic stress“).

Cardiovascular System (I00-I99).

• Arrhythmias (cardiac arrhythmias).
• Amplification of existing diseases such as heart failure (cardiac insufficiency).

Liver, gallbladder, and bile ducts-pancreas (pancreas) (K70-K77; K80-K87).

• Acute liver failure – genetic defect in an intracellular transport protein may cause children to develop acute liver failure in high fever (very rare)

Psyche – nervous system (F00-F99; G00-G99).

• Alterations of consciousness in the presence of existing organic brain disease.
• Delirium (clouding of consciousness)
• Encephalopathy (pathological brain changes).
• Increase/increased intracranial pressure
• Seizures
• Enhancement of cerebrovascular insufficiency (restriction of cerebral blood flow).

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

• Febrile convulsions, especially in infants and young children.
• Heat shock in hyperthermia → associated with “multi-organ dysfunction syndrome” in 75% of cases; typical complications include:
  • Shock with consecutive disturbance in electrolyte and acid-base balance, which may lead to acute renal and liver failure.
  • Acute respiratory failure (“acute respiratory distress syndrome”).
  • Rhabdomyolysis (dissolution of striated muscle fibers) with acute renal failure (ANV).
  • Disseminated intravascular coagulopathy (DIC; coagulopathy (clotting disorder) resulting from intravascular activation of blood clotting).
  • Liver failure
• Inflammation, Augementation of the same (increase in inflammation).
• Tachycardia (heartbeat too fast: > 100 beats per minute).

Further

• Mortality (death rate) of intensive care patients; in patients:
  • With infections, mortality decreased continuously with increasing temperature; lowest mortality was 39.0-39.5 °C* .
  • With infections and hypothermia, the highest mortality was detectable
  • Without infections, a much broader temperature optimum was detectable; above 38.5 °C* , mortality was found to increase
• Vasodilation

* Peak temperature in the first 24 hours after ICU and hospital admission.