Statistics from Altmetric.com
High fever and serious infection
Parents worry when their child has a very high fever, but as paediatricians we are often more relaxed; we assume that such high temperatures in otherwise healthy children are more likely to be due to viral infection, while those with serious sepsis often have only a mild fever. Is our assumption justified? Researchers from Israel did a systematic review (Rosenfeld-Yeoshua et al. Eur J Pediatrics doi.org/10.1007/s00431-018-3098-x). They looked for studies comparing rates of serious bacterial infection (SBI) depending on the child’s presenting temperature. They found 11, and distinguished those looking at hyperpyrexia (> 41°C) and high fever (>40 °C). The two hyperpyrexia studies showed a significantly higher risk of SBI at all ages (pooled OR 1.96; 95% CI 1.3 to 2.0), but both studies were old (1976 and 1990) and pre-dated routine vaccination against H. influenza B, pneumococcus and meningococcus. Five studies looked at otherwise healthy older children with a temperature of >40 °C. Together these gave a risk of SBI only slightly greater than for those with a lower temperature (OR 1.36; 95% CI 1.2 to 1.6). However in collating results from 5 studies of infants under 3 months they found the risks to be much higher: those with fever >40 °C were 3 times …
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.