fever in children
Introduction
Introduction Fever is a very common symptom in infants and young children, and many diseases appear to be fever at the beginning. In daily life, we often see some parents touch the child's head with their hands, touch the child's palm, feel the skin is hot, and think that the child has a fever. Some parents believe that as long as the child's temperature exceeds 37 ° C is sick. In fact, this understanding is not entirely correct. Heat stroke, certain intracranial injuries, epileptic seizures and seizures, neonatal dehydration, etc. can also cause acute hyperthermia.
Cause
Cause
(1) Certain allergic reactions, such as vaccination, allergies to infusion and transfusion, allogeneic serum, and allergic reactions can cause acute hyperthermia.
(2) Heatstroke, certain intracranial injuries, epileptic seizures and seizures, neonatal dehydration, etc. can also cause acute high fever.
(3) Acute infectious diseases in the early stages of acute infectious diseases or in various systems can also cause acute high fever.
(4) Certain malignant tumors, such as leukemia, malignant lymphoma, malignant histiocytosis, connective tissue disease, etc., may cause long-term hyperthermia in children.
(5) sepsis, Salmonella infection, tuberculosis, rheumatic fever, juvenile rheumatism, etc. can also cause long-term high fever in children.
Examine
an examination
Related inspection
Regression hot spiral (BR) neutralization test
First, laboratory inspection
1. Laboratory tests are 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 whether there are abnormal lymphocytes or immature cells in the peripheral blood, and abnormal lymphocytes suggest virus 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
Differential diagnosis
Infectious fever: various infectious diseases such as bacteria, viruses, fungi, spirochetes, malaria parasites, etc. act on the body temperature regulation center, body temperature central dysfunction or excessive heat production caused by various causes, heat dissipation is reduced, resulting in an increase in body temperature beyond normal The scope of the situation. The white blood cell count is higher than 1.2x109/L or lower than 0.5109/L.
Unexplained fever: The concept of generalized unexplained fever refers to all fevers of unknown origin. However, in the clinic, the narrow concept of fever is also adopted, that is, fever of unknown cause. The fever lasted for more than 3 weeks, the body temperature was above 38.5 °C, and the diagnosis was not confirmed by detailed medical history, physical examination and routine laboratory tests.
Central fever: refers to the fever caused by central nervous system disorders caused by abnormalities in the central nervous system. Before the diagnosis, the fever caused by systemic or local inflammation should be strictly excluded, and other causes of fever are excluded. Most cases of intracranial disease with fever are critical cases, most of which are caused by intracranial inflammation, intrapulmonary infection, and urinary tract infection. For the unexplained increase in moderate body temperature, the source of infection or the cause of infection cannot be found at one time, and it cannot be easily considered as central fever.
