Pyrexia?

9 July , 2004

Is pyrexia, symptoms pertaining to a fever, just another term for trench fever?

What's the difference, if any, from a medical standpoint?

Relative in Notts&Derby Labour Btn. is reported as suffering from it, eventually discharged 1918.

9 July , 2004

I'm not sure what the proper answer to your question is, Simon, but I thought that "pyrexia" just meant high temperature or "a fever" and that it was an indication of an illness, not the name of an illness itself. "PUO" was often used to mean "Pyrexia of Unknown Origin" which meant the man was ill because he had a fever, but the doctor didn't yet know what illness/disease/infection was making him unwell.

Tom

9 July , 2004

That's my understanding too.

PUO - thanks, didn't know that.

9 July , 2004

Pyrexia means "Fever". A rise in temperature of the body, frequently a symptom of an infection.

9 July , 2004

War Diaries of medical units frequently state that the most common illness in a particular period is "PUO". I am not a medical person, but when I "googled" this some time ago I learned that this is still a common term. The basic definition is " PUO is defined as undiagnosed fever of more than 3 weeks duration". One can get tricky about defining what temperature a patient must have or what degree of hospital intervention is required for this determination.

My admiration for the medical profession knows no bounds, especially for the medical officers operating in dreadful conditions in 1914-1918. Nonetheless I am cynical enough to suggest that the term "PUO" was used in preference to the more accessible "Jeez! I don't know what the heck is wrong with him!". A professional must sound like a professional.

Nothing personal! :-)

9 July , 2004

Pyrexia would occur with Trench Fever. Not all pyrexias were due to Trench Fever. Trench Fever included several other symptoms, in addition to pyrexia. This is because it was an illness related to tick-borne Bartonella infection, though the pathogenesis was not understood at the time.

PUO refers to a prolonged fever, as mentioned. It does suggest a whole different set of causes, other than just infection. This is why it is an important concept in medicine. During WW1, the most common cause would probably have been deep infection from penetrating wounds or compound fractures, or TB. Rarely, there are lymphoid and other cancers, plus a host of other uncommon and very rare conditions that can produce PUO.

Robert

9 July , 2004

Nothing personal! :-)

Not taken as such . I hope my explanations are not too 'professional'.

Robert

9 July , 2004

I researched an Argyll and Sutherland Highlander who died of pyrexia and I remember reading that it could be as a result of kidney problems after exposion to certain types of gas.

Mick

9 July , 2004

I researched an Argyll and Sutherland Highlander who died of pyrexia and I remember reading that it could be as a result of kidney problems after exposion to certain types of gas.
Mick

30 seconds after posting this I realised that I'm talking a load of tosh.... I was thinking of nephritis.

9 July , 2004

People with severe kidney problems, whatever the cause, had a high chance of developing lethal infections in the days before dialysis and antibiotics. The immune system becomes suppressed. The infection would cause pyrexia.

Robert

9 July , 2004

Found this in a 1987 medical text book. Phil B

9 July , 2004

Wow, 1 to 5% of them got it through changing thermometers. The mind boggles

9 July , 2004

I suppose it depends from whom, and what part of whom, they switched it! That Q Fever sounds pretty mysterious too! Phil B

9 July , 2004

Q fever is an infection caused by Coxiella burnetii. It is somewhat similar to Trench Fever in the way that it affects people, though there is a chronic form (which is why it gets into the PUO list) that occurs in some individuals. First described in Australia but occurs in many parts of the world.

The 'changing thermometers' and 'injecting pyrogenic material' refers to people deliberately causing a 'fever'. Thus, a person will dip the thermometer in a hot drink while the nurse is not looking. 'Pyrogenic material' refers to stuff that causes fever. It may be a health professional that will do this to themselves but it also happens with some intravenous drug users.

Robert

9 July , 2004

I had brucellosis as a child. Moral of the story, don't drink untreated milk. ( Don't think I can spell Pasteurised)

Roger.

10 July , 2004

Back to the original question - Is PUO the same as trench fever. Well, I`ve read the following and I still don`t know! Probably the answer is yes & no! Phil B

Trench Fever

Updated - Saturday, 17 August, 2002

'Trench Fever' was first reported in the trenches of the Western Front in December 1914.

Unlike the similar-sounding condition Trench Foot incidences of Trench Fever continued to grow throughout the war.

Trench Fever attacked all armies and until the final year of the war baffled doctors and researchers. Chief symptoms of the disease were headaches, skin rashes, inflamed eyes and leg pains.

Despite such wide-ranging symptoms (which resembled typhoid and influenza) the condition was not itself particularly serious, with patients recovering after some five or six days although prolonged hospitalisation amounting to several weeks was common.

In military terms however it proved one of the most significant causes of sickness and military authorities were therefore keen to determine the root of the problem.

In 1918 the cause was identified as excretions from lice, affecting all trenches: Rickettsia quintana. The disease was transmitted via the bites of body lice and was chiefly prevalent on the somewhat warmer Western and Italian Fronts.

In 1917 a renewed incidence of the disease was recorded with effects much as before although the average duration of sickness was slightly longer. In 1918 victims reported suffering frequent relapses after intervals of several days.