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Dr K K Aggarwal

Tips to clinically differentiate between different types of fever

By Dr K K Aggarwal
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  • If a patient comes with fever with chills and rigors, think of Malaria in north and filaria in Vidarbha region in India.
  • In malaria, chills are in the afternoon; in filaria, the chills occur in the evening.
  • Fever with joint pains on extension often is due to Chikungunya (flexion improves the pain)
  • Think of dengue if there is fever with itching, rash and periorbital pain.
  • In fever with single chills, think of pneumonia.
  • Fever with sore throat, no cough, no nasal discharge: Think of streptococcal sore throat, especially in the children.
  • Fever with red angry–looking throat: Think of streptococcal sore throat
  • Fever with red epiglottis: Think of Hemophilus infection
  • Fever with cough and or nasal discharge: Think of common flu
  • Fever with cough, nasal discharge, nausea and vomiting: Think of H1N1 flu
  • Fever with toxic look, persistent fever: Look for typhoid
  • Fever with no or low rise in pulse: Look for typhoid
  • Fever with urinary symptoms (burning, frequency): Rule out urinary infection.
  • Fever with high TLC (white cell count) and liver pain: Rule out liver abscess
  • Fever with watery diarrhea, with no blood or mucous: Rule out acute gastroenteritis
  • After the fever is over, jaundice appears: This is viral hepatitis
  • After the fever is over, one feels very weak: Rule our dengue hemorrhagic fever.

1.  Music therapy can ameliorate physical and emotional distress.

2.  It can improve distress caused by pain, decrease muscle tension and promote relaxation, decrease anxiety, improve chemotherapy-related nausea and emesis, and improve overall mood [1,2].

3.  It can help manage postoperative nausea and vomiting [3].

4.  It reduces pain intensity levels and opioid requirements [4,5].

5.  Music has significant effect on anxiety, perception of hospitalization or procedure, relaxation and stress levels in brain tumor patients undergoing surgery [6,7].

6.  Music therapy in treatment areas and hospital rooms may help to improve mood and decrease anxiety in cancer patients.

1.     J Adv Nurs 2006; 54:553.

2.      Music Ther Perspect 1992; 9:91.

3.      West J Nurs Res 1989; 11:298.

4.     J Adv Nurs 1999; 29:1130.

5.      Cochrane Database Syst Rev 2006; :CD004843.

6.     Hawaii Med J 2007; 66:292.

7.     J Music Ther 2008; 45:349.