Fever in children

WikiDoc Resources for Fever in children
Articles
Most recent articles on Fever in children Most cited articles on Fever in children Review articles on Fever in children Articles on Fever in children in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Fever in children Images of Fever in children Photos of Fever in children Podcasts & MP3s on Fever in children Videos on Fever in children
Evidence Based Medicine
Cochrane Collaboration on Fever in children Bandolier on Fever in children TRIP on Fever in children
Clinical Trials
Ongoing Trials on Fever in children at Clinical Trials.gov Trial results on Fever in children Clinical Trials on Fever in children at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Fever in children NICE Guidance on Fever in children NHS PRODIGY Guidance FDA on Fever in children CDC on Fever in children
Books
Books on Fever in children
News
Fever in children in the news Be alerted to news on Fever in children News trends on Fever in children
Commentary
Blogs on Fever in children
Definitions
Definitions of Fever in children
Patient Resources / Community
Patient resources on Fever in children Discussion groups on Fever in children Patient Handouts on Fever in children Directions to Hospitals Treating Fever in children Risk calculators and risk factors for Fever in children
Healthcare Provider Resources
Symptoms of Fever in children Causes & Risk Factors for Fever in children Diagnostic studies for Fever in children Treatment of Fever in children
Continuing Medical Education (CME)
CME Programs on Fever in children
International
Fever in children en Espanol Fever in children en Francais
Business
Fever in children in the Marketplace Patents on Fever in children
Experimental / Informatics
List of terms related to Fever in children

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Synonyms and keywords: Fever in kids

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

• Fevers may be classified based on duration into:
  • Acute fevers: <7 days duration, if untreated it can become persistent or chronic, attributes to infectious disease such as upper respiratory tract infection and malaria.
  • Sub-acute fevers: <2 weeks, seen in typhoid fever and intra-abdominal abscess.
  • Chronic fevers: >2 weeks, typical of chronic bacterial infections like tuberculosis, viral infections like HIV, cancers and connective tissue diseases.

• fevers 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	98.6-100.4
Mild/low grade fever	38.1-39	100.5-102.2
Moderate grade fever	39.1-40	102.2-104.0
High grade fever	40.1-41.1	104.1-106
Hyperpyrexia	>41.1	>106.0

-Hyperpyrexia in severe malaria is defined as rectal tem-perature above 40◦C

Pathophysiology

The pathophysiological mechanisms for the injurious effects of a fever, classified as follows:

• 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:

• Dyspnea
• Vomiting
• Rash
• Seizures

Serious bacterial infections include:

• Meningitis
• Septicaemia
• Pneumonia

Causes of undiagnosed fever in children include:

• 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].