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Fever, Pediatric

Fever, Pediatric is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Fever is defined as a temperature of 38°C (100.4°F) rectally:
    • Oral and tympanic temperatures are generally 0.6°C–1°C lower.
  • Tympanic temperatures are not accurate in children younger than 6 mo.
  • Axillary temperatures are generally unreliable.
  • Children who are afebrile but have a reliable history of documented fever should be considered to be febrile to the degree reported.

Etiology

  • Bacteremia (Haemophilus influenzae type B, Streptococcus pneumoniae), viral illness, often accompanied by exanthem (varicella, roseola, rubella), coxsackievirus (hand-foot-and-mouth disease), abscess:
    • H. influenzae type B and S. pneumoniae vaccines have reduced incidence of Haemophilus and pneumococcal disease
  • CNS: Meningitis, encephalitis
  • Head, eyes, ears, neck, and throat (HEENT): Otitis media, facial cellulitis, orbital/periorbital cellulitis, pharyngitis (group A β-hemolytic streptococcus, herpangina, adenovirus pharyngoconjunctival fever), viral gingivostomatitis (herpes and coxsackievirus), cervical adenitis, sinusitis, mastoiditis, conjunctivitis, peritonsillar/retropharyngeal abscess
  • Respiratory: Croup (paramyxovirus), epiglottitis, bronchiolitis (respiratory syncytial virus [RSV]), pneumonia, empyema, influenza
  • Cardiovascular: Purulent pericarditis, endocarditis, myocarditis
  • Genitourinary (GU): Cystitis, pyelonephritis
  • GI: Bacterial diarrhea, intussusception, appendicitis, hepatitis
  • Extremity: Osteomyelitis, septic arthritis, cellulitis
  • Miscellaneous: Herpes simplex virus infection in the neonate, Kawasaki disease, vaccine (DPT) reaction, heat exhaustion/stroke, factitious, familial dysautonomia, thyrotoxicosis, collagen vascular disease, vasculitis, rheumatic fever, malignancy, drug induced, overbundling (uncommon, recheck 15 min after unbundling)

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Citation

Rosen, Peter, et al., editors. "Fever, Pediatric." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307391/all/Fever_Pediatric.
Fever, Pediatric. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307391/all/Fever_Pediatric. Accessed June 27, 2019.
Fever, Pediatric. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307391/all/Fever_Pediatric
Fever, Pediatric [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 June 27]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307391/all/Fever_Pediatric.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Fever, Pediatric ID - 307391 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307391/all/Fever_Pediatric PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -