Related Experiment Videos
Relative bradycardia is not a feature of enteric fever in children
T M Davis1, A E Makepeace, E A Dallimore
1University of Western Australia, Department of Medicine, Fremantle Hospital, Australia. tdavis@cyllene.uwa.edu.au
Insights
Children with enteric fever do not exhibit relative bradycardia. Pulse rate is linked to age and temperature, not the specific infection type in children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiology
Background:
- Enteric fever is a significant global health concern, particularly in children.
- Relative bradycardia (slower than expected heart rate) has been anecdotally associated with enteric fever, but lacks robust investigation in pediatric populations.
- Understanding pulse-temperature relationships is crucial for accurate diagnosis and management of febrile illnesses in children.
Purpose of the Study:
- To investigate the relationship between pulse rate and body temperature in children diagnosed with enteric fever compared to those with other infections.
- To determine if relative bradycardia is a characteristic clinical feature of enteric fever in children.
- To identify factors influencing pulse rate in children with febrile illnesses.
Main Methods:
- A comparative study involving 66 children with enteric fever and 76 children with other infections.
- Utilized multiple linear regression analysis to assess the association of pulse rate with age, oral temperature, diagnostic group, and gender.
- Adjusted baseline pulse rates for age (72 months) to enable direct comparison between groups.
Main Results:
- Children with enteric fever were older than those with other infections but had similar mean oral temperatures.
- Baseline pulse rates were lower in the enteric fever group, but this difference disappeared after age adjustment.
- Pulse rate was independently associated with age (inversely) and oral temperature (positively), but not diagnostic group or gender.
- During treatment, children with enteric fever had slightly higher temperatures and age-adjusted pulse rates compared to the other infection group.
Conclusions:
- Relative bradycardia is not a characteristic clinical finding in children with enteric fever.
- Age and oral temperature are significant independent predictors of pulse rate in children with febrile illnesses.
- The findings underscore the importance of considering age-specific physiological parameters when interpreting vital signs in pediatric patients.
Abstract:
We investigated pulse-temperature relationships in 66 children with enteric fever (group 1) and in 76 with other infections (group 2). Group 1 children were older than group 2 children (mean age +/- SD, 91 +/- 36 vs. 66 +/- 32 months, respectively; P < .001) and had mean oral temperatures +/- SD similar to those of group 2 children (38.3 +/- 1.0 vs. 38.3 +/- 0.9 degrees C, respectively; P > .2); however, group 1 children had lower mean baseline pulse rates +/- SD than did group 2 children (119 +/- 25 vs. 127 +/- 28 beats/min, respectively; P < .001). In a multiple linear regression model, pulse rate was independently associated with age (inversely; P < .001) and oral temperature (positively; P < .006) but not with diagnostic group or gender (P > .5). After adjustment of the mean initial pulse rate +/- SD to age of 72 months, there was no difference between group 1 and group 2 children (126 +/- 24 vs. 126 +/- 20 beats/min, respectively; P > .5). From 4 to 72 hours after commencement of treatment, the mean oral temperature in group 1 patients was approximately 0.3 degrees C higher than that in group 2 patients, and the age-adjusted pulse rate was 5 beats/min higher in group 1 children than in group 2 children. These data suggest that relative bradycardia is not characteristic of enteric fever in children.