All issues > Volume 33(11); 1990

Original Article

J Korean Pediatr Soc. 1990;33(11):1516-1525. Published online November 30, 1990.

Prolonged Fever in Korean Children: Review of 120 Cases.

Ho Seong Kim¹, Dong Goo Lee¹, Dong Soo Kim¹

¹Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea

Received: May 9, 1990;  Accepted: July 24, 1990.

Abstract

The authors reviewed the 120 patients with prolonged fever whose temperature was over 38.5°C and of undetermined etiology, who were admitted in Y야isei Medical Center from March 1982 to March 1989. The results were as follows; 1) The children admitted with prolonged fever were 0.3% of total in-patients at the same time. 2) 20 cases were less than 1 year of age on admission and 39 were between 1 and 6 years. The ratio of male to female was 1.5:1. 3) There was no remarkable seasonal variation, but prolonged fever was prevalent in summer time (from May to October). 4) In 87 cases (72.5%), the fever persisted 2 to 3 weeks before admission and in 21 cases (17.5%) lasted longer than a month. Three patterns of fever were observed; intermittent type in 75 cases (62.5%), daily spiking in 28 cases (23.3%) and constant in 17 cases (14.2%). 5) Infections accounted for 72 cases (60%), malignancy for 16 cases (13.3%), collagen diseases for 10 cases (8.3%) and miscellaneous cause for 2 cases (1.7%). Twenty cases remained undiagnosed. Infection was the most common etiology in all age groups. Seventy percent of collagen diseases were in older age group than 6 years old. Malignancy had no age predilection. In infections, sepsis accounted for 23 cases, tuberculosis for 9 cases, infective endocarditis for 6 cases. These three consisted of 52.8% of all infections. Compared to previous reports, tuberculosis and typhoid fever showed a decreasing tendency. 6) The involved organs were as follows; multiple organs accounted for 41 cases (34.2%), hematopoietic system for 13 cases (10.8%), respiratory system for 12 cases (10.0%). The involved organs had no age predilection. 7) Fifty six point seven percent of all cases were diagnosed within a week and defeverscent period was a week in 27.5%. Thirty point eight percent of all cases was discharged within 2 weeks of admission. 8) Careful history taking and repeated physical examination were helpful in 76 cases (63.3%). Routine CBC, urinalysis, chest P-A were helpful in 25 cases (20.8%). Among 120 bacterial culture studies, 35 cases (29.2%) were positive on blood culture, 12 cases (10.0%) on urine culture, 15 cases (12. 5%) on stool culture. More specific studies were considered according to the progress of the disease and were absolutely helpful for more accurate diagnosis. 9) The outcome were as follows; 89 cases (74.2%) were improved, 22 cases (18.3%) discharged without improvement and 9 cases (7.5%) expired.

Keywords :Prolonged fever