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Shivering in Febrile Children: Frequency and Usefulness in Predicting Serious Bacterial Infections - A Prospective

Yair Erell1, Ilan Youngster2, Ibrahim Abu-Kishk3

  • 1Pediatric Department, Assaf Harofeh Medical Center, Zerifin, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

The Journal of Pediatrics
|September 12, 2017
PubMed

Insights

Shivering affects nearly 30% of febrile children in emergency departments. This study found no increased risk of serious bacterial infection in children who shiver.

Area of Science:

  • Pediatric Emergency Medicine
  • Infectious Diseases
  • Clinical Significance of Symptoms

Background:

  • Fever is a common symptom in children presenting to emergency departments.
  • Shivering is a frequent physiological response to fever, but its clinical significance in children is not well-defined.
  • Distinguishing benign causes of fever from serious infections is critical in pediatric care.

Purpose of the Study:

  • To determine the prevalence of shivering in febrile children in a pediatric emergency setting.
  • To evaluate the clinical significance of shivering by assessing the association with serious bacterial infection.
  • To provide data to aid clinicians in the management of febrile children.

Main Methods:

  • Prospective case-control study design.
  • Inclusion of febrile children presenting to a pediatric emergency department.
  • Matching of children with shivering to controls without shivering based on relevant clinical factors.

Main Results:

  • Shivering was observed in 186 out of 645 febrile children, a prevalence of 28.8%.
  • The incidence of serious bacterial infection was comparable between the group of children who shivered (86 cases) and their matched controls (86 cases).

Conclusions:

  • Shivering is a common finding in febrile children in the emergency department.
  • The presence of shivering in febrile children does not appear to be associated with an increased risk of serious bacterial infection.
  • These findings suggest that shivering alone may not be an indicator of a more severe underlying condition in febrile pediatric patients.

Keywords:
chillsfeverrigorssepsis workup

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