(单词翻译:单击)
Approach To Fever
诊断发烧的方法
Intro Fever also called Pyrexia, is one of the most common presenting complaints in medical practice.
前言：发烧又称发热，是医疗实践中最常见的主诉之一。
It is defined as a body temperature that is above the normal range, for that individual, without any physiological cause to it.
对个人来说，它被定义为没有任何生理原因而高于正常范围的体温。
In other words, temperature raise due to exercise or menstrual cycle doesn't count as fever.
换句话说，运动或月经周期引起的体温升高不算发烧。
This is usually above 38°C recorded by thermometer.
发烧时温度计记录的温度通常在38°C以上。
In this case, oral and rectal temperature readings are more accurate than axillary temp.
在这种情况下，口腔和直肠温度读数比腋窝温度更准确。
The most important thing to keep in mind is that fever, in it of itself, is not a disease, but rather a symptom that indicates an underlying disease process.
最重要的是要记住，发烧本身并不是一种疾病，而是一种表明潜在疾病过程的症状。
Mechanism of Fever: Body temperature is usually set to its normal range by the hypothalamus, which acts as a sort of thermostat.
发烧的机制：体温是由下丘脑控制在正常范围内，下丘脑起着一种恒温器的作用。
When the body suffers from certain pathological processes, namely "inflammation", certain chemicals are released by the body, collectively called pyrogens, in other words, of which is interleukin-2.
当身体遭受某些病变，即“炎症”时，身体会释放某些化学物质，统称为热原，也就是其中有白细胞介素-2。
Pyrogens set the thermoregulatory point of the hypothalamus to a higher temperature, thus resulting in fever.
热原使下丘脑的温度调节点升高，从而导致发烧。
The causes of fever can be divided into the broad categories of 1) Infections, which is the most common cause of pyrexia.
引起发烧的原因可以分为以下几大类：1）感染，这是最常见的发烧原因。
It can include bacterial, viral, fungal or parasitic infections.
它包括细菌、病毒、真菌或寄生虫感染。
2) Clots 3) Cancers 4) Auto Immune Diseases, and 5) Miscellaneous, which can include things like heat stroke, medications, brain lesions and thyroid storm to name a few.
2）血栓，3）癌症，4）自身免疫性疾病，5）其他，包括中暑、药物、脑部损伤和甲状腺肿大等，不一而足。
Diagnosing the Cause of Fever
诊断发烧的原因
We have mentioned 5 categories of diseases that usually result in fever and each category consists of a multitude of possible diseases.
我们已经提到了5类通常会导致发烧的疾病，每一类都由多种可能的疾病组成。
In order to narrow down our diagnosis, we need to do a thorough history and examination, and request appropriate lab investigations where relevant.
为了缩小诊断范围，我们需要做一次彻底的病史和检查，并在相关的情况下要求进行适当的实验室检查。
Fever is usually accompanied by other symptoms as well, which may guide the diagnosis of underlying disease.
发烧通常还伴有其他症状，这可能会指导潜在疾病的诊断。
Important questions to ask in history.
经常会问的重要问题。
These can be broadly divided into 2 categories: 1) General Fever Related 2) Review of Systems
可以大致分为两类：1）一般发烧的相关问题；2）系统复查
Fever specific questions include: the duration of fever, the timing of the fever: what time of day is it more prominent?
发烧的具体问题包括：发烧的持续时间、发烧的时间：一天中什么时候发烧比较严重？
the character: Is it remitting or relapsing?
问患者：有所减轻还是反复发作？
Is it accompanied by chills or rigors?
是否伴有寒冷的感觉？
Is there night sweating?
晚上盗汗吗？
Is there weight loss?
体重减轻了吗？
Is there pain anywhere?
感觉到哪里疼吗？
Review of systems is a systematic approach to identify accompanying symptoms in other body organs.
系统检查是一种系统的方法，用来识别身体其他器官的伴随症状。
This is especially important in identifying a possible focus of infection.
这在确定可能的感染源时尤其重要。
Ask relevant questions pertaining to each organ system and move from head to toe.
从头到脚询问与每个器官系统相关的问题。
So for example, ask about headache? Neck stiffness? Eye pain? Skin rashes or itching?
比如举个例子，头疼吗？脖子僵硬吗？眼睛疼吗？有皮疹或皮肤瘙痒吗？
Runny nose? Ear pain or discharge? Coughing? Sputum? Sore throat?
流鼻涕吗？耳朵痛吗或者耳道有分泌物吗？咳嗽吗？有痰吗？喉咙痛吗？
Pain on swallowing? Is there difficulty breathing or chest pain? Is there any abdominal pain?
吞咽疼痛吗？感到呼吸困难或胸痛吗？腹痛吗？
Any change in bowel habits? Is there any lymph node enlargement? Any burning sensation while urinating?
大便习惯有什么变化吗？淋巴结肿大吗？小便时有烧灼感吗？
Any discharge from genitals? Any recent injuries? Any muscle or bone pain? Any recent surgery?
生殖器有异常分泌物吗？最近有没有受伤？感觉到肌肉或骨骼疼痛吗？最近做过手术吗？
Your history will be directed further by the patients' responses and will probably start moving towards a probable diagnosis.
你的病史询问将进一步引导患者的反应，并可能开始朝着可能的诊断方向发展。
Examine the relevant organ system in thorough detail.
彻底检查相关器官系统。
You mainly need to decide which of the 5 categories does the disease belong to and which organ system is likely affected.
你主要需要决定患者疾病属于这5类中的哪一类，以及哪个器官系统可能受到影响。
For example, acute fever with complaint of burning sensation during urination points to an infection of the urinary tract, whereas chronic low grade fever with anemia and weight loss might be indicating a hematological cancer.
例如，排尿时伴有烧灼感的急性发热应该是泌尿道感染，而伴有贫血和体重减轻的慢性低烧可能时血液系统癌症。
