Blog

Curator of the 2nd Pediatric Clinic of the Athens Pediatric Center

Fever is a non-specific sign that occurs in a wide range of diseases. Axillary temperature measurement is the method preferred by parents and doctors. The temperature range in young children ranges from 35.2-37^o C.

Fever is defined as an axillary temperature greater than 37^o C or greater than 38^o C in a rectal thermometer.

The effects of fever on the physiology of the body include:

• increased metabolic rate
• tachypnea
• tachycardia
• malaise
• irritability
• vasodilation causing red, moist, and warm skin

The differential diagnosis between microbial or viral infection is a serious challenge.

The history of a sick child with a fever should focus on changes in activity, behavior, appetite, thirst, and water excretion.

A detailed physical examination is required by the pediatrician, which may reveal the source of the infection or even a change in behavior.

Signs of complacency include spontaneous eye contact, interest in the environment, vocalization and communication with parents, and smiling.

Investigation of fever in infants who do not show a source of infection includes blood cultures, a complete blood count, urinalysis, and urine culture.

A virus can be identified in 40% of febrile illnesses if adequate investigation is performed. With the improvement of techniques, this percentage may increase, although in everyday clinical practice, virological studies are usually reserved for cases where the diagnosis is considered necessary. Fever above 42^o C is rare and is usually due to trauma to the central nervous system or heat stroke rather than infection.

Treatment of fever

Treatment is not required for all types of fever.

It is more important to treat the patient than their temperature.

Fever is a normal response to infection.

Parental complacency is important. They should know how to treat fever, what to expect from treatment, and when to seek pediatric help.

Parents should seek medical help for children over 2 years of age: if the fever does not respond to antipyretic treatment, if it persists for more than 48-72 hours, if the child has a hemorrhagic rash, if he refuses to drink fluids, if he is unresponsive, or if he is irritable.

Symptomatic fever reduction includes:

1. Adequate oral hydration with cool fluids.
2. Removal of bed linens and clothing to reduce heat retention.
3. Administering antipyretics as directed by a physician.
4. Warm water compresses to facilitate evaporation from skin surfaces.