question: what causes the achy joints when you have a high fever?
comment: Complement cascade resulting in loads of other stuff going on in the body. It’s not the high fever that causes the achy joints...it’s the responses that infection provoked in your body to try and get rid of it
passages: Following the fever, strong joint pain or stiffness occurs; it usually lasts weeks or months, but may last for years. The joint pain can be debilitating, often resulting in near immobility of the affected joints. Joint pain is reported in 87–98% of cases, and nearly always occurs in more than one joint, though joint swelling is uncommon. Typically the affected joints are located in both arms and legs, and are affected symmetrically. Joints are more likely to be affected if they have previously been damaged by disorders such as arthritis. Pain most commonly occurs in peripheral joints, such as the wrists, ankles, and joints of the hands and feet as well as some of the larger joints, typically the shoulders, elbows and knees. Pain may also occur in the muscles or ligaments.
   BULLET::::- Poststreptococcal reactive arthritis: The presentation of arthritis after a recent episode of group A streptococcal pharyngitis raises suspicion for acute rheumatic fever since it is one of the Jones criteria for that separate complication. However, when the arthritis is an isolated symptom then it is referred to as poststreptococcal reactive arthritis. This arthritis can involve a variety of joints throughout the body, unlike the arthritis of acute rheumatic fever which primarily impacts larger joints like the knee joints. It can present less than 10 days after the group A streptococcal pharyngitis.
  
  Section::::Cause.
   BULLET::::- Familial Mediterranean Fever. For some patients with FMF, episodes of knee or joint inflammation may be the only presenting symptom during an acute inflammatory episode. The MEFV gene mutations associated with FMF have been implicated in the pathogenesis of both palindromic rheumatism and IH.
  
  BULLET::::- Other conditions for consideration (or exclusion) are other periodic arthropathies, crystal arthopathy, prepatellar bursitis (housemaids knee), pigmented villonodular synovitis, trauma and infectious causes.
  
  Section::::Treatment.
   Section::::Diagnosis.:Other.
  
  Infectious arthritis is another severe form of arthritis. It presents with sudden onset of chills, fever and joint pain. The condition is caused by bacteria elsewhere in the body. Infectious arthritis must be rapidly diagnosed and treated promptly to prevent irreversible joint damage.
   The causes of "arthralgia" are varied and range, from a joints perspective, from degenerative and destructive processes such as osteoarthritis and sports injuries to inflammation of tissues surrounding the joints, such as bursitis. These might be triggered by other things, such as infections or vaccinations.
  
  Add to table below: Chikungunya fever. “Chikungunya” is Maconde (a local Tanzanian language) for "he who bends" and describes the huddled up body posture caused by the intense arthralgia which normally accompanies the acute infection.
  
  Section::::Diagnosis.
   Shar Pei fever
  
  Shar Pei fever (also called familial Shar Pei fever or FSF) is a condition seen in Shar Pei characterized by recurring fever and swelling of the hocks. It is similar to familial Mediterranean fever in humans. The cause is unknown, but it is thought to be inherited. Shar Pei fever can result in renal and liver failure through accumulation of amyloid in those organs (amyloidosis).
   Drug-induced hyperthermia, as the sole symptom of an adverse drug reaction, should always be considered. Disseminated granulomatoses such as tuberculosis, histoplasmosis, coccidioidomycosis, blastomycosis and sarcoidosis are associated with FUO. Lymphomas are the most common cause of FUO in adults. Thromboembolic disease (i.e. pulmonary embolism, deep venous thrombosis) occasionally shows fever. Although infrequent, its potentially lethal consequences warrant evaluation of this cause. Endocarditis, although uncommon, is another important etiology to consider. An underestimated reason is factitious fever. Patients frequently are women that work, or have worked, in the medical field and have complex medical histories. Bartonella infections are also known to cause fever of unknown origin.
   Section::::Diagnosis.
  
  Hyperthermia is generally diagnosed by the combination of unexpectedly high body temperature and a history that supports hyperthermia instead of a fever. Most commonly this means that the elevated temperature has occurred in a hot, humid environment (heat stroke) or in someone taking a drug for which hyperthermia is a known side effect (drug-induced hyperthermia). The presence of signs and symptoms related to hyperthermia syndromes, such as extrapyramidal symptoms characteristic of neuroleptic malignant syndrome, and the absence of signs and symptoms more commonly related to infection-related fevers, are also considered in making the diagnosis.
   Section::::Setting.
   About 95% of symptomatic cases report joint pain. This is typically symmetrical and with acute onset, affecting the fingers, toes, ankles, wrists, back, knees and elbows. Fatigue occurs in 90% and fever, myalgia and headache occur in 50–60%.
   Despite all this, diagnosis may only be suggested by the therapy chosen. When a patient recovers after discontinuing medication it likely was drug fever, when antibiotics or antimycotics work it probably was infection. Empirical therapeutic trials should be used in those patients in which other techniques have failed.
  
  Section::::Diagnosis.:Definition.
  
  In 1961 Petersdorf and Beeson suggested the following criteria:
  
  BULLET::::- Fever higher than 38.3 °C (101 °F) on several occasions
  
  BULLET::::- Persisting without diagnosis for at least 3 weeks
  
  BULLET::::- At least 1 week's investigation in hospital
  
  A new definition which includes the outpatient setting (which reflects current medical practice) is broader, stipulating:
   BULLET::::- Erythema marginatum: A long-lasting reddish rash that begins on the trunk or arms as macules, which spread outward and clear in the middle to form rings, which continue to spread and coalesce with other rings, ultimately taking on a snake-like appearance. This rash typically spares the face and is made worse with heat.
  
  BULLET::::- Sydenham's chorea (St. Vitus' dance): A characteristic series of involuntary rapid movements of the face and arms. This can occur very late in the disease for at least three months from onset of infection.
  
  Section::::Diagnosis.:Minor criteria.
  
  BULLET::::- Fever of
   Fever may be present since this is an inflammatory process.
  
  Section::::Causes.
   In infection, there is often weakness, fever and chills. If due to a bacterial infection, the sputum may be slightly streaked with blood and coloured yellow or green.
  
  Section::::Causes.
  
  As the lungs tend to be vulnerable organs due to their exposure to harmful particles in the air, several things can cause an acute exacerbation of COPD:
   Affected Shar Pei have an elevated level of interleukin 6, and this leads to an accumulation of acute phase proteins in the body during the fevers. The acute phase proteins are broken down to form type AA amyloid, which deposits in the kidneys and less so in the liver, spleen, and gastrointestinal tract. This eventually leads to kidney or liver failure by the age of six years.
   Section::::Diagnosis.
  
  Chikungunya is diagnosed on the basis of clinical, epidemiological, and laboratory criteria. Clinically, acute onset of high fever and severe joint pain would lead to suspicion of chikungunya. Epidemiological criteria consist of whether the individual has traveled to or spent time in an area in which chikungunya is present within the last twelve days (i.e.) the potential incubation period). Laboratory criteria include a decreased lymphocyte count consistent with viremia. However a definitive laboratory diagnosis can be accomplished through viral isolation, RT-PCR, or serological diagnosis.
   Of 64 patients meeting the CDC criteria before October 29, 2014, 80% had had a preceding respiratory illness and 75% reported fever in the days leading up to limb weakness, the onset of which was generally abrupt. By November 20, the number of confirmed cases stood at 88 from 29 states.
  
  The CDC requested that physicians provide information about cases meeting these criteria: patients diagnosed after August 1, 2014, who are no older than 21 years of age, showing acute onset of focal limb weakness, with a spinal cord lesion largely restricted to grey matter visualized by MRI.
   BULLET::::- Numbness or tingling in the fingers and toes happens to nearly everyone having oxaliplatin and is usually worse if you are cold. You may have trouble with fiddly tasks such as doing up buttons. This can start a few days or weeks after treatment and usually goes away within a few months of the treatment finishing
   Signs and symptoms include fever in excess of 100.4 °F (38 °C), lethargy (weakness), headaches, muscle pain (myalgia), loss of appetite, nausea, diarrhea, weight loss, joint pain (arthralgia), low white blood cell count (leukopenia) and easy bruising due to a low platelet count (thrombocytopenia). Elevated liver transaminases may also be present.
  
  Section::::Infection.:Risk factors.
   The earliest signs may include: masseter muscle contracture following administration of succinylcholine, a rise in end-tidal carbon dioxide concentration (despite increased minute ventilation), unexplained tachycardia, and muscle rigidity. Despite the name, elevation of body temperature is often a late sign, but may appear early in severe cases. Respiratory acidosis is universally present and many patients have developed metabolic acidosis at the time of diagnosis. A fast rate of breathing (in a spontaneously breathing patient), cyanosis, hypertension, abnormal heart rhythms, and high blood potassium may also be seen. Core body temperatures should be measured in any patient undergoing general anesthesia longer than 30 minutes.
   Section::::Treatment.
  
  Currently, no specific treatment for chikungunya is available. Supportive care is recommended, and symptomatic treatment of fever and joint swelling includes the use of nonsteroidal anti-inflammatory drugs such as naproxen, non-aspirin analgesics such as paracetamol (acetaminophen) and fluids. Aspirin is not recommended due to the increased risk of bleeding. Despite anti-inflammatory effects, corticosteroids are not recommended during the acute phase of disease, as they may cause immunosuppression and worsen infection.
   Pain in or around the hip and/or limp in children can be due to a large number of conditions. Septic arthritis (a bacterial infection of the joint) is the most important differential diagnosis, because it can quickly cause irreversible damage to the hip joint. Fever, raised inflammatory markers on blood tests and severe symptoms (inability to bear weight, pronounced muscle guarding) all point to septic arthritis, but a high index of suspicion remains necessary even if these are not present. Osteomyelitis (infection of the bone tissue) can also cause pain and limp.
   In the acute phase of chikungunya, the virus is typically present in the areas where symptoms present, specifically skeletal muscles, and joints. In the chronic phase, it is suggested that viral persistence (the inability of the body to entirely rid itself of the virus), lack of clearance of the antigen, or both, contribute to joint pain. The inflammation response during both the acute and chronic phase of the disease results in part from interactions between the virus and monocytes and macrophages. "Chikungunya virus" disease in humans is associated with elevated serum levels of specific cytokines and chemokines. High levels of specific cytokines have been linked to more severe acute disease: interleukin-6 (IL-6), IL-1β, RANTES, monocyte chemoattractant protein 1 (MCP-1), monokine induced by gamma interferon (MIG), and interferon gamma-induced protein 10 (IP-10). Cytokines may also contribute to chronic "Chikungunya virus" disease, as persistent joint pain has been associated with elevated levels of IL-6 and granulocyte-macrophage colony-stimulating factor (GM-CSF). In those with chronic symptoms, a mild elevation of C-reactive protein (CRP) has been observed, suggesting ongoing chronic inflammation. However, there is little evidence linking chronic "Chikungunya virus" disease and the development of autoimmunity.
   In August 2013 further reports tied to the New England compounding center said that about 750 people were sickened, including 63 deaths, and that infections were linked to more than 17,600 doses of methylprednisolone acetate steroid injections used to treat back and joint pain that were shipped to 23 states. At that time, another incident was reported after at least 15 people at two Texas hospitals developed bacterial infections. All lots of medications dispensed since May 9, 2013, made by Specialty Compounding, LLC of Cedar Park, Texas were recalled. The hospitals reported affected were Corpus Christi Medical Center Bay Area and Corpus Christi Medical Center Doctors Regional. The patients had received intravenous infusions of calcium gluconate, a drug used to treat calcium deficiencies and too much potassium in the blood. Implicated in these cases is the Rhodococcus bacteria, which can cause symptoms such as fever and pain.
   In the main, patients are mostly free of other symptoms. Fever is rare. There no signs of local inflammation or lymphatic involvement. Laboratory tests are generally normal or within reference limits.
  
  Section::::Cause.
  
  The cause is unknown but allergic and auto-inflammatory mechanisms have been proposed.
  
  In a 1957 review of IH, Mattingly did not find evidence that the condition is inherited unlike Reimann who, in 1974, describes the condition as “heritable, non-inflammatory, and afebrile”.
  
presuppositions: High fever causes achy joints. Fever causes achy joints.
corrections: High fever does not cause achy joints. Achy joints aren't caused by fever but by other immune system activities.
raw_presuppositions: High fever causes achy joints. Fever causes achy joints.
raw_corrections: High fever does not cause achy joints. Achy joints aren't caused by fever but by other immune system activities.