Fever in children: Difference between revisions
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==Classification== | ==Classification== | ||
* | *'''Fever''' may be classified based on duration into:<ref name="pmid21843857">{{cite journal| author=Ogoina D| title=Fever, fever patterns and diseases called 'fever'--a review. | journal=J Infect Public Health | year= 2011 | volume= 4 | issue= 3 | pages= 108-24 | pmid=21843857 | doi=10.1016/j.jiph.2011.05.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21843857 }} </ref> | ||
**Acute | **'''Acute fever''': (<7 days duration), if untreated it can become [[persistent]] or [[chronic]], attributes to [[infectious]] disease such as [[upper respiratory tract infection]] (URTI) and [[malaria]]. | ||
**Sub-acute | **'''Sub-acute fever''':(<2 weeks), seen in [[typhoid fever]] and [[intra-abdominal abscess]]. | ||
**Chronic | **'''Chronic fever''': (>2 weeks), typical of [[chronic]] [[bacterial infections]] ([[tuberculosis]] [[TB]]), [[viral infections]] ([[HIV]]), [[cancers]] and [[connective tissue diseases]]. | ||
* | *[[Fever]] also can be classified based on height of body temperature into: | ||
**Low grade fever | **Low grade fever | ||
**Moderate grade fever | **Moderate grade fever | ||
**High grade fever (attributes to Serious bacterial infections in infants) | **High grade fever (attributes to Serious [[bacterial infections]] in [[infants]]) | ||
**Hyperpyrexia | **Hyperpyrexia | ||
*The height of fever may correlate with severity of illness, such as in dengue fever, shigellosis, and acute falciparum malaria. | *The height of fever may correlate with [[severity]] of [[illness]], such as in [[dengue fever]], [[shigellosis]], and [[acute]] [[falciparum malaria]]. | ||
*There are three major fever type: Sustained/continuous fever, intermittent fever and remittent fever. | *There are three major [[fever]] type: [[Sustained]]/[[continuous]] [[fever]], [[intermittent]] fever and [[remittent]] fever. | ||
**Continuous or sustained fever does not fluctuate more than about 1°C (1.5°F) during 24hours, but never touches normal, characteristics of lobar and gram negative pneumonia, typhoid, acute bacterial meningitis, and urinary tract infection. | **[[Continuous]] or [[sustained]] [[fever]] does not [[fluctuate]] more than about 1°C (1.5°F) during 24hours, but never touches normal, characteristics of [[lobar]] and [[gram negative]] [[pneumonia]], [[typhoid]], [[acute]] [[bacterial]] [[meningitis]], and [[urinary tract infection]]. | ||
{| style="border: 2px solid #4479BA; align="left" | {| style="border: 2px solid #4479BA; align="left" | ||
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! style="width: 400px; background: #4479BA;" | {{fontcolor|#FFF|°F}} | ! style="width: 400px; background: #4479BA;" | {{fontcolor|#FFF|°F}} | ||
|- | |- | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |Normal | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |'''Normal''' | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |37-38°C | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |37-38°C | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |98.6-100.4°F | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |98.6-100.4°F | ||
|- | |- | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |Mild/low grade fever | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |'''Mild/low grade fever''' | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |38.1-39°C | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |38.1-39°C | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |100.5-102.2°F | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |100.5-102.2°F | ||
|- | |- | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |Moderate grade fever | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |'''Moderate grade fever''' | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |39.1-40°C | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |39.1-40°C | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |102.2-104.0°F | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |102.2-104.0°F | ||
|- | |- | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |High grade fever | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |'''High grade fever''' | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |40.1-41.1°C | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |40.1-41.1°C | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |104.1-106°F | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |104.1-106°F | ||
|- | |- | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |Hyperpyrexia | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |'''Hyperpyrexia''' | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |>41.1°C | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |>41.1°C | ||
| style="padding: 0 5px; background: #F5F5F5; text-align: left;" |>106.0°F | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |>106.0°F |
Revision as of 04:22, 1 February 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Zaida Obeidat, M.D.
Synonyms and keywords: Fever in kids
Overview
Historical Perspective
- [Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
- In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
- In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].
Classification
- Fever may be classified based on duration into:[1]
- Acute fever: (<7 days duration), if untreated it can become persistent or chronic, attributes to infectious disease such as upper respiratory tract infection (URTI) and malaria.
- Sub-acute fever:(<2 weeks), seen in typhoid fever and intra-abdominal abscess.
- Chronic fever: (>2 weeks), typical of chronic bacterial infections (tuberculosis TB), viral infections (HIV), cancers and connective tissue diseases.
- Fever also can be classified based on height of body temperature into:
- Low grade fever
- Moderate grade fever
- High grade fever (attributes to Serious bacterial infections in infants)
- Hyperpyrexia
- The height of fever may correlate with severity of illness, such as in dengue fever, shigellosis, and acute falciparum malaria.
- There are three major fever type: Sustained/continuous fever, intermittent fever and remittent fever.
- Continuous or sustained fever does not fluctuate more than about 1°C (1.5°F) during 24hours, but never touches normal, characteristics of lobar and gram negative pneumonia, typhoid, acute bacterial meningitis, and urinary tract infection.
Body temperature | °C | °F |
---|---|---|
Normal | 37-38°C | 98.6-100.4°F |
Mild/low grade fever | 38.1-39°C | 100.5-102.2°F |
Moderate grade fever | 39.1-40°C | 102.2-104.0°F |
High grade fever | 40.1-41.1°C | 104.1-106°F |
Hyperpyrexia | >41.1°C | >106.0°F |
Pathophysiology
The pathophysiological mechanisms for the injurious effects of a fever, classified as follows:[2]
- Direct cellular damage:
- Membrane, mitochondrial and DNA damage
- Stimulation of excitotoxic mechanisms
- Protein denaturation
- Cell death
- Local effects:
- Cytokine stimulation
- Inflammatory response
- Vascular stasis
- Extravasation
- Oedema
- Systemic effects:
- Endotoxaemia
- Gut bacterial translocation
Causes
Common conditions that can cause fevers include:
- Upper respiratory tract infections (URTI)
- Flu
- Ear infections
- Roseola
- Tonsillitis
- Urinary tract infections (UTI)
- Chickenpox and Pertussis (Whooping cough)
Fever in children can sometimes associated with more serious signs and symptoms, such as:
Serious bacterial infections include:
Causes of undiagnosed fever in children include:[3]
- Infection
- Viruses
- Pyogenic Inection
- Salmonella Infection
- Brucellosis
- Tuberculosis
- Collagen Vascular Diseases
- Neoplasm
Differentiating [disease name] from other Diseases
For further information about the differential diagnosis, click here.
Epidemiology and Demographics
- The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
- In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
Age
- Patients of all age groups may develop [disease name].
- [Disease name] is more commonly observed among patients aged [age range] years old.
- [Disease name] is more commonly observed among [elderly patients/young patients/children].
Gender
- [Disease name] affects men and women equally.
- [Gender 1] are more commonly affected with [disease name] than [gender 2].
- The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
Race
- There is no racial predilection for [disease name].
- [Disease name] usually affects individuals of the [race 1] race.
- [Race 2] individuals are less likely to develop [disease name].
Risk Factors
- Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
Natural History, Complications and Prognosis
- The majority of patients with [disease name] remain asymptomatic for [duration/years].
- Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
- If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
- Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
- Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is approximately [#%].
Diagnosis
Diagnostic Criteria
- The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
- [criterion 1]
- [criterion 2]
- [criterion 3]
- [criterion 4]
Symptoms
- [Disease name] is usually asymptomatic.
- Symptoms of [disease name] may include the following:
- [symptom 1]
- [symptom 2]
- [symptom 3]
- [symptom 4]
- [symptom 5]
- [symptom 6]
Physical Examination
- Patients with [disease name] usually appear [general appearance].
- Physical examination may be remarkable for:
- [finding 1]
- [finding 2]
- [finding 3]
- [finding 4]
- [finding 5]
- [finding 6]
Laboratory Findings
- There are no specific laboratory findings associated with [disease name].
- A [positive/negative] [test name] is diagnostic of [disease name].
- An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
- Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
Electrocardiogram
There are no ECG findings associated with [disease name].
OR
An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
X-ray
There are no x-ray findings associated with [disease name].
OR
An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
Echocardiography or Ultrasound
There are no echocardiography/ultrasound findings associated with [disease name].
OR
Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
CT scan
There are no CT scan findings associated with [disease name].
OR
[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
MRI
There are no MRI findings associated with [disease name].
OR
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
Other Imaging Findings
There are no other imaging findings associated with [disease name].
OR
[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
- [Disease name] may also be diagnosed using [diagnostic study name].
- Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
- There is no treatment for [disease name]; the mainstay of therapy is supportive care.
- The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
- [Medical therapy 1] acts by [mechanism of action 1].
- Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
Surgery
- Surgery is the mainstay of therapy for [disease name].
- [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
- [Surgical procedure] can only be performed for patients with [disease stage] [disease name].
Prevention
- There are no primary preventive measures available for [disease name].
- Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
- Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
References
- ↑ Ogoina D (2011). "Fever, fever patterns and diseases called 'fever'--a review". J Infect Public Health. 4 (3): 108–24. doi:10.1016/j.jiph.2011.05.002. PMID 21843857.
- ↑ Walter EJ, Hanna-Jumma S, Carraretto M, Forni L (2016). "The pathophysiological basis and consequences of fever". Crit Care. 20 (1): 200. doi:10.1186/s13054-016-1375-5. PMC 4944485. PMID 27411542.
- ↑ BREWIS EG (1965). "CHILD CARE IN GENERAL PRACTICE. UNDIAGNOSED FEVER". Br Med J. 1 (5427): 107–9. PMC 2165027. PMID 14218464.