Recurrent Fever in Children

Abstract

Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time.

Risk Factor Analysis and Risk Prediction Model Construction of Pressure Injury in Critically Ill Patients with Cancer: A Retrospective Cohort Study in China

“…PI, diarrhea, and recurrent fever were evaluated by the ostomy therapist and intensivist nurses as follows: (1) PI was characterized according to the definition and staging of PI issued by the National Pressure Ulcer Advisory Panel (NPUAP) in 2016 [ 15 ]. Only PIs with stage II and above were included in this study, including stages II, III, IV, non-staging, and suspected deep tissue damage; (2) diarrhea was determined when the number of stools per day exceeded 3 times, with trait changes [ 16 ]; (3) recurrent fever was determined according to previous reports and defined as an abnormal increase in body temperature resulting in higher than 38°C that occurred 3 or more times during the stay in the ICU [ 17 , 18 ]. For each patient, the APACHE II score was calculated within 24 h of admission from patient age and 12 routine physiological measurements: PaO2, temperature (rectal), mean arterial pressure, arterial pH, heart rate, respiratory rate, Glasgow Coma Scale, and serum sodium, serum potassium, creatinine, hematocrit, and white blood cell levels.…”

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