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Association of hyperpyrexia with serious disease in children
1University of Miami School of Medicine, Florida.
Insights
Hyperpyrexia (temperature >= 41.1°C) in children is rare but often indicates serious illness, most commonly pneumonia. Clinical appearance is the only reliable indicator of severe disease in pediatric patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Emergency Medicine
Background:
- Hyperpyrexia (temperature >= 41.1°C) in children is a critical clinical sign.
- Understanding its incidence and associated conditions is vital for prompt diagnosis and management.
- Previous studies have not comprehensively evaluated hyperpyrexia in a large pediatric emergency department setting.
Purpose of the Study:
- To determine the incidence of hyperpyrexia in a pediatric emergency department.
- To identify sensitive indicators of serious illness in children with hyperpyrexia.
- To characterize the types of illnesses associated with hyperpyrexia in pediatric patients.
Main Methods:
- Prospective study conducted over 7 years.
- Evaluation of 105 consecutive pediatric patients presenting with temperature >= 41.1°C.
- Analysis of incidence, clinical indicators, diagnoses, and outcomes.
Main Results:
- Hyperpyrexia incidence was 0.36 per 1,000 visits.
- 61.9% of patients had serious illnesses, with pneumonia being the most common (36.2%).
- Other diagnoses included probable viral illness, bacteremia, and bacterial meningitis; 17.1% experienced seizures, and 3.8% died.
Conclusions:
- Hyperpyrexia in children is associated with a high rate of serious underlying disease, predominantly pneumonia.
- No reliable indicators, apart from clinical appearance, were found to distinguish serious illness.
- Prompt evaluation and management are crucial for pediatric patients with hyperpyrexia.
Abstract:
In a prospective study over 7 years, 105 consecutive pediatric patients with hyperpyrexia (temperature > or = 41.1 degrees C [106 degrees F]) were evaluated to determine the incidence, sensitive indicators, and types of illnesses encountered. The incidence of hyperpyrexia in a large urban pediatric emergency department was 0.36 per 1,000 visits or approximately one in 2,759 visits. In patients with temperature > or = 41.1 degrees C, 65 (61.9%) had a serious illness. Pneumonia (33 lobar, three interstitial, two clinical) was the most common diagnosis (36.2%), followed by probable viral illness in 20 (19.0%) of the patients. Bacteremia (6.7%) and bacterial meningitis (5.7%) were less commonly found. Four (3.8%) patients died. The admission rate was 62.9%. Eighteen patients (17.1%) also had seizures. Sensitive indicators to help distinguish those with serious illness, with the exception of clinical appearance, were not found. Pneumonia is commonly found in children with hyperpyrexia. Temperature > or = 41.1 degrees C was associated with a high rate of serious disease.