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Hyperpyrexia among infants younger than 3 months

Rachel Stanley1, Zrinka Pagon, Richard Bachur

  • 1Department of Emergency Medicine, Hurley Medical Center, University of Michigan, Ann Arbor, MI, USA. stanleyr@med.umich.edu

Pediatric Emergency Care
|May 6, 2005
PubMed

Insights

Hyperpyrexia is rare in infants under 3 months but indicates a high risk of serious bacterial infection (SBI). Nearly 40% of infants with temperatures of 40°C or higher had SBI, primarily urinary tract infections.

Area of Science:

  • Pediatrics
  • Infectious Disease
  • Emergency Medicine

Background:

  • Fever in infants under 3 months necessitates careful evaluation for serious bacterial infection (SBI).
  • Hyperpyrexia (temperature ≥40°C) is uncommon but may signify a higher risk of infection.

Purpose of the Study:

  • To determine the prevalence of SBI in infants younger than 3 months presenting with fever ≥40°C.
  • To compare the incidence of SBI in infants with hyperpyrexia versus those with lower fevers.

Main Methods:

  • Retrospective review of medical records for infants <3 months with fever presenting to a pediatric emergency department.
  • Comparison of SBI prevalence between infants with hyperpyrexia (≥40°C) and those with lower fevers.

Main Results:

  • Of 5279 febrile infants, 98 (1.7%) had hyperpyrexia (≥40°C).
  • SBI was diagnosed in 38% of infants with hyperpyrexia, most commonly urinary tract infections (71%).
  • SBI prevalence was significantly higher in infants with hyperpyrexia (38%) compared to those with lower fevers (8.8%).

Conclusions:

  • Hyperpyrexia is a rare but significant finding in febrile infants.
  • Infants with hyperpyrexia have a substantially increased risk of SBI.
  • Consideration of hyperpyrexia as a risk factor in clinical algorithms for febrile infants is warranted.
Abstract

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