QUOTIDIAN FEVER

SYMPTOMS

Quotidian fever can be caused by a wide range of conditions, including:

• Malaria: The most common cause of quotidian fever is infection with Plasmodium falciparum, a parasite transmitted by Anopheles mosquitoes. The characteristic pattern of fever spikes every 24 hours is often seen in cases of uncomplicated malaria.
• Other Infections: Quotidian fever may also occur in other infectious diseases such as sepsis, bacterial endocarditis, tuberculosis, brucellosis, or certain viral infections.
• Autoimmune Disorders: Some autoimmune diseases, such as systemic lupus erythematosus (SLE) or Still’s disease, may present with quotidian fever as part of their clinical manifestation.
• Neoplastic Disorders: Certain malignancies, particularly hematological malignancies such as leukemia or lymphoma, may cause fever spikes with a quotidian pattern.
• Drug Reactions: Fever may be a side effect of certain medications, including antibiotics, anticonvulsants, or nonsteroidal anti-inflammatory drugs (NSAIDs), leading to a cyclic pattern of fever recurrence.

DIAGNOSIS

Diagnosing the underlying cause of quotidian fever involves a comprehensive evaluation, which may include:

• Medical History: Gathering information about the onset, duration, frequency, and pattern of fever spikes, as well as associated symptoms, recent travel history, exposure to infectious agents, and medication use.
• Physical Examination: Conducting a thorough physical examination to assess for signs of infection, inflammation, lymphadenopathy, hepatosplenomegaly, or other abnormalities suggestive of an underlying condition.
• Laboratory Tests: Performing blood tests, including a complete blood count (CBC), inflammatory markers (e.g., C-reactive protein, erythrocyte sedimentation rate), blood cultures, and serological tests for specific pathogens (e.g., malaria, tuberculosis, viral serologies).
• Imaging Studies: In some cases, imaging studies such as chest X-ray, ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) may be indicated to evaluate for structural abnormalities, organ involvement, or neoplastic lesions.

Additional tests and consultations with specialists may be necessary based on the suspected underlying cause of quotidian fever.

TREATMENT

Treatment of quotidian fever depends on the underlying cause and may include:

• Antimicrobial Therapy: If an infectious etiology is identified, treatment with appropriate antimicrobial agents targeting the specific pathogen (e.g., antimalarial drugs for malaria, antibiotics for bacterial infections) is essential.
• Anti-inflammatory Medications: Inflammatory or autoimmune conditions causing quotidian fever may require treatment with corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), or disease-modifying antirheumatic drugs (DMARDs) to suppress inflammation and alleviate symptoms.
• Supportive Care: Symptomatic treatment with antipyretic medications (e.g., acetaminophen, ibuprofen) and adequate hydration to relieve fever-associated discomfort and prevent dehydration.
• Monitoring and Follow-Up: Regular monitoring of body temperature, clinical symptoms, and response to treatment is necessary to assess disease progression, adjust therapy as needed, and prevent complications.

In some cases, hospitalization may be required for close monitoring, intravenous fluids, and more intensive treatment, especially if the underlying condition is severe or life-threatening.