chills

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Classification according to ICD-10
R50.8 Other specified fever
B54 Malaria, unspecified
R68.8 Other specified general symptoms
ICD-10 online (WHO version 2019)

Chills or feverish frost ( Latin: Febris undularis ) refers to involuntary, rapid trembling movements of the skeletal muscles. These are usually accompanied by a feeling of cold. Often the chills are the sick person's feeling of frost that leads to the illness - especially as a fever in acute febrile illnesses ( intermittent fever attack ). It also occurs as an accompanying symptom of other different diseases .

Appearance

Chills are expressed by a tremor of the skeletal muscles associated with a feeling of cold , a rapid and persistent sequence of contraction and slackening . Chills cannot be deliberately influenced. The major muscles of the thighs and back are particularly affected , but also the masticatory muscles . As heat is generated when the muscles are exercised, the body is heated up. Chills usually come on in bouts of a few minutes.

A distinction is often made between four stages of chills:

  1. Increase in temperature (typical muscle tremors and chattering teeth)
  2. High temperature (signs of heat such as dry, hot skin and thirst)
  3. Defever (strong sweats)
  4. Exhaustion sleep (deep sleep for regeneration / recovery)

The appearance is similar to muscle tremors when the body is hypothermic . The rapid clonic spasms of many muscles, which are the only characteristic of a chill, cannot, however, be differentiated with certainty from the simple tremor that many normal people exhibit in excitement.

causes

In healthy people, the liver's metabolic processes and normal muscle activity are sufficient to maintain a core temperature of around 37 ° C. In the event of an infection by pathogens, this setpoint can be adjusted to a higher value using pyrogens . Then the current body temperature represents an actual value that is too low, whereupon the regulation system reacts by increasing the body temperature by means of muscle tremors, changes in metabolism and blood flow to the limbs (see thermoregulation ).

Chills can appear as a symptom of various diseases. Often there is a febrile illness such as malaria or influenza ; but also with a sunstroke it can come to chills. Other typical illnesses are pneumonia , scarlet fever , wound rose , tetanus , inflammation of the renal pelvis and fungal or blood poisoning . Chills may develop as a symptom of mastitis in breastfeeding women .

In addition to these pathological causes, chills can also arise from a purely physiological point of view as a result of sudden, large or long-lasting exposure to cold ( shivering cold ).

Diagnosis

The chills provides a strong stress on the heart and circulation and metabolism. Because there often is a septic bacteria seeding in the blood (which chills bacteremia is), can arise as a consequence new outbreaks ( sepsis ), should be as a blood culture to be removed .

The usual other inflammation and pathogen diagnostics to search for a source of inflammation in the body is also necessary.

Differential diagnostics

therapy

Chills can be stopped by giving an opiate or opioid intravenously , such as tramadol . The use of thermal blankets is also useful. A hot bath (possibly with nettle) is a quick remedy and in an emergency is the most obvious solution of the old home medicine. As a rule, antibiotic treatment will also begin after a bacteriological diagnosis has been taken .

literature

  • Ferdinand Held: The chills: its diagnostic and prognostic significance. Inaugural dissertation at the University of Halle-Wittenberg. 1872.
  • Ulrich Ebbecke: Chills in cold, fever and affect. Klinische Wochenschrift 26, pp. 39-40 (1948): pp. 609-613.

Web links

Wiktionary: Chills  - explanations of meanings, word origins, synonyms, translations
  • Chills - Article in Meyers Großes Konversations-Lexikon 1905 (via Zeno.org )

Individual evidence

  1. ↑ a b c Alphabetical directory for the ICD-10-WHO Version 2019, Volume 3. German Institute for Medical Documentation and Information (DIMDI), Cologne, 2019, p. 787.
  2. ↑ a b Susanne Schewior-Popp, Renate Fischer: Examination care. Written exam day 2 . Thieme, Stuttgart; Edition: 1 (March 21, 2007). P. 220.
  3. ↑ Chills - Article in Meyers Großes Konversations-Lexikon 1905 (via Zeno.org )
  4. ↑ Annette Lauber, Petra Schmalstieg: Understanding & Care, Volume 2: Perceiving and Observing . Thieme, Stuttgart; Edition: 1 (July 2007). ISBN 978-3131285911 . Page 172/173.
  5. ↑ Richard C. Cabot, H. Ziesché: Chills. Differential diagnosis. Springer, Berlin Heidelberg 1922, pp. 367-388.
  6. ↑ Hermann Sebastian Füeßl: Internal medicine in questions and answers . Thieme, Stuttgart; Edition: 8th, unchanged. A. (December 10, 2003). P. 350.