Fever in infants – general

The body temperature of healthy people varies between 1 and 1.5 ° C. The normal body temperature is 37 ° C (between 36.5 ° C and 37.5 ° C). The fever that peaks in the evening changes for most people throughout the day. Normal body temperature is controlled by a center called the hypothalamus in the head via a complex system. For rectal measurements, temperatures above 38 ° C are generally considered abnormal.

The course of fever in children can vary depending on the type and age of the disease. Although there is a pronounced infection in newborns, it may not respond to fever or have a low fever, whereas older infants and children under 5 years of age are prone to severe bacterial infection or excessive fever up to 40.5 ° C can respond viral image. This fever level in older children and adults is unusual and indicates an important pathological event. Fever caused by bacteria, viruses, fungi or parasites, malignancy, autoimmune diseases or fever caused by medication not from Fever with fever course can be distinguished.

Most feverish Diseases in children can be classified as follows:

Short-term fever, accompanied by anamnesis and physical examination as well as signs and symptoms.

Fever, which usually occurs in children under 3 years of age, without symptoms that cannot be determined by medical history and physical examination, but can be diagnosed by laboratory tests.

Fever of unknown origin (NBA); Fever of more than 14 days without a medical history, physical examination and routine laboratory tests. In older children and adults, fever that persists for more than 3 weeks and lasts for 7 days in hospital but is not diagnosed above 38 ° C is usually defined as an NBA.


In this age group, there is a higher risk of serious bacterial infections compared to fever in older infants. Young infants may not have a key symptom and may have non-specific symptoms such as meningitis, urinary tract infection or pneumonia that are not only well absorbed. Fever is often the only symptom of severe bacterial infection in early childhood. However, the most common febrile diseases in this age group are caused by viral pathogens. It is often difficult to distinguish between viral and bacterial infections. Therefore, infants who appear sick under 3 months and all infants younger than 1 month (especially those suspected of follow-up care) are generally hospitalized. After culturing blood, urine and cerebrospinal fluid, most of these infants receive broad-spectrum antibiotics.


In children 3 months to 2 years of age, most febrile episodes involve a significant source of infection (pharyngitis, otitis media, bronchitis, upper respiratory tract infection) that can be identified by physical examination or medical history. The evaluation of infants with febrile, good-looking, but infectious foci is based on clinical trials to focus the white blood cells (leukocytes) on the complete blood count, to determine the blood sedimentation rate, the blood culture, the complete urine examination, the urine culture and the chest film as well as the focus of infection.

Fever of unknown origin is defined as a fever that persists for more than 14 days and persists in older children and adults for more than three weeks above 37 ° C and above 38 ° C, despite the fact that a comprehensive medical history, physical examination and routine laboratory tests are available. Infectious diseases, connective tissue diseases and malignant diseases are the three most common types of fever in children. It is a difficult problem in which many patients could not be diagnosed even after being in the hospital for a week. The differential diagnosis between occult infections and malignant diseases often required invasive interventions. The development of diagnostic imaging techniques such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and radionuclide scanning with gallium or technicium significantly reduces the number of undiagnosed patients in this class, however, in 10-20% of children with a fever of unknown cause despite research no diagnosis can be made.

Dr. Example: Levent AKGÜNGÖR
Bayındır Hospital Department of Pediatrics


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