NELSON’S HOUR

APPROACH TO FEVER

Dessa Anne Victoria C. Baleros

July 12, 2022
 FEVER
• Rectal temperature of 38˚C (100.4˚F) or above
• 4 categories
• Fever in the neonate
• Fever with localizing signs
• Fever without source (FWS)
• Fever of unknown origin (FUO)
FEVER OF WITHOUT SOURCE
 URINARY TRACT INFECTION

• Occult in children younger than 24 months because the symptoms, except for fever, are
nonspecific or nonexistent.
• 7% of febrile children younger than 2 years
• Prevalence varies by height of the fever, duration of the fever, age, gender, race, and circumcision
status
• Children with fever greater than 39°C are at a higher risk of UTIs
• Boys with fever for more than 2 days and girls with fever for more than 1 day are more likely to
have a UTI
• Higher rates of UTIs are found in girls, especially those younger than 12 months of age.
• For febrile boys younger than 3 months of age, 20.1% of those who are uncircumcised have a UTI
• For circumcised boys the rate is 2.4%
 CHILDREN OLDER THAN 36 MONTHS

• For children in this age group who do not appear ill, no

screening diagnostic tests are indicated
• Close attention should be paid to environmental exposures
and ill contacts because of the high likelihood of increased
contacts in this school-aged cohort.
FEVER OF UNKNOWN ORIGIN
✔️

✔️
 EXPOSURE TO WILD OR
DOMESTICATED ANIMALS

• Zoonoses • Q fever
• Cat scratch disease • Rat bite fever
• Tularemia • Psittacosis
• Salmonellosis • Toxoplasmosis
• Brucellosis • Visceral larva migrans
• Leptospirosis
 RASH OR PETICHIAE

• Lyme disease • LE Kawasaki disease

• JIA • Rocky Mountain spotted
• Acute rheumatic fever fever
• Endocarditis • Histiocytosis
• Dermatomyositis • Serum sickness
• SLE • Tularemia
• EBV
 TRAVEL OR EXPOSURE TO PERSONS
RECENTLY TRAVELED

• Coccidiomycosis • Rocky Mountain spotted

• Histoplasmosis fever
• Malaria • Tuberculosis (TB)
• Blastomycosis • Ehrlichiosis
• Lyme disease • Babesiosis
• Typhoid fever
• Other endemic diseases
THANK YOU