[QUOTE=Joey P]
:dubious: Can I get a cite on that? I was of the understading that the fever is a byproduct of your antibodies working to kill off whatever is making you sick. They work harder, they produce heat, you get a fever. I don’t think the fever itself is getting rid of the ‘invader.’ That’s like saying the warm exhaust pipe propels the car foward. No, it’s just a byproduct of internal combustion.
Now, wheather or not breaking the fever via medication prolongs healing time, I don’t know.
[/QUOTE]
Why sure: http://www.springerlink.com/content/p478466r72j38756/
*"Conclusion
The febrile response is a critical host defense mechanism that favors the host and is only detrimental to the infecting pathogen. The height of the fever elevation, the fever pattern, and pulse-temperature relationships have important diagnostic implications which are eliminated if antipyretics are employed. Similarly, in many cases, the only way to assess the efficacy of antimicrobial therapy in a septic patient is the febrile response to appropriate antimicrobial therapy. If a febrile response is removed by antipyretics, the clinician has no way to assess the adequacy or inadequacy of antimicrobial therapy. Because there are no data or reason to employ antipyretics, this practice should be eliminated. Fever has survival value to the host, and confers great advantages to the host, and should not be blunted or eliminated except under relatively few circumstances. The many benefits of fever should not be denied to the septic patient by administering antipyretics [1,34,35].
“Why, the fever itself is Nature’s instrument.” “Fever is the great engine that nature brings to the field to fight disease.” “While acetylsalicylic acid decreases the temperature in fever, we are not convinced that this has any beneficial effect.”*
It’s not quite that simple, of course; but on average those of us geezers who have been in medicine awhile are not convinced that the rush to treat the average fever is anything more than the need to do something, as opposed to just standing there–even when the latter is more appropriate.
The arguments and studies for the beneficial role of fever are not hard to come by.
The arguments for treating fever boil down to two:
First, a direct empiric argument that says a high prolonged fever is directly bad for you. This is true, but it has to be high and prolonged. A sudden spike in temperature in a kid might produce convulsions, but these types of febrile seizures are fairly benign, and outcome is more related to the underlying cause than the fact that a febrile seizure occurred. In cases where there is a very high and prolonged fever, the underlying cause is hard to sort out from the direct effect of the fever itself although there are certainly hyperthermic syndromes where you more or less cook the brain to encephalopathy.
Second, an indirect argument says that pyrogenic cytokines are themselves harmful and contribute to the physiologic burden of the illness. This is a little tougher to prove, since the underlying pathophysiology is a titchy bit hard to sort out from the fever itself. If you have a specific badness producing pyrogens, how do you sort out the underlying badness from the fever? Want a cite to help here, too? I don’t do literature searches for a single SDMB post, but you could start here for a nice discussion: http://www.annals.org/cgi/content/full/120/12/1037 Don’t make the medical student mistake of pulling out only comments favorable to your bias. It’s hard to read that article and decide fever should be treated aggressively. One of the conclusions this author seems to suggest is that when fever is detrimental, it’s detrimental because the cause is lost, and nature likes to weed out the dying. OK…but it’s really the presence of pyrogenic cytokines that are the putative enemy, and not fever per se (in this article).
As a practicing clinician I treated fevers aggressively if they wanted to stay over 103F and for comfort if they were below that. Kids, for instance, will sometimes be perkier and more inclined to take fluids if they don’t stay in a prolonged hot state (plus their insensible fluid losses are less at lower temps). Nevertheless I think fever is way over-treated. It’s the result, and not the cause, of the illness most of the time, and if Mother Nature has given us a febrile response when we are ill, I need a lot of persuading to say she screwed it up.
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