Discrepancies Between Ear and Axillary Temperatures - Internal Medicine

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Understanding discrepancies between ear and axillary temperatures can be quite complex, especially for individuals with underlying health conditions such as rheumatoid arthritis (RA) and asthma, as you mentioned. The differences in temperature readings can arise from several factors, including the method of measurement, the physiological state of the body, and even the specific conditions affecting the individual.

Firstly, it’s important to understand how temperature is measured. Ear thermometers (tympanic thermometers) measure the infrared heat emitted by the eardrum and surrounding tissue, while axillary thermometers measure the temperature of the skin in the armpit. Generally, ear temperatures are considered to be more reflective of core body temperature than axillary readings, but they can still vary due to several factors, including the technique used during measurement and the presence of earwax or other obstructions in the ear canal.

In your case, you’ve noted that your ear temperatures often read around 38 degrees Celsius while your axillary temperatures remain normal or even low. This discrepancy could be attributed to several factors:
1. Infection and Inflammation: Since you have a history of acute asthma exacerbation and fever, it’s possible that your body is still in a state of heightened immune response. Inflammatory processes can lead to localized increases in temperature, which may be more pronounced in the ear area due to increased blood flow or inflammation in the surrounding tissues.

2. Autonomic Nervous System Response: Conditions like RA can affect the autonomic nervous system, which regulates body temperature. This dysregulation can lead to sensations of heat in certain areas (like the head) without a corresponding increase in overall body temperature.

3. Measurement Technique: Variability in measurement technique can also lead to discrepancies. For example, if the ear thermometer is not positioned correctly, it may yield higher readings. Consistency in measurement technique is crucial for accurate tracking of temperature changes.

4. Environmental Factors: External factors such as room temperature, humidity, and even the time of day can influence temperature readings. Body temperature naturally fluctuates throughout the day, typically being lower in the morning and higher in the late afternoon and evening.

5. Underlying Conditions: Autoimmune conditions like RA can lead to systemic inflammation, which might manifest as localized temperature changes. Additionally, if there is any ongoing infection, even if it is not overtly symptomatic, it could contribute to these temperature discrepancies.

Given your situation, it would be prudent to continue monitoring your temperatures as advised by your physician. If you notice persistent discrepancies or if you experience other symptoms such as increased fatigue, joint pain, or changes in your respiratory status, it would be wise to consult your healthcare provider. They may consider further investigations to rule out any underlying infections or complications related to your autoimmune condition.

In summary, while discrepancies between ear and axillary temperatures can be concerning, they can often be explained by a combination of measurement technique, physiological responses, and underlying health conditions. Regular monitoring and communication with your healthcare provider will be key in managing your health effectively.