title: Fever as a predictor of infection in burned children.
abstract: Although children with burns often develop fevers, we have found no reports characterizing the course and duration of these fevers. To evaluate the predictive value of fever as an indicator of infection in burned children, we reviewed the hospital charts of all 223 children admitted to a regional burn center in the years 1979 through 1982. The highest temperature reading for each 8-hour period of the child's hospitalization was recorded. The highest mean temperature in burned children occurred at 38 to 96 hours after the burn injury; the peak temperatures appeared at the same time, regardless of whether the child had an infection. All of the 23 children with infections (100%) and 145 of the 200 without infections (73%) had a recorded temperature reading of 38.2 degrees C or higher within 2 weeks after their burn injury. When children less than 4 years, or children with more than 20% total body surface area burns were considered alone, the presence of a temperature greater than 38.2 degrees C was not significant in differentiating those with infections. Fever is not a specific predictor of infection in burned children; in children less than 4 years of age and in children with more than 20% burns, fever has no predictive value for the presence of infection. The physical examination is a reliable source of information about wound infection, sepsis, or other childhood infections, and should be the primary tool used in making the diagnosis of infection in burned children.
mesh_terms: D002056:Burns / Q000150:complications*; D002648:Child; D005334:Fever / Q000209:etiology*; D006801:Humans; D013997:Time Factors; D014946:Wound Infection / Q000175:diagnosis / Q000209:etiology*