Characteristic Features of Different Types of Fever
Certain characteristic features of different types of fever:
Fever with rigors or chills: Malaria, pneumonia (lobar), pyelonephritis, bacterial endocarditis, abscess, cholangitis.
Step ladder fever: enteric fever
Relapsing or periodic fever: (Fever occurring in bouts lasting for days with afebrile phases) - Brucellosis, Hodgkin's disease
Sudden onset fever: Pyelonephritis, Pneumonia
Gradual onset fever: Typhoid, infective endocarditis, TB, Brucellosis.
Double rise of fever: Kala-azar, malaria, liver abscess, typhoid, UTI
Common Causes of Fever in Children
Granulomatous disorders or sarcoidosis
Note: Fever in an infant less then 3 mo of age should be considered as bacterial until proved otherwise.
Pyrexia of unknown origin (PUO)Fever lasting for at least 10 days with no apparent diagnosis after investigations.
Approach to a Child With Fever
Associated signs and symptoms:
- Cough, cold, breathlessness: URTI, bronchitis, pneumonia, empyema, sinusitis, lung abscess, otitis media, pharyngitis
- Vomiting, pain in abdomen:Hepatitis, appendicitis, enteric fever, amoebas
- Post-tussive vomiting: Pertussis
- Projectile vomiting: Meningitis
- Jaundice: hepatitis
- Splenomegaly: malaria, kala-azar, infectious mononucleosis, lymphoma, enteric fever, bacterial endocarditis
- Headache: sinusitis, otitis media, meningitis
- Skin rash: measles, chickenpox, rubella, meningococcemia, fifth disease, rickettsia
- Joint swelling: septic arthritis
- Lymphadenopathy: tuberculosis, toxoplasmosis, Infectious mononucleosis, Brucellosis, HIV, lymphoma
- Conjunctivitis: Bulbar conjunctivitis-Kawasaki's disease, leptospirosis; Palpebral conjunctivitis-measles, infectious mononucleosis