Certain characteristic features of different types of fever:
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.
Fever lasting for at least 10 days with no apparent diagnosis after investigations.
Pyrexia of unknown origin (PUO)
Associated signs and symptoms:
Approach to a Child With Fever
- 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