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Pathophysiology and management of fever in infants and children

INTRODUCTION

Fever is an abnormal elevation of body temperature that occurs as part of a specific biologic response that is mediated and controlled by the central nervous system.  

The pathophysiology and treatment of fever in infants and children will be reviewed here. Other causes of elevated body temperature in children and the evaluation and management of fever in specific populations of infants and children are discussed separately:

TEMPERATURE MEASUREMENT

The most common sites of temperature measurement in clinical practice are the rectum, mouth, and axilla; in addition, parents and caregivers may measure temperature at the tympanic membrane or forehead (temporal artery). Each of these sites has its own range of normal values [1].

Opinions differ about the best site of temperature measurement for young children who cannot cooperate with oral thermometry. The Bright Futures Guidelines for Health Supervision suggest rectal thermometry for children younger than four years of age [2]. In contrast, the National Institute for Clinical Excellence recommends electronic axillary thermometry for children younger than four weeks, and axillary (electronic or chemical dot) or infra-red tympanic membrane thermometry for children four weeks to five years of age because these methods are quicker, easier to use, and better accepted by children and their caregivers [3].

                         

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Literature review current through: Apr 2013. | This topic last updated: Mar 7, 2013.
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