Chronic inflammation involves prolonged active inflammation, tissue destruction, and repair that lasts weeks to months. It is caused by persistent infections, prolonged exposure to toxic agents, or autoimmune disorders. Chronic inflammation is characterized by mononuclear cell infiltration, ongoing tissue damage, and attempts at healing through angiogenesis and fibrosis. A granuloma forms as a cellular attempt to contain a difficult to eradicate offending agent, consisting of aggregated macrophages surrounded by lymphocytes and occasionally plasma cells. Systemic effects of inflammation include fever, acute phase protein production, leukocytosis, and symptoms like anorexia and somnolence.