high fever in children
Introduction
Introduction to children's high fever Fever is a common symptom of many diseases. Normal body temperature in children is usually measured by anal temperature of 36.5 ~ 37.5 ° C, and temperature of 36 ~ 37 ° C. Under normal circumstances, the temperature of the sputum is 0.2 to 0.5 ° C lower than the mouth temperature (sublingual), and the temperature of the anus is about 0.5 ° C higher than the temperature of the sputum. If the temperature exceeds 37.4 ° C and the body temperature fluctuates above 1 ° C during the day, it is considered to be fever. The so-called low heat means that the temperature is 37.5 ° C ~ 38 ° C, moderate heat 38.1 ~ 39 ° C, high heat 39.1 ~ 40 ° C, ultra high heat is 41 ° C or more. Long-term fever is caused by fever for more than two weeks. basic knowledge The proportion of illness: 0.38% Susceptible people: young children Mode of infection: non-infectious Complications: epilepsy dehydration brain edema coma
Cause
Pediatric hyperthermia
Non-infectious diseases (30%):
Heat syndrome, neonatal dehydration fever, intracranial injury, convulsions and epileptic seizures. Neonatal dehydration heat means that when the water lost by breathing, skin and urine exceeds the amount of liquid obtained by feeding the newborn, dehydration heat can occur. When the weather is dry and hot, or the room temperature is too high, and the warmth is excessive, the water in the newborn can be lost too much. If the supplement is insufficient, it can cause fever.
Allergic reaction (20%):
Allergies, allogeneic serum, vaccination response, infusion, transfusion reactions, etc. Allergies, abnormalities in the susceptibility of organisms to certain drugs or external stimuli, drug allergies. Allergies are simply allergic to a substance. When you eat, touch or inhale a substance, the body will react excessively; the substance that causes this reaction is the so-called "allergen."
Infectious disease (30%):
Early acute infectious diseases, acute infectious diseases of various systems.
Long-term high fever
1, common diseases: sepsis, Salmonella infection, tuberculosis, rheumatic fever, juvenile rheumatism.
2, rare diseases: malignant tumors (leukemia, malignant lymphoma, malignant histiocytosis), connective tissue disease.
Prevention
Pediatric fever prevention
1, clothing should be cool, should not use the method of quilt sweating.
2, the room air should be circulated, if necessary, use the electric fan to blow back and forth, do not close the window to keep the children from seeing the wind.
3. Encourage drinking water, keep your tongue moist, and urinate.
4, pay attention to nutrition, do not arbitrarily avoid mouth, no obvious cough can eat more fruits, especially watermelon, can not only add water, sugar and vitamins, but also have the effect of heat, in addition, should pay attention to smooth stool.
The occurrence of high heat should be treated urgently. The method of cold compressing and swabbing should be used to cool the child as soon as possible. The cold and wet towel can be used for the amount of water. The plastic bag with no water leakage can be wrapped with dry towel and wrapped around the neck and neck. The armpits and groin are better. Dilute 75% alcohol with water. Wipe the head, neck, armpits, chest and back with a small towel. If the children are cold or wiped, the skin will be "chicken skin". It should be replaced with warm water slightly lower than the skin temperature to wipe the limbs until it turns red and warm. When it is treated physically, it must also take antipyretics. If there is a history of high heat cramps, add sedative medicine. Everything is carried to the hospital with the child, especially if the home is far away from the hospital and the traffic is inconvenient. Otherwise, the sick child can easily go on the way or in the busy emergency room waiting room, the body temperature continues to rise and an accident occurs. Emergency treatment.
Complication
Pediatric hyperthermia complications Complications epilepsy dehydration cerebral edema coma
If not handled properly, it can lead to death or sequelae in children, such as epilepsy. In addition, high fever in children can lead to electrolyte imbalance in children, and dehydration can cause acidosis.
1. High-heat cramps Generally speaking, children under 6 months or older will not cause cramps due to high fever. Only 2 to 5% of children aged 1 to 6 will have such cramps. Cramps occur mostly in high heat. At that time, only one episode of fever is taken, rarely more than 2 times. As long as the convulsion time is not long, proper treatment has little effect on the health of the child, but repeated or continuous cramps can cause brain hypoxia and damage the brain.
2. "Burn the brain" generally has little effect on the body tissues and organs, and can accelerate the generation of resistance. When the body temperature exceeds 41 °C, the protein in the body will decompose, causing brain edema and causing death or leaving the brain disease. The sequelae, therefore, children must be treated urgently if they have a fever above 40 °C.
3. Dehydrated summer children have more water than other seasons through breathing and skin. When they suffer from fever, the body temperature rises by 1 °C, and the amount of water per kilogram of body weight per hour increases by 0.5 ml. When a large amount of sweating, the body loses more water. Dehydration not only makes the fever difficult (the fever can be caused by dehydration in small infants), but also affects metabolism and blood circulation, acidosis, etc. Therefore, children with high fever must encourage drinking water. Infusion under the guidance of a doctor if necessary.
4. Hypernatremia or hyponatremia, initial dehydration, elevated blood sodium concentration, hypertonic blood, thirst, dry mouth, irritability and even nonsense or cramps, heat not only does not retreat and will be higher, fever for a long time Insufficient diet, hyponatremia, child fatigue or even apathy or coma, these conditions are more common in infants and young children who are malnourished.
In addition, in small babies due to high fever can cause heart rate to accelerate, and a little longer can cause heart failure.
Symptom
High fever symptoms in children Common symptoms Leg and cramps febrile seizures
The temperature exceeds 37.4 °C, and the body temperature fluctuates more than 1 °C in one day. The low heat refers to the temperature of 37.5 °C to 38 °C, the moderate heat is 38.1 to 39 °C, the high heat is 39.1 to 40 °C, and the super high heat is above 41 °C. The fever takes more than two weeks for long-term fever.
Examine
Pediatric fever check
Common tests for blood, urine, and feces are the preferred items for screening. The total number of white blood cells and neutrophils are increased, and more bacterial infections are considered. Those with reduced weight are more likely to be infected with viruses or bacilli.
If necessary, check the fatda reaction, the external Fischer reaction, the heterophilic agglutination test, the condensation set test, the anti-streptolysin O or the rheumatoid factor test.
Chest X-ray examination is helpful for the diagnosis of lung and chest diseases. Others such as malignant tumors may be selected for CT, nuclear magnetic resonance, angiography, radioisotope, B-mode ultrasound, and living tissue according to the site.
Diagnosis
Pediatric hyperthermia diagnosis
It is generally clear by inspection and diagnosis.
In the summer, fever can also be related to other viral infections or bacterial infections, such as suppurative tonsillitis, lymphadenitis, pneumonia, bacterial dysentery, typhoid and even Japanese encephalitis, but these diseases will have other performances besides fever. Careful examination is not difficult to diagnose. However, if infants and young children have high fever, they must pay attention to the so-called "hidden" bacterial blood test. In the past 10 years, there have been reports in foreign countries: bacteria are found in the blood of infants under 2 years old who have fever, if not Timely treatment will develop into pneumonia and even meningitis. The incidence of bacteremia is not high, but it should not be taken lightly.
