Fever good or bad? Is a fever necessary?

Fever is the body's response to an infectious agent. Although causing a lot of discomfort and fatigue, fever actually does more harm than good.

Fever has been and is one of the central themes of medicine for centuries. Until now, people have been able to detect and control fever well in most cases. However, there is still much controversy about why fever should be reduced and whether it is necessary to do so.
Fever is considered a part of the body's natural immune response to eliminate pathogens, most commonly parasites and viruses. For centuries, scientists have described fever as a disease rather than a sign of another.
Fever is defined as a condition that occurs when the body temperature rises above the normal thermal limit. Although it took hundreds of years for scientists to reach some consensus regarding the nature and definition of fever, there is consensus on when, why, and whether fever should be controlled. Whether to treat fever in patients or not is still a controversial issue.

Fever both protects the body from bad agents and has certain effects on human health.
2.1. Effects of fever When having a fever, the body's immune system increases its activity, stimulates the immune response and destroys disease-causing antigens. Therefore, when a child is vaccinated, if a child has a fever and must use antipyretic drugs, it will lead to a decrease in the child's immune response.
Fever stimulates metabolic processes in cells and facilitates the accumulation of stored energy. Currently, people have applied artificial fever to patients for the purpose of treating some cases such as keloid scars, post-burn scars. The mechanism of this process is that fever has the ability to inhibit scar formation and soften scars. In addition, the febrile response also reduces the damage caused by spinal cord injury, early treatment in syphilis patients with nerve damage...

2.2. The effects of fever Besides the benefits, fever also has certain effects on the body. High fever increases the risk of hypersensitivity reactions, causes shock, increases destruction, leading to a decrease in zinc and iron in the blood.
In addition, fever also causes dehydration, electrolyte disturbances, causing convulsions, very dangerous for children and infants. Subjects with high fever may experience other neurological damage, such as delirium, confusion, exhaustion, fatigue, heart failure, anorexia, respiratory failure...

In general, when faced with a patient with a fever, there are two schools of action: one is to treat the fever and the other is to let it happen.
3.1. Perspectives on the need for antipyretic treatment Proponents of antipyretic therapy offer two hypotheses to answer the question “Why should fever be reduced?” , however both have not been experimentally verified:
Fever is a harmful condition for the body. Suppressing the fever will reduce its harmful effects. One thing many researchers consider before treating fever is that the total cost of treatment outweighs the benefit to the patient. However, again, this conclusion needs to be considered and calculated more precisely.
Currently, in clinical practice, the only situation in which a patient definitely needs active antipyretic therapy is during acute brain injury. In addition, even when dealing with febrile convulsions in children, the use of antipyretics is not recommended because prophylactic treatment with antipyretics does not reduce the recurrence of seizures or epilepsy.
Fever reduction through cooling in the ICU has been documented in a randomized controlled trial and has been shown to benefit patients with septic shock resulting in a reduced effect of vasopressors and death. Meanwhile, most other studies related to the role of fever reduction have not shown very positive results. Theoretically, only patients with fever due to severe illness or those experiencing severe psychophysiological stress could benefit greatly from fever reduction, but so far there is little evidence. to come to a clear conclusion as to why antipyretics should be taken.
3.2. The concept of letting the fever go away naturally Proponents of this view argue that fever is a defense mechanism for the body by enhancing immune cell function and promoting the destruction of pathogens. . Over the decades, several studies have supported this hypothesis.
A randomized controlled trial investigating the effects of fever reduction in critically ill febrile patients published in 2005 found evidence to support this view. Specifically, when comparing the group of patients who received active antipyretic treatment with drugs early on with the group that only started to reduce fever when the body temperature rose to a serious level, the cases where the fever occurred naturally were observed. recorded significantly fewer deaths.
Another randomized controlled trial performed in critically ill patients presenting with a fever ≥ 38.5 °C (without neurologic complications or severe hypoxia) failed to Discuss the role and cause of fever reduction. Accordingly, the trial results showed that between the two groups with and without antipyretic treatment, there was no significant difference in the likelihood of fever recurrence, degree of infection, the need for antibiotic treatment, rate of hospital stay and length of hospital stay.

Is fever a good or bad sign and why should it be reduced? Until now, scientists have not been able to determine exactly. However, from an evolutionary standpoint, a feverish reaction could be a sign of adaptation. This is because the febrile reaction is estimated to have appeared more than 4 million years ago (in different animals). Although medical research has long been started, the exact mechanism of fever, its potential protective effects on the body, and why it is necessary to reduce fever are still controversial issues. controversial and not fully documented on experimental studies.
Many people lean towards the theory that treating fever compromises immune function and makes patients more susceptible to infections. However, many doctors still consider antipyretic treatment necessary in most cases.

References: ncbi.nlm.nih.gov