RISK-TO-BENEFIT CONSIDERATIONS
Data illustrating fever’s beneficial effects originate from several sources. Studies of the phylogeny of fever have shown the response to be widespread within the animal kingdom.[165] With few exceptions, mammals, reptiles, amphibians, and fish, as well as several invertebrate species, have been shown to elevate the core temperature in response to a challenge with microorganisms or other known pyrogens ( Fig. 47–6 ). It has been assumed, although not established conclusively, that such elevations in temperature are the poikilothermic corollary of fever. The prevalence of such “febrile responses” has been offered as some of the strongest evidence that fever is an adaptive response, on the basis of the argument that the metabolically expensive increase in body temperature that accompanies the febrile response would not have evolved and been so faithfully preserved in the animal kingdom unless fever had some net benefit to the host.
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Figure 47-6 Evolutionary tree of animals. A febrile response has been documented in the Vertebrata, Arthropoda, and Annelida. These observations suggest that the febrile response evolved more than 400,000,000 years ago at about the time evolutionary lines leading to arthropods and annelids diverged. |
- PART I - BASIC PRINCIPLES IN THE DIAGNOSIS AND MANAGEMENT OF INFECTIOUS DISEASES
- PART II - MAJOR CLINICAL SYNDROMES
- SECTION A - Fever
- Chapter 47 - Temperature Regulation and the Pathogenesis of Fever
- CLINICAL THERMOMETRY
- THERMOREGULATION
- ENDOGENOUS PYROGENS
- ACUTE-PHASE RESPONSE
- ENDOGENOUS CRYOGENS
- RISK-TO-BENEFIT CONSIDERATIONS
- ANTIPYRETIC THERAPY
- References
- References
- Chapter 48 - Fever of Unknown Origin
- Chapter 49 - The Acutely Ill Patient with Fever and Rash
- SECTION B - Upper Respiratory Tract Infections
- SECTION C - Pleuropulmonary and Bronchial Infections
- SECTION D - Urinary Tract Infection
- SECTION E - Sepsis
- SECTION F - Intra-abdominal Infection
- SECTION G - Cardiovascular Infections
- SECTION H - Central Nervous System Infections
- SECTION I - Skin and Soft Tissue Infections
- SECTION J - Gastrointestinal Infections and Food Poisoning
- SECTION K - Bone and Joint Infections
- SECTION L - Diseases of the Reproductive Organs and Sexually Transmitted Diseases
- SECTION M - Eye Infections
- SECTION N - Hepatitis
- SECTION O - Acquired Immunodeficiency Syndrome
- SECTION P - Miscellaneous Syndromes
- PART III - INFECTIOUS DISEASES AND THEIR ETIOLOGIC AGENTS
- PART IV - SPECIAL PROBLEMS
- Cover
- Frontmatter
- Contributors
- Preface to the First Edition
- Preface to the Sixth Edition
