A prospective study was done to determine the incidence of serious illness in children under two years of age with hyperpyrexia (temperature of 41.1 degrees C [106 degrees F] or greater). Nineteen children were seen and followed in the emergency department of Oklahoma Children's Memorial Hospital over a one-year period. The final clinical diagnoses included acute otitis media, pneumonia, acute gastroenteritis, roseola, and cellulitis of the leg. In the entire group there was no meningitis or subsequent death. One child was hospitalized. The statistical analysis (binomial test at the 0.05 level) confirms that the incidence of serious illness manifested only by high fever is no higher than 0.15. The mere presence of very high fever does not necessarily indicate a serious illness. Laboratory and other diagnostic work-up and hospitalization should be based on clinical evaluations, rather than done routinely.

Acute Disease↗

PubMed1979

Hyperpyrexia (temperature greater than 40 C) in children.

A total of 516 charts of children who presented to the Oklahoma Children's Memorial Hospital Emergency Department or Walk-In Clinic with a temperature of 40 C(104 F) or more were reviewed. The findings were consistent with the concept that high fever in children is most often associated with common illnesses such as upper respiratory tract infections, otitis media, pneumonia, acute gastroenteritis, urinary tract infection, etc. There were only 22 (4%) admissions from the entire group and one death, actually due to delay in seeking medical help. The incidence and recurrence of febrile seizures (24 cases) was related to the use and compliance with anticonvulsant drugs rather than antipyretic measures. Appropriate laboratory work, x-rays and cultures should be done only when consistent with clinical findings. Follow-up can be done without hospitalization or antibiotics, as most children have a benign illness. The need for treatment of the underlying cause of the fever should, of course, remain the paramount goal. With proper parental guidance and education, the use of traditional methods of lowering fever can be discouraged.

Adolescent↗

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