How often have you noticed the chief complaint of “fever for 3 days” but the patient does not have a fever in the office? This is often of concern in pediatrics where a fever in small children may suggest need for medical tests and hospital observation. A recently completed ethnographic study of fever and dizziness in Cambodians living in Seattle has helped us understand more about this dilemma. The common term for illness in Cambodian is “krun” and it does not necessarily mean there is an elevated body temperature. (Only 2 of 26 informants indicated that they took a temperature at home and their ideas of an elevated temperature ranged from 96 to 103 degrees.) The common translation of “krun” into English is “fever”. “Krun” was used by our informants to describe a wide range of symptoms including “feeling ill”, “feeling hot and cold”, having a specific illness such as ear infection, common cold or flu and “having a warm body”. Providers who hear this complaint of fever or “krun” need to ask specifically if the patient’s body has felt hotter than normal. Krun associated with a hot body temperature is considered a concerning and potentially dangerous illness. Similar terms and translation confusions are found in Thai, Laotian and Vietnamese.
References
Muecke, Marjorie. In Search of Healers – Southeast Asian Refugees in the American Health Care System. West J Med, 1983; 139:835-840.