FEVER

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Last Updated : 12/31/2010
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Ira Shah
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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

Infections
- Bacterial
- Viral
- Spirochaetal
- Protozoal
- Fungal
- Ricketssial

Neoplasms
Allergic reactions
Collagen disorders
Drugs
Granulomatous disorders or sarcoidosis
Heat stroke
Factitious fever

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



Contributor Information and Disclosures Ira Shah
Consultant Pediatrician, B.J.Wadia Hospital for Children, Mumbai, India


First Created : 2/28/2001
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