Vomiting is an unpleasant experience and more so when it arises suddenly with no obvious cause. The reasons for vomiting varies but it usually indicates an irritation of the upper part of the gut. Foods, beverages, medication and even psychological stress can cause vomiting. However, when fever is present with vomiting then it is more likely to be associated with an infection.
Why does vomiting occur with fever?
The presence of two or more symptoms can be due to the same cause. Often it is incorrectly thought that vomiting can be caused by fever and vice versa. However, this is unlikely. Instead both the vomiting and fever are due to the same cause, like an infection. While a fever may occur with a host of different infections, the simultaneous occurrence of vomiting is indicative of an infection that involves the digestive system.
It is important to understand why vomiting occurs and why fever occurs as two different clinical signs. Firstly, vomiting is most commonly due to irritation of the gastrointestinal tract. This irritation is caused by a host of stimuli, such as toxins, infectious agents, certain foods and drinks and so on. The nerves from the gut then carries signals to the vomiting centers of the brain.
Vomiting is elicited as a way of eliminating these irritants from the gut. The muscles in the wall of the upper gut contract and relax with force and in a rhythmic manner to push the gastrointestinal contents in the reverse direction. Evetually these contents are pushed out of the mouth in a process referred to as vomiting. Sometimes the vomiting centers are stimulated by substances in the bloodstream despite the lack of gut irritation.
A fever on the other hand is a rise in body temperature above the normal range. Although the normal body temperature is 98.6°F (37°C), there can be some fluctuation from 97°F (36.1°C) to 99°F (37.2°C) which is still considered normal. Once the temperature exceeds 100.4°F (38°C) then it is classified as a fever. It occurs as a result of the themoregulatory center in the brain being disrupted which allows the body temperature to rise above normal.
Causes of Vomiting with Fever
Vomiting is a symptom in a wide range of conditions, as is a fever. It is therefore important to look at the conditions where vomiting and fever are present simultaneously. Some of the more common conditions have been discussed below. However, there may be other causative conditions, some of which can be serious and life threatening in a short period of time. Therefore it is important to seek medical attention when symptoms like vomiting and fever arise, especially if it is worsening.
Most of the time vomiting with a fever is due to infectious gastroenteritis. This is inflammation of the stomach (gastro-) and small intestine (enteritis) which may be caused by viruses, bacteria or protozoa. The toxins produced by some of these infectious agents can also cause gastroenteritis, even if the virus, bacteria or protozoa is absent. However, not every case of infectious gastroenteritis results in fever or vomiting.
For example, in cholera which is caused by the Vibrio cholerae bacteria, there is vomiting but usually there is no fever. On the other hand, with an infection caused by the Campylobacter species of bacteria there is fever but no vomiting. Since not all cases of gastroenteritis are due to infections or biological toxins, there may be no fever in these non-infectious cases as well.
Other symptoms: Diarrhea, nausea and abdominal pain.
Gallstones may also present with vomiting and fever. These stones form from the bile in the gallbladder. It may pass out of the gallblader unnoticed if the stones are small. However, slightly larger stones can block the ducts of the gallbladder thereby leading to a build up of bile and this may lead to inflammation of the gallbladder (cholecystitis). Women around the age of forty and who are overweight are more commonly affected.
Other symptoms: Nausea and upper middle abdominal pain.
Appendicitis is inflammation of the vermiform appendix, a small outpouching from the large intestine. It may become obstructed and infected. If left untreated, the appendix can burst and cause a condition known as peritonitis. The infection may spread and even enter the bloodstream which can result in serious and even life threatening complications. Fever and vomiting are common symptoms in acute appendicitis.
Other symptoms: Lower right abdominal pain, abdominal tenderness, abdomial bloating, nausea, constipation or diarrhea.
Hepatitis is inflammation of the liver and most of the time it is caused by a viral infection. Hepatitis A is one of the more common types of viral hepatitis and it is highly contagious. The infection is most commonly acquired from food or water that is contaminated with fecal particles from a person who has the infection. Mild cases may not be serious but in some cases the infection can be severe and lead to liver failure.
Other symptoms: Fatigue, nausea, jaundice, abdominal pain, pale stools and dark urine.
Meningits and Encephalitis
Meningitis and encephalitis are infections of the central nervous system. Meningitis involves the lining around the brain and spinal cord, known as the meninges. Encephalitis involves the brain. Both of these infections are serious and potentially life threatening without immediate medical care. Fever is one of the first symptoms and is often high. Vomiting is less prominent in encephalitis and mainly seen in infants and young children.
Other symptoms: Headaches, neck stiffness, light sensitivity, confusion and seizures.
Kidney and Urinary Tract Infection
A kidney infection (pyelonephritis) can occur when infectious agents, particularly bacteria, reach the kidney. It usually arises as a complication of a urinary tract infection (UTI) where bacteria ascend to the kidneys. Sometimes these bacteria may reach the kidney through the bloodstream from an infection elsewhere in the body. Vomiting and fever are common symptoms of pyelonephritis and may in some cases even occur with lower urinary tract infections.
Other symptoms: Flank and back pain, frequent urination, persistent urge to urinate, nausea, burning when urinating and urine that smells bad with blood or pus.
- Autoimmune conditions such as systemic lupus erythematosus (SLE) or Crohn’s disease (IBD)
- Brain abscess
- Other drugs
- Illicit substances
- Infections like ebola, chikungunya,dengue, Rocky Mountain spotted fever, tularemia, fluke infestation.