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Fever in HIV-infected children

Susan L Gillespie, MD, PhD
Section Editor
Mary E Paul, MD
Deputy Editor
Carrie Armsby, MD, MPH


Febrile children with human immunodeficiency virus (HIV) infection are diverse in their clinical presentations, necessitating a thoughtful and varied diagnostic approach. Acutely febrile HIV-infected children who are well controlled by combination antiretroviral therapy often have illness that is mild and self-limited. Not all of these patients require diagnostic testing or antibiotic therapy. However, a few of these children have more serious infectious diseases. Differentiating these seriously ill patients from the larger group of mildly ill children can be difficult. HIV-infected children with prolonged fever often have complicating medical conditions, and the diagnostic evaluation can be complex.

An approach to the evaluation of fever in HIV-infected children is reviewed here. The epidemiology, classification, clinical manifestations, and outcome of pediatric HIV are discussed separately. (See "Pediatric HIV infection: Classification, clinical manifestations, and outcome" and "Epidemiology of pediatric HIV infection".)


The following terms are used throughout this discussion:

Focal infection — A focal infection is associated with localizing signs or symptoms that suggest a source (eg, pneumonia, cellulitis, osteomyelitis, otitis media, herpes simplex virus stomatitis).

Fever without a source (FWS) — Acute fever lasting one week or less with no source identified through the history and physical examination is referred to as fever without a source (FWS). Alternative terms are fever without localizing signs (FWLS) or fever without a focus. (See "Fever without a source in children 3 to 36 months of age".)

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Literature review current through: Nov 2017. | This topic last updated: Nov 08, 2017.
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