fever in children
Introduction
Introduction to children's fever Pediatric fever refers to fever in children, the temperature is about 39.1 ~ 41 °C. Long-term fever is caused by fever for more than two weeks. 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 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 41 ° C or higher. basic knowledge The proportion of illness: 80% (children's morbidity) Susceptible people: children Mode of infection: non-infectious Complications: dehydration, hyponatremia, dystrophy, brain edema
Cause
Pediatric fever cause
Allergic reaction (20%):
For example, vaccination, allergic reactions to infusion and blood transfusion, allogeneic serum, and allergic reactions can cause acute hyperthermia.
General disease factors (30%):
Heat stroke, certain intracranial injuries, epileptic seizures and seizures, neonatal dehydration, etc. can also cause acute hyperthermia.
Infectious disease factors (25%):
Early acute infections or acute infectious diseases of various systems can also cause acute hyperthermia.
Malignant tumors (15%):
For example, leukemia, malignant lymphoma, malignant histiocytosis, connective tissue disease, etc. may cause long-term high fever in children.
Other diseases (5%):
Sepsis, Salmonella infection, tuberculosis, rheumatic fever, juvenile rheumatism, etc. can also cause long-term high fever in children.
Prevention
Pediatric fever prevention
While applying antipyretics, physical cooling can also be carried out. If conditions permit, the sick children should be placed in an air-conditioned room. Apply a warm towel to the forehead, neck, armpits, groin, etc. In addition to taking the above measures, they should be sent to the hospital for treatment.
In addition, during the fever, let the sick child rest in bed, and do not get hot, just let the sick child get up. When you have a fever, your child's physical energy consumption is very high, and there is a lot of sweating when you have a fever. Therefore, you must pay attention to add enough water to encourage your child to drink more water. Diet should be light, eat some rice soup, gruel, soy milk, milk, noodles and other liquid diet. Drinking water, diet should be a small number of times, do not overeating.
Complication
Pediatric fever complications Complications dehydration hyponatremia dystrophy cerebral edema
(1) Dehydration is easy due to high heat, and more water is lost in the body when sweating a large amount of antipyretics. Dehydration not only makes it difficult to eliminate fever, but also affects metabolism and blood circulation, and acidosis. Therefore, children must be encouraged to drink more water. At the same time, the concentration of sodium in the blood is increased, and the blood is hypertonic. The child may have dry mouth and thirst, irritability and even nonsense or cramps. The heat will not be retreated and will be higher, hyponatremia may occur, and it is more common in normal times. Malnourished infants and young children.
(2) Some children may cause cramps and even febrile seizures. Most of the cramps occur at the time of high fever, only one time for one fever, rarely more than 2 times, as long as the pumping time is not long, the treatment is proper, and the health of the child is not affected much.
(3) General fever has little effect on body tissues and organs, and can accelerate the generation of resistance. However, when the body temperature exceeds 41 ° C, the protein in the body will be decomposed, causing brain edema and causing death of the sick child or leaving the sequela of encephalopathy. Therefore, children who have a fever above 40 °C must be treated urgently.
(4) Small babies may cause heartbeat to be accelerated due to high fever, and may also cause heart failure.
Symptom
Children with fever symptoms Common symptoms Fever high fever low heat pharyngeal congestion granulocytosis wheezing wheezing snoring acute abdomen ecchymosis
1. Classification of fever degree:
(1) low heat: 37.5 ° C -38 ° C;
(2) Medium heat: 38.1 ° C - 39 ° C;
(3) High heat: 39.1 ° C -40 ° C;
(4) Ultra high heat: 40 ° C or more.
2, after careful physical examination, according to some signs can help to find the cause of high fever in children, mainly in the following aspects:
(1) If the skin of the child has a rash, it may be a common rash infection, such as children's acute rash, measles, rubella, etc.;
(2) If you find herpes, it may be chickenpox;
(3) If skin is found to have ecchymosis, epidemic cerebrospinal meningitis should be considered, and blood system diseases should also be considered;
(4) If superficial lymphadenopathy is found, infectious mononucleosis, mucocutaneous lymph node syndrome should be considered, and leukemia and malignant lymphoma should also be noted;
(5) If pharyngeal congestion and tonsil enlargement are found, it may be upper respiratory tract infection or acute tonsillitis;
(6) If the oral mucosa is found to have spots, it may be measles;
(7) If the lungs auscultation and snoring or blisters are signs of acute bronchitis or bronchial pneumonia, the auscultation of the lungs has wheezing, and asthmatic bronchitis or bronchial asthma should be considered;
(8) Abdominal tenderness or other signs, should pay attention to acute abdomen, such as acute appendicitis, intestinal obstruction.
Examine
Pediatric fever check
First, laboratory inspection
1. Laboratory examination is very important for the diagnosis of high fever in children. The general examination found that the white blood cells in the peripheral blood decreased, and should be considered as a viral infection. Increased white blood cells should be considered as bacterial infections.
2, children with fever should also pay attention to check for abnormal lymphocytes or immature cells in the peripheral blood, abnormal lymphocytes suggest viral infection. For children with long-term fever, blood culture should be done to check for erythrocyte sedimentation rate, anti-streptolysin "O", liver and kidney function, etc., and tuberculin test should also be done. For patients with clinical considerations of digestive system infection, routine stool examination must be performed. If necessary, tests such as fatda reaction, external Fischer's reaction, heterophilic agglutination test, condensation set test, and rheumatoid factor may be performed.
Second, chest X-ray examination
Helps diagnose lung and chest diseases. Others such as malignant tumors can be selected for CT, nuclear magnetic resonance, angiography, radioisotope, B-ultrasound, and living tissue according to the site.
Diagnosis
Pediatric fever diagnosis
(1) Check whether the skin of children with high fever has rash, whether there is ecchymosis, whether the superficial lymph nodes are swollen, whether the pharynx is congested, whether the tonsils are swollen, whether there are spots or ulcers in the oral mucosa, whether the cardiopulmonary auscultation is abnormal or not, and the abdomen Whether there is tenderness, whether the liver and spleen are swollen. If you find a rash, you should consider common rash infections, such as children with acute rash, measles, rubella and so on.
(2) The detection of herpes should consider chickenpox. If skin ecchymosis is found, epidemic cerebrospinal meningitis should be considered, or it may be a blood system disease. If superficial lymphadenopathy is found, infectious mononucleosis should be considered. Skin and mucous membrane lymph node syndrome should also pay attention to leukemia and malignant lymphoma. If pharyngeal congestion and tonsil enlargement are found, upper respiratory tract infection and acute tonsillitis should be considered.
(3) Check that the oral mucosa has spots, should pay attention to measles, such as lung auscultation and snoring or blisters, is a sign of acute bronchitis or bronchial pneumonia, lung auscultation has wheezing, should consider asthmatic bronchial Inflammation or bronchial asthma. Abdominal tenderness or other signs, should pay attention to acute abdomen, such as acute appendicitis, intestinal obstruction.
(4) High fever in summer may be related to viral infection or bacterial infection, such as suppurative tonsillitis, lymphadenitis, pneumonia, bacterial dysentery, typhoid and even encephalitis. However, these diseases will have other performances besides fever, and should be carefully identified.
