Distinguishing among prolonged, recurrent, and periodic fever syndromes: approach of a pediatric infectious diseases subspecialist.
Most children with prolonged, recurrent, or periodic fever are healthy and have self-limited, common illnesses, and the primary care practitioner usually can reassure families and continue to reassess the patient as circumstances dictate. For a child with true fever of unknown origin, a pediatric infectious diseases subspecialist should be consulted. This article discusses three objectives for the clinician: (1) to categorize patterns of fever illnesses and prioritize differential diagnoses; (2) to diagnose and manage the most frequently encountered prolonged fever syndrome, deconditioning; and (3) to expand knowledge and approach to diagnosing periodic fever syndromes. The approach described in this article represents the honed, 30-year experience of a pediatric infectious diseases subspecialist.
Long
Sarah S
SS
Department of Pediatrics, Drexel University College of Medicine, Philadelphia, PA 19134, USA. sarah.long@drexelmed.edu
D000465:Algorithms; D000486:Allergy and Immunology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018493:Cardiovascular Deconditioning; D002648:Child; D003663:Decision Trees; D003937:Diagnosis, Differential; D010505:Familial Mediterranean Fever / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005190:Family / Q000523:psychology; D005335:Fever of Unknown Origin / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D008487:Medical History Taking; D008511:Medicine / Q000379:methods*; D010372:Pediatrics / Q000379:methods*; D010507:Periodicity; D010808:Physical Examination; D011241:Prednisone / Q000627:therapeutic use; D011320:Primary Health Care / Q000379:methods; D012008:Recurrence; D012017:Referral and Consultation; D013038:Specialization; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D011241:Prednisone