Fever in children without local symptoms – frequency

Often, when examining a child with fever, the only symptom that can be identified is fever itself or such nonspecific signs as malaise or irritability. If this fever has recently arisen, it is referred to as a fever with no local symptoms, as opposed to the term “fever of unknown origin”, which refers to cases of persistent fever that cannot be explained.

Fever of unknown origin will be discussed in another article on our site. A fever with no local symptoms is a particularly difficult and demanding problem that practical pediatricians often face.

When analyzing 40,000 visits to the pediatric clinic, McCarthy found that 8400 of them were associated with fever. The author does not particularly note how many of these 8400 children had a fever without local symptoms. However, he points out that blood cultures were carried out in 1719 of these patients and 294 (17%) of them had fever with no local symptoms. Since the criteria for performing blood cultures are not given, we do not know how many of the other patients also had fever without local symptoms. Thus, the figure 294 of 8400 represents only the minimum value. This means that at least 3.5% of the total number of children with fever did not have any local symptoms that could serve as an explanation for the cause of the fever.

According to Tomlinson, in 5% of children with a body temperature of 40 ° C and above, the final diagnosis was fever with no local symptoms.
Apparently, a fever without local symptoms was a preliminary diagnosis in an even larger percentage of patients, because the author claims that, in chest radiography, some patients were diagnosed with pneumonia, which was not determined clinically.

local_offerevent_note January 24, 2019

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