title: Tympanic temperature versus temporal temperature in patients with pyrexia and chills.
abstract: Accurate body temperature (BT) measurement is critical for immediate and correct estimation of core BT; measurement of changes in BT can provide physicians the initial information for selecting appropriate diagnostic approach and may prevent unnecessary diagnostic investigation. This study aimed to assess differences in tympanic and temporal temperatures among patients with fever in different conditions, especially in those with and without chills. This prospective study included patients from the emergency department between 2011 and 2012. All temperature measurements were obtained using tympanic thermometers and infrared skin thermometers. Differences in tympanic and temporal temperatures were analyzed according to 6 age groups, 5 ambient temperature groups, and 6 tympanic and temporal temperature subgroups. General linear model analysis and receiver operating characteristic curve analysis were used to estimate the differences in mean tympanic and temporal temperatures. Of the 710 patients enrolled, 246 had tympanic temperature more than 38.0°C, including 46 with chills (18.7%). Fourteen patients (3.0%) had chills and tympanic temperature less than 38°C. In the tympanic temperature subgroup of 39.0 to less than 39.5°C, approximately one-third of the patients had chills (32.3%). In the tympanic temperature subgroup of 38.0 to less than 39.0°C, the tympanic temperature was 0.4°C higher than the temporal temperature in patients without chills and 0.9°C higher in patients with chills. In the tympanic temperature subgroup of 39.0°C or more, tympanic temperature was 0.7°C higher than temporal temperature in patients without chills and 0.8°C higher in patients with chills. Temporal thermometer is more reliable in the age group of less than 1 year and 18 to less than 65 years. When the patients show tympanic temperature range of 38.0 to less than 39.0°C, 0.4°C should be added for patients without chills and 0.9°C for patients with chills to obtain core temperature. However, in patients with tympanic temperature of 39.0°C or more, 0.7°C to 0.8°C should be added, regardless of the presence of chills.
authors.affiliation: Department of Pediatric Emergency Medicine, Changhua Christian Children's Hospital, Changhua School of Medicine, Kaohsiung Medical University, Kaohsiung School of Medicine, China Medical University Department of Developmental and Behavioral Pediatrics, Children's Hospital, China Medical University Department of Thoracic Surgery, Chung-Shan Medical University Hospital Institute of Medicine, Chung-Shan Medical University School of Chinese Medicine, China Medical University Department of Hemato-oncology, Children's Hospital, China Medical University Hospital Laboratory of Epidemiology and Biostastics, Children's Hospital Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Kweishan College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Wen-Chieh
authors.initials: WC
authors.lastname: Yang
authors.forename: Huang-Tsung
authors.initials: HT
authors.lastname: Kuo
authors.forename: Ching-Hsiao
authors.initials: CH
authors.lastname: Lin
authors.forename: Kang-Hsi
authors.initials: KH
authors.lastname: Wu
authors.forename: Yu-Jun
authors.initials: YJ
authors.lastname: Chang
authors.forename: Chun-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Han-Ping
authors.initials: HP
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001831:Body Temperature; D002648:Child; D002675:Child, Preschool; D023341:Chills / Q000175:diagnosis*; D005260:Female; D005334:Fever / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013821:Thermometers; D014432:Tympanic Membrane; D055815:Young Adult