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Prolonged fever in children

C H Chien1, C Y Lee, L M Huang

  • 1Department of Pediatrics, Provincial Hsin-Chu Hospital, Hsin-Chu City, Taiwan, R.O.C.

Zhonghua Minguo Xiao Er Ke Yi Xue Hui Za Zhi [Journal]. Zhonghua Minguo Xiao Er Ke Yi Xue Hui
|January 1, 1996
PubMed
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Diagnosing prolonged fevers in children is challenging. This study found infections, autoimmune diseases, and neoplasms were common causes, with a high diagnostic rate achieved through thorough clinical evaluation.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Rheumatology

Background:

  • Prolonged fever in children without an initial diagnosis poses a clinical challenge.
  • Identifying the underlying cause is crucial for appropriate management and prognosis.

Purpose of the Study:

  • To retrospectively analyze the causes and outcomes of prolonged fever in children.
  • To evaluate the diagnostic rate and methods used in a cohort of pediatric patients.

Main Methods:

  • Retrospective analysis of 86 children with fever lasting at least 6 days.
  • Inclusion criteria: absence of diagnosis after initial examination and preliminary tests.
  • Data collected on patient demographics, diagnoses, diagnostic methods, and outcomes.

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Main Results:

  • Infections (bacterial, viral, mycoplasmal, malaria) accounted for 43% of cases.
  • Collagen vascular diseases (15%) and neoplastic/hematological diseases (15%) were significant contributors.
  • Central fever was diagnosed in 16% of patients.
  • Overall diagnostic rate was 98%.
  • Poor outcomes were observed in 22% of children, particularly those with collagen vascular diseases or neoplasms.

Conclusions:

  • Prolonged fever in children has diverse etiologies, including infections, autoimmune conditions, and malignancies.
  • A comprehensive approach combining medical history, physical examination, laboratory tests, and clinical course observation is key to diagnosis.
  • Invasive studies should be reserved for specific indications.