temperatures has been found. Central temperatures, such as rectal temperatures, are more accurate than peripheral temperatures. Fever is generally agreed to be present if the elevated temperature is caused by a raised set point and: Temperature in the anus (rectum/rectal) is at or over An ear (tympanic) or forehead (temporal) temperature may also be used. Temperature in the mouth (oral) is at or over in the morning or over in the afternoon Temperature under the arm (axillary) is usually about below core body temperature. In adults, the normal range of oral temperatures in healthy individuals is among men and among women, while when taken rectally it is among men and among women, and for ear measurement it is among men and among women. Normal body temperatures vary depending on many factors, including age, sex, time of day, ambient temperature, activity level, and more. Normal daily temperature variation has been described as 0.5 °C (0.9 °F). A raised temperature is not always a fever. For example, the temperature rises in healthy people when they exercise, but this is not considered a fever, as the set point is normal. On the other hand, a "normal" temperature may be a fever, if it is unusually high for that person; for example, medically frail elderly people have a decreased ability to generate body heat, so a "normal" temperature of may represent a clinically significant fever. Hyperthermia Hyperthermia is an elevation of body temperature over the temperature set point, due to either too much heat production or not enough heat loss. Hyperthermia is thus not considered fever. Hyperthermia is not to be confused with hyperpyrexia (which is a very high fever). Clinically, it is important to distinguish between fever and hyperthermia as hyperthermia may quickly lead to death and does not respond to antipyretic medications. The distinction may however be difficult to make in an emergency setting, and is often established by identifying possible causes. Types Various patterns of measured patient temperatures have been observed, some of which may be indicative of a particular medical diagnosis: Continuous fever, where temperature remains above normal and does not fluctuate more than in 24 hours (e.g. in bacterial pneumonia, typhoid, infective endocarditis, tuberculosis, or typhus. Intermittent fever is present only for a certain period, later cycling back to normal (e.g., in malaria, leishmaniasis, pyemia, sepsis, or African trypanosomiasis. Remittent fever, where the temperature remains above normal throughout the