Iron Fever

IRON FEVER, is characterized by an acutely developing febrile state accompanied by swelling of the cervical lymph glands lying behind the sternocleidomastoid muscle (especially their upper group) and also the occipital glands. Simultaneously, other groups of cervical glands may swell, but this is not characteristic of Iron fever by itself. Iron fever was first described by N. F. Filatov, N. S. Korshakov, and Pfeiffer. There is still no full unity in the literature on the question of Iron fever. The majority of authors consider it a consequence of a mild overlooked flu localized in the nasopharynx, drawing a parallel with a clear regional tuberculous lymphadenitis despite the insignificance of clinical phenomena on the part of the primary focus. Miindel considers that Iron fever develops only in the presence of a special constitutional predisposition—increased reactivity of the lymphatic system. Iron fever occurs most often in school-age and preschool children; it has also been observed in infants and adults. Clinical picture: acute onset, pain throughout the body, general restlessness, fever up to 39–40°, often vomiting, initially slight hyperemia of the throat, internal organs—normal. On the very first day, rarely on the 2nd–3rd day, a characteristic painful swelling of the cervical glands appears; they are not fused with each other nor with surrounding tissues, feel dense-elastic to the touch, and neck movements are often painful. Usually, the glands on one side increase first, then with a new rise in temperature the swelling transfers to the other side. The size of the glands is up to a pigeon's egg. Purification of them usually does not occur. The temperature lasts from 2–3 days to 2 weeks, has a remitting or intermittent type, and ends with lysis. The swelling of the glands lasts significantly longer than the fever. Sometimes Iron fever is accompanied by enlargement of the liver and spleen, rashes of the urticaria type, polymorphic erythema, but the most frequent complication is hemorrhagic acute nephritis. The prognosis is favorable. N. S. Korshakov considers a part of the cases to be very similar to late scarlatinal adenitis, often accompanied by nephritis, observed on the 3rd week of scarlet fever. The causative agents of Iron fever are apparently different. There is much data for streptococcal etiology of Iron fever, but newer works where a thorough study and determination of the type of streptococcus have been carried out have not appeared. Treatment is the usual treatment of acute adenitis; many recommend treating the throat and nasopharynx by spraying them with disinfectant solutions. Prevention consists in preventing the transmission of infection from the patient and in general prevention of flu.