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Accuracy of the Axillary Temperature Screening Compared to Core Rectal Temperature in Infants
Yazeed Alayed1, Mohammed A Kilani2, Abdullah Hommadi3
1Paediatric Resident, King Saud Medical City, Paediatric Hospital, Riyadh, Saudi Arabia.
Insights
Rectal temperature measurement is more sensitive than axillary temperature in infants presenting with fever. This study highlights the importance of rectal temperature for accurate diagnosis in pediatric emergency care.
Area of Science:
- Pediatrics
- Emergency Medicine
- Clinical Thermometry
Background:
- Accurate temperature measurement is crucial for diagnosing fever in infants.
- Axillary and rectal temperatures are commonly used methods, but their comparative sensitivity in infants is debated.
- Fever in infants can indicate serious underlying conditions requiring prompt diagnosis.
Purpose of the Study:
- To compare the diagnostic sensitivity of axillary versus rectal temperature measurements in infants presenting to the emergency department with a history of fever.
- To evaluate the accuracy of axillary temperature in detecting fever compared to the gold standard rectal temperature.
- To determine the clinical utility of each method for prompt diagnosis in pediatric emergency settings.
Main Methods:
- A single-center, cross-sectional comparative study involving 201 infants (up to 12 months) with a recent history of fever.
- Demographic data, including age, gender, and weight, were collected.
- Mean axillary and rectal temperatures were recorded, with fever defined as rectal temperature >38°C and axillary temperature >37.4°C.
Main Results:
- The mean rectal-axillary temperature difference was 0.8°C ± 0.7°C, a statistically significant finding (P < .001).
- The axillary method demonstrated a sensitivity of 79.34% for detecting fever (defined by rectal temperature).
- Specificity, positive predictive value, and negative predictive values for the axillary method were 14.3%, 96.2%, and 2.4%, respectively.
Conclusions:
- The rectal temperature method remains essential for accurate and timely diagnosis of fever in infants.
- Axillary temperature measurement shows lower sensitivity and specificity compared to rectal measurements in this population.
- Clinical decisions regarding fever management in infants should consider the superior accuracy of rectal thermometry.
Abstract:
Purpose. To compare the sensitivity of axillary and rectal temperature in infants who presents to the emergency department with a recent history of fever. Methods. A single-center cross-sectional comparative study of 201 patients who presents with a recent history of fever. Infants Up to 12 months of age were included. Demographic characteristics such as age and gender, weight, mean axillary and rectal temperatures were documented. Fever is defined as rectal temperature >38°C as opposed to >37.4 in the axillary method. Results. The mean age was 6.1 ± 3.5 months. The mean (SD) rectal-axillary temperature difference was 0.8°C ± 0.7°C which was statistically significant (P < .001). The sensitivity, specificity, positive predictive and negative predictive values of the axillary method for fever >37.4 were 79.34% (95% CI [73-84.9]), 14.3% (95% CI [0.36-57.9]), 96.2% (95% CI [95-97.2]), and 2.4% (95% CI [0.4-13.5]), respectively. Conclusion. The rectal method remains highly important for accurate and prompt diagnosis in infants.
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