title: Fever after intraventricular neuroendoscopic procedures in children.
abstract: OBJECTIVE
  The purpose of this paper was to study the incidence and clinical significance of fever after intraventricular neuroendoscopic procedures in children.
  
  
  METHODS
  We retrospectively assessed all children subjected to an intraventricular neuroendoscopic procedure between 2004 and 2015. Body temperature 6 days postoperatively, symptoms and signs, and eventual cerebrospinal fluid analysis were evaluated. Fever was defined as temperature above 38 °C.
  
  
  RESULTS
  Fifty-five children (mean age 4.8 years) had 67 procedures. Forty-three children (47 procedures, 70 %) developed fever, mostly the day of surgery (n = 17; 25 %) or the next day (n = 33; 49 %). All children who were clinically ill (n = 9, including 7 with fever) suffered serious illness, as opposed to none of the children with fever without being clinically ill (n = 36). Fever was unrelated to gender, indication for, and type of procedure and did not influence ETV success rate at 3 months. Children under 1 year less frequently developed fever (p = 0.032).
  
  
  CONCLUSIONS
  Fever frequently develops after intraventricular neuroendoscopic procedures in children and follows a rather predictable course, peaking the day of surgery and/or the next day, and rapidly subsiding thereafter. Fever is not a cardinal symptom except when combined with other symptoms in children who are clinically ill (which most of them are not). Close observation avoiding invasive diagnostic tests may suffice for those who are not clinically ill, while extra attention should be paid to those whose temperature rises after day 2 especially when clinically ill, as they likely suffer serious illness. We recommend to closely observe children after any intraventricular neuroendoscopic procedure for at least 5 days.
authors.affiliation: Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: S L
authors.initials: SL
authors.lastname: de Kunder
authors.affiliation: Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: M P
authors.initials: MP
authors.lastname: Ter Laak-Poort
authors.affiliation: Department of Child Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Nicolai
authors.affiliation: Department of Child Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: J S H
authors.initials: JS
authors.lastname: Vles
authors.affiliation: Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands. E.cornips@mumc.nl.
authors.forename: E M J
authors.initials: EM
authors.lastname: Cornips
mesh_terms: D000293:Adolescent; D001831:Body Temperature; D002552:Cerebral Ventricles / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D044583:Neuroendoscopy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012189:Retrospective Studies; D013997:Time Factors
keywords: Children; Complications; Endoscopic third ventriculostomy; Neuroendoscopy; Postoperative fever