Clinical profile and etiology of children presenting with prolonged fever in tertiary care centre of Southern Rajasthan

Anuradha Sanadhya; Sakshi Setia; Suresh Goyal; Ritika Kachhwaha

doi:10.18203/2349-3291.ijcp20231847

Authors

Anuradha Sanadhya Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India
Sakshi Setia Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India
Suresh Goyal Department of Pediatrics, Pacific Institute of Medical Sciences, Umra, Rajasthan, India
Ritika Kachhwaha Department of Pediatrics, Manipal Hospitals Columbia Asia IN, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20231847

Keywords:

Hematological malignancies, Prolonged fever, Prolonged undiagnosed fever

Abstract

Background: Fever is the most common complain of a child presenting to a health care setting. A prolonged fever however, is an intriguing challenge for clinicians and remains overly medicated and inappropriately worked up, provided a systemic approach is not followed. Our study aims to find the etiologic diagnosis in these cases of prolonged fever.

Methods: The present study was conducted in a tertiary care hospital in southern Rajasthan over a period of 12 months from November 2021 to October 2022. Our descriptive, observational study enrolled 150 children who were prospectively followed during their stay in hospital. Each patient was subjected to a set of mandatory investigations followed by other investigations as per the diagnostic clues. Patients were monitored closely during their course of stay until discharge, at which the final diagnosis was charted.

Results: A diagnosis could be reached for 138 patients (92%) and in 12 patients (8%), the cause of fever remained undiagnosed until discharge/death. Out of the 138 patients diagnosed, 118 patients (85.5%, 78.6% overall) had an infection as the cause of fever and 20 cases (14.49%,13.3% overall) had a non-infective etiology.

Conclusions: Infections are the most common cause of prolonged fever in pediatric population - tuberculosis being the most frequent infection. Hematological malignancies were found as an emerging cause of prolonged fever in our study.

Metrics

Metrics Loading ...

References

Linda S, Kamat D. Fever in Nelson Textbook of Pediatrics. Elsevier, 21st edition. 2020:1386-88.

Dinarello CA, Porat R. Fever in Harrison’s Principles of Internal Medicine. Mcgraw-Hill, 20th edition. 2018:102-105.

Wallenstein MB, Schroeder AR, Hole MK, Ryan C, Fijalkowski N, Alvarez E, et al. Fever literacy and fever phobia. Clin Pediatr. 2013;52:254-9.

Dai YT, Lu SH. What’s missing for evidence-based fever management? Is fever beneficial or harmful to humans? Int J Nurs Stud. 2012;49:505-7.

Avinash LA, Singhal T. Etiology of fever of unknown origin in children from Mumbai, India. Indian Pediatr. 2018;55:71-2.

Sharma BK , Kumari S, Varma SC, Sagar S, Singh S. Prolonged undiagnosed fever in northern India.Trop Geogr Med. 1992;44(1-2):32-6.

Joshi N, Rajeshwari K, Dubey AP, Singh T, Kaur R. Clinical spectrum of fever of unknown origin among Indian children. Ann Trop Paediatr. 2008;28(4):261-6.

Cruz G. Fever of unknown origin in children. An Esp Pediatr. 1978;11(10):683-92.

Ergin Ç, Erdal İ, Ülker D. Pyrexia of unknown origin in children: a review of 102 patients from Turkey. Annals Tropical Paediat. 2003;23(4):259-263.

Sumathisri R, Karuppiah P, Srinivasan S. Fever in the tropics: aetiology and clinical profile of fever of unknown origin in children-a prospective observational study in a tertiary care hospital in South India. Int J Contemp Pediatr. 2019;6(5):1834-8.