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High fever in children usually indicates common illnesses, not serious conditions. Prompt medical attention is crucial, but most children recover without hospitalization or antibiotics.
Area of Science:
- Pediatrics
- Infectious Diseases
Background:
- High fever in children is a common presenting complaint in emergency departments.
- Distinguishing between benign and severe causes of fever is critical for appropriate management.
Purpose of the Study:
- To analyze the causes and outcomes of high fever in pediatric patients.
- To evaluate the necessity of hospitalization and antibiotic use for febrile children.
Main Methods:
- Retrospective review of 516 pediatric patient charts with temperatures of 40°C (104°F) or higher.
- Analysis of presenting illnesses, diagnostic workups, treatment decisions, and patient outcomes.
Main Results:
- Most high fevers were associated with common childhood illnesses like respiratory infections and gastroenteritis.
- Only 4% of children required hospital admission, and one death occurred due to delayed medical care.
- Febrile seizures were linked to anticonvulsant compliance, not fever reduction methods.
Conclusions:
- High fever in children is typically benign and often managed effectively on an outpatient basis.
- Diagnostic testing and antibiotic use should be guided by clinical findings, not solely by fever height.
- Parental education on fever management and discouraging traditional methods is important.
Abstract:
A total of 516 charts of children who presented to the Oklahoma Children's Memorial Hospital Emergency Department or Walk-In Clinic with a temperature of 40 C(104 F) or more were reviewed. The findings were consistent with the concept that high fever in children is most often associated with common illnesses such as upper respiratory tract infections, otitis media, pneumonia, acute gastroenteritis, urinary tract infection, etc. There were only 22 (4%) admissions from the entire group and one death, actually due to delay in seeking medical help. The incidence and recurrence of febrile seizures (24 cases) was related to the use and compliance with anticonvulsant drugs rather than antipyretic measures. Appropriate laboratory work, x-rays and cultures should be done only when consistent with clinical findings. Follow-up can be done without hospitalization or antibiotics, as most children have a benign illness. The need for treatment of the underlying cause of the fever should, of course, remain the paramount goal. With proper parental guidance and education, the use of traditional methods of lowering fever can be discouraged.