Fevers

Dr. Christopher Drumm Family Practitioner Norristown, PA

Dr. Christopher Drumm is a family practitioner practicing in Norristown, PA. Dr. Drumm specializes in comprehensive health care for people of all ages. In addition to diagnosing and treating illnesses, family practitioners also put focus on preventative care with routine checkups, tests and personalized coaching on how... more

Doctors have never been afraid of fevers. Until now. It gave us information. Physicians have defined fever as a temperature greater than 100.4 degrees. Fever is an abnormal elevation of body temperature that occurs as a biologic response mediated by the central nervous system. Now the idea of having a fever has changed. When patients used to have a fever I used to immediately say get them in for a visit. Fevers can come from medications, infections, autoimmune illnesses, and malignancies. Now everything is Covid until proven otherwise. 

These patients are not allowed into my outpatient office. What a strange world in which I only see patients IN PERSON for physicals and injuries. It is amazing how a pandemic can shift our paradigm. Arriving at work every morning I get my temperature checked to make sure that I am not putting others at risk. The question is what method of measurement should be used? Well - Rectal temperatures are generally considered the gold standard. Due to obvious issues, this is not considered feasible in the average American workplace. Oral temperatures can run up to 1 degree lower than rectal temperatures due to mouth breathing. They are also affected by whether or not we had recently ingested any cold or hot liquids. This has not kept me from drinking my morning coffee though. 

Infrared thermometry and axillary thermometry are good options for small children that do not want to open their mouths or have trouble using an oral thermometer. Fever is the body telling us something. During a pandemic that is scary but still extremely helpful information. There is a famous mnemonic that all physicians learn in medical school about the causes of postoperative fever. Wind, Water, Wound, Walking, and Wonder. This refers to in order - Lung infections including atelectasis (wind), urinary tract infections (water), skin infections (wound), DVTs (walking or lack of walking), and drug fever (wonder what we did to the patient). This is a time in the world for sacrifice.  Wear your masks. Wash your hands. Get your temperature checked. Orally. Not Rectally. Stay safe. Stay home if you are sick. 

Christopher Drumm M.D.

Norristown Family Physicians Einstein Medical Center Montgomery