Fever, beneficial or harmful?
Keywords:
fever, temperature, body temperature regulation, induced hyperthermia, health.Abstract
Introduction: Fever has had contradictions in medical practice due to its positive and negative effects on the organism.
Objective: To describe the health benefits and detriments of fever.
Methods: A documentary review was carried out in SciELO, CENTRAL, Medline, LILACS and Scopus during June and November 2022. Theoretical analytic-synthetic, induction-deduction and historical-logical methods were used.
Results: Body temperature depends on the balance between heat generation and heat loss systems. Fever is caused by the action of endogenous and exogenous pyrogens, which stimulate the thermoregulatory center located in the hypothalamus. It exerts direct antimicrobial effects, inhibits viral replication, and increases cellular and humoral immune response; however, it also increases basal metabolism, general symptomatology and can produce cell damage if it exceeds 41 oC. This risk-benefit ratio maintains controversies about its emergency treatment, mainly in children and the elderly.
Conclusions: Fever constitutes a process to face the diseases that originate it, but it is harmful in the face of extreme temperatures and in patients with polymorbidities. Given its benefits, it should not be routinely treated with antipyretics before an etiologic diagnosis is available.
Downloads
References
1. Balli S, Sharan S. Physiology, Fever. Treasure Island (FL): StatPearls Publishing; 2022 [acceso 28/08/2021]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK562334/
2. Mileno MD. Fever and febrile syndromes. En: Wing EJ, Schiffman FJ. Cecil Essentials Of Medicine. 10 ed. Philadelphia: Elsevier; 2021. p 848-57.
3. El-Radhi AS. The role of fever in the past and present. Med J Islamic World Acam Sci. 2011 [acceso 28/08/2021];19(1):9-14. Disponible en: https://medicaljournal-ias.org/jvi.aspx?pdir=ias&plng=eng&un=IAS-46362
4. Chen W. Thermometry and interpretation of body temperature. Biomed Eng Lett. 2019;9(1):3-17. DOI: https://doi.org/10.1007/s13534-019-00102-2
5. Belon L, Skidmore P, Mehra R, Walter E. Effect of a fever in viral infections-the ‘Goldilocks’ phenomenon? World J Clin Cases. 2021;9(2):296-307. DOI: https://doi.org/10.12998/wjcc.v9.i2.296
6. Walter EJ, Hanna-Jumma S, Carraretto M, Forni L. The pathophysiological basis and consequences of fever. Crit Care. 2016;20(1):200. DOI: https://doi.org/10.1186/s13054-016-1375-5
7. Nolla ME, Moya NL. Síndrome febril. En: Goderich R. Temas de Medicina Interna tomo 3. 5 ed. La Habana: Editorial de Ciencias Médicas; 2017. p 460-5.
8. Corrard F, Copin C, Wollner A, Elbez A, Derkx V, Bechet S, et al. Sickness behavior in feverish children is independent of the severity of fever. An observational, multicenter study. PLoS One. 2017;12(3):e0171670. DOI: https://doi.org/10.1371/journal.pone.0171670
9. Romero FR, Farías JM. La fiebre. Rev Fac Med UNAM. 2014 [acceso 28/08/2021];57(4):20-33. Disponible en: https://www.scielo.org.mx/pdf/facmed/v57n4/0026-1742-FACMED-57-04-00020.pdf
10. Surana NK, Dinarello CA, Porat R. Fiebre. En: Loscalzo J, Fauci A, Kasper D, Hauser S, Longo D, Jameson JL. Principios de Medicina Interna. 21 ed. Nueva York: McGraw Hill; 2022 [acceso 28/08/2021]. Disponible en: https://accessmedicina.mhmedical.com/content.aspx?bookid=3118§ionid=267810244
11. Wrotek SK. LeGrand E, Dzialuk A. Let fever do its job, the meaning of fever in the pandemic era. Evol Med Public Health. 2020;9(1):26-35. DOI: https://doi.org/10.1093/emph/eoaa044
12. Tran LT, Park S, Kim SK, Lee JS, Kim KW, Kwon O. Hypothalamic control of energy expenditure and thermogenesis. Exp Mol Med. 2022;54:1-12. DOI: https://doi.org/10.1038/s12276-022-00741-z
13. Chang RB. Body thermal responses and the vagus nerve. Neurosci Lett. 2019;698:209-16. DOI: https://doi.org/10.1016/j.neulet.2019.01.013
14. Osterhout JA, Kapoor V, Eichhorn SW, Vaughn E, Moore JD, Liu D, et al. A preoptic neuronal population controls fever and appetite during sickness. Nature. 2022;606(7916):937-44. DOI: https://doi.org/10.1038/s41586-022-04793-z
15. Geoghegan G, Simcox J. SON-light activation of glucose regulation. Cell. 2023;186(2):238-40. DOI: https://doi.org/10.1016/j.cell.2022.12.045
16. Real R, Fridman V. Abordaje clínico de adultos con fiebre prolongada. Rev Méd La Paz. 2016 [acceso 28/08/2021];22(2):19-21. Disponible en: http://www.scielo.org.bo/scielo.php?script=sci_arttext&pid=S1726-89582016000200004
17. Prajitha N, Athira SS, Mohanan Pv. Comprehensive biology of antipyretic pathways. Cytokine. 2019;116:120-7. DOI: https://doi.org/10.1016/j.cyto.2019.01.008
18. Holgersson J, Ceric A, Sethi N, Nielsen N, Jakobsen JC. Fever therapy in febrile adults: systematic review with meta-analyses and trial sequential analyses. BMJ. 2022;378:e069620. DOI: https://doi.org/10.1136/bmj-2021-069620
19. Eskilsson, A, Shionoya, K, Blomqvist A. Prostaglandin production in brain endothelial cells during the initiation of fever. Communic Integ Biol. 2023;16(1):2166237. DOI: https://doi.org/10.1080/19420889.2023.2166237
20. Cruz AJ. Los antagonistas fisiológicos de los pirógenos endógenos y su papel en la fiebre. Rev Cient Cienc Méd. 2019 [acceso 28/08/2021];22(2):36-46. http://www.scielo.org.bo/scielo.php?script=sci_arttext&pid=S1817-74332019000200006
21. Ludwig J, McWhinnie H. Antipyretic drugs in patients with fever and infection: literature review. Br J Nurs. 2019;28(10):610-8. DOI: https://doi.org/10.12968/bjon.2019.28.10.610
22. Chang M, Hou Z, Wang M, Li C, Lin J. Recent advances in hyperthermia therapy-based synergistic immunotherapy. Advanc Mater. 2021;33(4):e2004788. DOI: https://doi.org/10.1002/adma.202004788
23. Drewry AM, Mohr NM, Ablordeppey EA, Dalton CM, Doctor RJ, Fuller BM, et al. Therapeutic hyperthermia is associated with improved survival in afebrile critically ill patients with sepsis: a pilot randomized trial. Critical Care Medic. 2022;50(6):924-34. DOI: https://doi.org/10.1097/CCM.0000000000005470
24. Hashimoto R, Suto M, Tsuji M, Sasaki H, Takehara K, Ishiguro A, et al. Use of antipyretics for preventing febrile seizure recurrence in children: a systematic review and meta-analysis. Eur J Pediat. 2021;180(4):987-97. DOI: https://doi.org/10.1007/s00431-020-03845-8
25. Eilbert W, Chan C. Febrile seizures: a review. JACEP Open. 2022;3(4):e12769. DOI: https://doi.org/10.1002/emp2.12769
26. Green R, Webb D, Jeena PM, Wells M, Butt N, Hangoma JM, et al. Management of acute fever in children: Consensus recommendations for community and primary healthcare providers in sub-Saharan Africa. Afr J Emerg Med. 2021;11(2):283-96. DOI: https://doi.org/10.1016/j.afjem.2020.11.004
27. Shimazui T, Nakada Ta, Walley KR, Oshima T, Abe T, Ogura H, et al. Significance of body temperature in elderly patients with sepsis. Crit Care. 2020;24:387. DOI: https://doi.org/10.1186/s13054-020-02976-6
28. Bauer AZ, Swan SH, Kriebel D, Liew Z, Taylor HS, Bornehag CG, et al. Paracetamol use during pregnancy-a call for precautionary action. Nat Rev Endocrinol. 2021;17(12):757-66. DOI: https://doi.org/10.1038/s41574-021-00553-7
29. Yamaya M, Nishimura H, Lusamba Kalonji N. Effects of high temperature on pandemic and seasonal human influenza viral replication and infection-induced damage in primary human tracheal epithelial cell cultures. Heliyon. 2019;5(2):e01149. DOI: https://doi.org/10.1016/j.heliyon.2019.e01149
Downloads
Published
How to Cite
Issue
Section
License
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes: Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons (CC-BY-NC 4.0) que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista. Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista. Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
Como Revista Cubana de Investigaciones Biomédicas forma parte de la red SciELO, una vez los artículos sean aceptados para entrar al proceso editorial (revisión), estos pueden ser depositados por parte de los autores, si estan de acuerdo, en SciELO preprints, siendo actualizados por los autores al concluir el proceso de revisión y las pruebas de maquetación.
