Duration of Fever and Course of Symptoms in Young Febrile Children Presenting with Uncomplicated Illness

作者：Kool Marijke; Elshout Gijs; Moll Henriette A; Koes Bart W; van der Wouden Johannes C; Berger Marjolein Y^*

来源：Journal of the American Board of Family Medicine, 2013, 26(4): 445-452.

DOI：10.3122/jabfm.2013.04.120265

• Body Temperature
• Child
• Family Practice
• Fever
• Infant
• Preschool Child

Purpose: It is important to advise parents when to consult a doctor when their child has fever. To provide evidence-based, safety-net advice for young febrile children, we studied the risk of complications, the occurrence of alarm symptoms, the duration of fever. %26lt;br%26gt;Methods: In a 7-day prospective follow-up study, we included 463 consecutive children aged 3 months to 6 years who presented with fever at a general practitioner out-of-hours service. We excluded 43 children with complicated illnesses at presentation. In a structured assessment, the duration of fever before presentation was noted and a physical examination was performed. Parents reported alarming symptoms and rectal temperature in a diary for 1 week. The total duration of fever included its duration before presentation. Median duration of fever was estimated using the Kaplan-Meier test. %26lt;br%26gt;Results: During follow-up, 3.2% of the children with uncomplicated illness at presentation developed a complicated illness. The presence of alarming symptoms dropped from 79.3% at day 2 of the fever episode to 36.7% at day 9. The estimated median duration of the total fever episode was 4.0 days (95% confidence interval, 3.6-4.4). %26lt;br%26gt;Conclusions: In children with uncomplicated illnesses, the daily occurrence of alarming symptoms reported by parents was high. The median duration of fever was 4 days. The predictive value of alarming symptoms reported by parents for complicated illness should be reconsidered.

• 出版日期2013-8