Elderly persons do not often manifest temperatures like children or adults do, as they generally develop a lower temperature for a similar condition. In general, the elderly have a narrower tolerance range than adults or children and so a fever in an elderly person should be viewed as being serious and the reason for its occurrence should be sought.

BODY RESPONSES TO INFECTION

When infection occurs, there may be a gradual or sudden onset of fever. Frequently it is of a gradual nature, but is more noticeable when it announces its presence with sudden chilling and shivering. When this happens, the body's thermostat receptors in the brain, spinal cord, and in other parts of the body suddenly reset themselves at a higher mark. Vasoconstriction (flushed face and coldness of the hands and feet) and shivering occur. The heart and respiration rates increase and the person affected may become lethargic and wish to sleep or excitable, alert and restless. As the blood pours into the body's central core for warming, the skin will often feel hot and dry while the hands and feet may feel cold. Pyrogens, given off by white blood cells, serve to increase temperature by acting with the body's prostaglandins to reset the thermostat. Aspirin, which will reduce a fever, inhibits prostaglandin synthesis. Association of aspirin usage in children with fevers and the onset of Reyes Syndrome (inflammation of the brain), has made this type of therapy less popular in recent years.

After the body has reached a sufficient temperature to overcome the infection, its "thermostat" resets at a lower temperature and sweating occurs. The fever is said to have "broken" and it is a sign that the crises has now passed. The person affected will begin to feel better after resting.

As the person recovers, sweating may occur periodically as the body attempts to cool things down to keep the temperature from getting higher. For this reason, the fluid intake should be monitored, particularly in children, because fluid replacement is essential if prolonged sweating occurs. One of the values of "chicken soup" lies in its fluid and electrolyte (sodium, potassium, chloride and other mineral salts) content which helps replenish body fluid stores. If fever is accompanied by vomiting, then they may be given by enema in order to rehydrate. If diarrhea is present, then intravenous fluid replacement is necessary if the condition is prolonged.

Fevers above 106 F should be controlled as brain damage may take place. While a core body temperature of 105 F to 106 F will not cause damage, the brain is comprised of much more delicate tissue than other organs and convulsions may occur. Convulsions are one of the first signs, along with extreme lethargy and unresponsiveness, that a fever is too high and should be brought down to a manageable 102 F to 104 F. Cold compresses to the neck and scalp will help decrease the temperature as will rubbing with alcohol or a Brand (decreasing temperature) bath. Anytime convulsions are present, the person should be seen by a physician immediately, especially if it is a child.

Fever without sweating is of concern, because elimination of toxins through the skin is important to temperature regulation and the body's ability to maintain optimal metabolic function. A fever can go on for a longer period of time provided it is accompanied by sweating. A high fever with no perspiration is cause for concern especially if the person is uncomfortable and unresponsive. In general, a fever can last anywhere from 1-4 days at temperatures between 101 F and 104 F and are higher in the morning and lower in the afternoon.