diease

Chills


OVERVIEW OF Chills :

When our body want to regulate the temperature by its own way it results in chillness of the body. During the chillness of the body the muscles contracts and relaxes spontaneously which might result in the warming up process of the body and the core temperature is maintained.


CAUSES :

Chills may be associated with the following reasons:

Appendicitis

Bacterial gastroenteritis(food poisoning)

Viral gastroenteritis(stomach flu)

Bronchitis

Common cold

Diverticulitis(inflammation of an abnormal pocket in the colon)

Ear infections

Infectious mononucleosis

Influenza(flu)

Meningitis(infection or inflammation of the sac around the brain or spinal cord)

Pneumonia

Streptococcal infection of the throat

Urinary trat infection especially a kidney infection(pyelonephritis

Other infectious causes of chills:

Abscess(collection of pus in the skin, brain, liver, kidney or other organ)

Acquired immunodeficiency syndrome

Cellulitis( bacterial skin infection)

Chest infection

Endocarditis(inflammation and infection of the lining inside the heart)

Kidney infection

Malaria

Pelvic inflammatory disease

Sepsis(life threatening bacterial blood infection)

Septic or infectious arthritis

Sexually transmitted diseases

Tuberculosis(serous infection affecting the lungs and other organs)

Inflammatory causes of chills:

Chills can also be caused by inflammatory conditions including:

Allergic reaction

Blood transfusion reaction

Inflammatory bowel disease including crohns disease and ulcerative colitis

Systemic lupus erythematosus( an autoimmune disorder meaning the body’s own immune system attacks the normal cells).

Malignant causes of chills:

Chills can also be caused by the malignant conditions including the following:

Leukaemia

Lymphoma

Cancer

Other causes:

Drug withdrawal(substance abuse)

Hangover symptoms

Low blood sugar which is termed as hypglycaemia in people with diabetes

Menopausal night sweats

Panic attacks

Parasitic infections like giardiasis

Viral infections

Sepsis


PATHOPHYSIOLOGY :

When hypothermia occurs that the reduction in the temperature it might results in the alternative contraction and relaxation of the actin and myosin filaments

This mechanism leads to the formation of the ATP molecules and the heat is evolved in this process.

The release of this heat might monitores the core temperature and maintains the body temperature.

Rigor mortis:

It is the third stage of the death. Due to chemical reactions within the muscle , the muscle might get stiffened. It is also known as postmortem rigidity.

The aerobic respiration in the organism ceases that is oxygen supply to the vital organs is reduced. The oxygen is essential for the adenosine triphosphosphate formation in the muscle that is binding of actin to myosin chain. When the body has no amount of oxygen supply it then the body tends to produce the ATP through anaerobic glycolysis. When the glycogen is depleted the ATP decreased and the body enters the mortis because loss of ability to break the actin an myosin cross linkage cycles.

Calcium enters the cytosol after death. Calcium is released into the cytosol due to the deterioration in the sarcoplasmic reticulum. The calcium activates the formation of actin myosin cross bridging. Once calcium is introduces it might result in the ATP formation and the muscle is unable to relax further and the contraction of the muscle continues.

 


COMMON CLINICAL SIGNS AND SYMPTOMS :

Fever may or may not accompany

Shivering

Aches and pain

Cough

Diarrhoea

Nausea

Vomiting

Lethargy

Sweating

Shortness of breathe

Wheezing

Seizures

Cyanosis might occur in complicated cases

Rigor mortis is a condition which occurs after the death of the person due to strong contraction of the mucle.


DIAGNOSTIC :

Diagnosis is mainly done by:

Blood test and blood culture

Sputum culture – lungs and bronchi

Urinanlysis

Chest Xray – In the cases of Pneumonia, tuberculosis and other infections.

 

Blood Culture:

1. culture-based methods;

2. nucleic acid amplification technology (NAAT)-based assays.

Culture based method for CRE screening:

Culture based methods have been widely used for CRE screening, several different cultural approaches have been described

 

NAAT for molecular screening:

Molecular based methods (NAAT) for CRE screening usually detect the presence of one or more  genes. For these characteristics these assays are able to identify only previously known resistance determinants.

NAAT-based assays validated for carbapenemase genes detection from rectal swabs can also be used as a confirmatory test for suspected colonies identified by culture-based methods, although not all commercial assays have an on-label indication for this.

The three types of NAAT based assays for the Surveillance of  CRE  is as follows:

In house molecular methods

Commercial molecular assays

Rapid/easy to use commercial molecular assays:

In house molecular methods can reveal best level of sensitivity and specificity . Moreover, these assays are less expensive if compared to molecular commercial method. Also it has important disadvantages are low level of automation, standardization and validation, and suboptimal inter-laboratory reproducibility.

Commercial molecular assays:

they are highly sensitive, specific and standardized, with TAT of few hours; the level of automation of these methods can vary from poor (need of sample preparation step, including extraction or lysis, and/or multiple hands-on steps), to good, but for all these assays laboratory experience and equipment are required.

Rapid/easy to use commercial molecular assays (REU-CMA) :

They might provide the same high standard of quality of results with shorter hands-on time and TAT (less than 1 h) and no requirement for batching


TREATMENT AND PROGNOSIS :

Aspirin

Acetaminophen

Ibuprofen


PROGNOSIS :

The person might get recovered from chills when the triggering factors is taken away. Chills occurring due to septicaemia requires immediate treatment otherwise it might result in life threatening to the patients.

 


PREVENTION :

  • Give lots to drink. This helps to prevent a lack of fluid in the body (dehydration). You might find that a child is more willing to have a drink if they are not so irritable. It may help to give some paracetamol and then try again with drinks half an hour or so later.
  • Tepid sponging is not recommended because the blood vessels under the skin become narrower if the water is too cold and this may further raise the temperature. People with rigors also find sponging uncomfortable in the shivery phase.
  • Cold fans are not recommended for the same reasons, although cooling an over-warm room with adequate ventilation is sensible.
  • Children with high temperature (fever) should not be underdressed or over-wrapped.
  • Medicines like paracetamol and ibuprofen should not be used for fever unless your child appears distressed

 


Medicines used in the Treatment :

Aspirin

Acetaminophen

Ibuprofen