Fever is not a disease; it is a symptom. It can mean anything or nothing, depending on its cause. In arthritis, fever can be a complicating infection in a joint or elsewhere, or it can be part of the disease, as in lupus, juvenile rheumatoid arthritis, or, more rarely, adult rheumatoid arthritis (RA). Of course, people with arthritis get fever for all the same reasons that anybody else does, and most fever with arthritis should not be treated any differently than if the person did not have arthritis. With fever, management is based on the condition that is causing the fever, not the fever itself.
Here are some points to keep in mind. Watch out for fever from a bacterial infection. This kind of fever requires the most urgent attention because antibiotics are necessary to treat the cause. Bacterial infections tend to be localized, and you usually can tell where the fever is coming from. It may be a sore throat, an earache, a boil, or a sore and swollen joint. Because of the way in which bacteria grow and divide, thev are usually found in a single location, surrounded by pus cells—the body’s response to the infection. With bacterial infections you mav have a shaking chill. See the doctor if you suspect a bacterial infection. In contrast, viral infections tend to be less distinct; you mav ache all over. These are less urgent, but anv fever that persists for over a week should be checked out.
Arthritis-related fevers are few. Drug fever is the most common of these, and you should always start by suspecting your medication. Rheumatoid arthritis occasionally causes low-grade fever, while lupus may show a more dramatic intermittent fever. Children with arthritis frequently have very high fevers. Infectious arthritis, such as gonococcal arthritis, can cause fever. You can also get an infection in a joint already damaged by RA (or any other arthritis). Such infections are not common and often are discovered by an alert patient who notices that a single joint is acting up badly while other joints are doing well.
Duration separates out the serious fevers, so pay attention to how long your fever lasts, as noted on the decision chart opposite.
You will usually be under the care of a doctor for vour arthritis, and you may want to give your doctor a call to check out your plan for treating fever. If a drug might be causing the problem, ask about stopping the drug. If the fever might be related to the arthritis, you should see your doctor.
For flu, minor fevers from viral illnesses, and other problems, you can take acetaminophen in a dosage of 650 mg even- four hours. For children, the appropriate dose is 65 mg even four hours for each year of age up to age ten, then the adult dose. Of course, if vou are already taking aspirin for your arthritis, a call to the doctor is in order.
Keep the room cool. Wear light clothing. Children mav require tepid baths to cool them down. Regular use of these measures is better and more comfortable than allowing the fever to go up and down like a yo-yo.
What to Expect at the Doctor’s Office
Examination and culture of any suspicious area for bacteria can be expected. A joint may be “tapped” and cultured. X-rays may be taken if a suspected infection is located near bone. Antibiotics may be prescribed if a bacterial infection is known or strongly suspected. Antibiotics do not help viral infections and should not be given for uncomplicated colds or flu.