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Journal of Pediatrics Review، جلد ۱۱، شماره ۳، صفحات ۶-۶
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| عنوان فارسی |
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| چکیده فارسی مقاله |
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| کلیدواژه‌های فارسی مقاله |
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| عنوان انگلیسی |
Case Series of Prolonged Febrile Illness in Pediatric Age Group - A Diagnostic Challenge |
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| چکیده انگلیسی مقاله |
Introduction: Fever is defined as a rectal temperature of 100.4oF or more, a physiologic response characterized by an elevation of body temperature above normal variation. It is one of the common causes of medical consultation in children, responsible for 15–25% of consultations in Pediatrics practice. Children with prolonged fever can be a source of concern for the parents and present as a diagnostic challenge to pediatricians. Persistence of fever raises clinical queries towards diagnosis especially in patients without identifiable focus. Children with a temperature >38°C (100.4°F) recorded by a healthcare professional and for whom the reason could not be determined after at least 8 days of evaluation should be classified as having Fever of unknown origin. Most fevers with unknown causes usually have atypical presentations of common illnesses. Case Description: We reviewed the case records of 9 children admitted to our Pediatric ward with prolonged fever episodes that turned out to be diagnostic challenges for clinicians during the period from December 2021 to October 2022. In our cases, 2 children had Scrub Typhus, 1 child was diagnosed with Acute Lymphoblastic Leukemia, one child had multidrug-resistant typhoid fever. However, 2 cases remained as Pyrexia of unknown origin (PUO). Three children were found to have co-infections and diagnosed with enteric fever with other co-infection like dengue, leptospirosis, and UTI. Cases 1, 2 and 9 were having persistent fever despite appropriate antibiotics therapy based on sensitivity patterns, hence turned were a significant challenge of diagnosis. Cases 3 and 6 had initial diagnostic deviations due to their atypical presentations and both cases were diagnosed to be Scrub Typhus. Case 4 was diagnosed as malignancy (Acute Lymphoblastic Leukaemia) after extensive evaluation. Cases 5 and 7 posed a diagnostic challenge in which the causes were not found after extensive evaluation and there was persistent fever after 10 days of admission. Hence diagnosed as Fever of unknown Origin. Conclusion: A though history and detailed examination is essential in evaluation of pediatric illnesses. We have found that there might be deviators during the course of a disease evolution. We should not settle with a single diagnosis until a good clinical response is achieved and also consider alternative diagnosis or co-infections. Common causes of prolonged fever should be ruled out first. Co-infections should also be considered if there is no clinical response to treatment in a patient. A practical, systematic, and stepwise approach can be helpful with the assessment and management of prolonged fever in the pediatric age group. |
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| کلیدواژه‌های انگلیسی مقاله |
Prolonged Fever, Fever of unknown origin, Malignancy, Co-infections, Pediatric |
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| نویسندگان مقاله |
| Noorul Aina
Department of Pediatrics, Chettinad Hospital and Research Institute, Chettinad Academy of Research Education, Tamil Nadu, India.
| Indumathi Dhayalan
Department of Pediatrics, Chettinad Hospital and Research Institute, Chettinad Academy of Research Education, Tamil Nadu, India.
| Jaishree Vasudevan
Department of Pediatrics, Chettinad Hospital and Research Institute, Chettinad Academy of Research Education, Tamil Nadu, India.
| Alexander Mannu
Department of Pediatrics, Chettinad Hospital and Research Institute, Chettinad Academy of Research Education, Tamil Nadu, India.
| Kathir Subramanian Thiagarajan
Department of Pediatrics, Chettinad Hospital and Research Institute, Chettinad Academy of Research Education, Tamil Nadu, India.
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| نشانی اینترنتی |
http://jpr.mazums.ac.ir/browse.php?a_code=A-10-1087-1&slc_lang=en&sid=1 |
| فایل مقاله |
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| کد مقاله (doi) |
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| زبان مقاله منتشر شده |
en |
| موضوعات مقاله منتشر شده |
Pediatrics |
| نوع مقاله منتشر شده |
Case Report and Review of Literature |
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