Hyperthermia syndrome is a concept that includes an increase in temperature above 38.5 ºC in the axillary region, as well as changes in the body's adaptive functions and homeostasis. Fever is an increase in temperature in a specific area of the body above normal. So, for example, in the axillary region, fever is considered to be a temperature increase of more than 37.5 ºC, in the rectal region, more than 38.0 ºC, in the oral and tympanic region, more than 37.6 ºC.
What is hyperthermia syndrome in children?
Hyperthermic syndrome in children is a more dangerous condition that requires observation and medical attention, since unwanted reactions of the body are possible.
Fever classification
Fever is classified according to several criteria:
By duration:
- about acute fever they say if it lasts no more than 2 weeks;
- subacute fever called when the total duration of the condition does not exceed 6 weeks;
- diagnosis of chronic fever Exhibited to patients who have been ill for more than 6 weeks.
By the level of temperature rise:
- subfebrile (temperature does not exceed 38 ºC);
- febrile (38.1 - 40.9 ºC);
- excessive febrile or hyperpyrexia (more than 41.0 ºC).
By type of temperature curve:
- prolonged persistent fever (on the graph it looks like an almost straight line, there are no pronounced rises and falls in temperature, fluctuations within 1 ºC are possible);
- intermittent (pronounced fluctuations from very high numbers to normal, decrease and rise in temperature occurs sharply, which exhausts the patient);
- remitting (without antipyretic drugs, the temperature does not drop to normal values);
- hectic (the gap between the maximum and minimum figures of temperature indicators reaches 5 ºC, jumps and falls can occur several times a day);
- undulating (gradual increase and decrease in temperature);
- returnable (the high temperature lasts for several days, then decreases and rises again);
- biphasic (with this type of fever, 2 phases of temperature rise are observed with the same disease);
- periodic (fever that recurs at regular intervals).
Hyperthermia in children can clinically occur in the form "Pink" and "white" fever... "Pink" or "red" fever has a more favorable course and a good response to the introduction of antipyretic drugs. Clinically, it is manifested by redness of the skin, limbs hot to the touch. And also "pink" fever is characterized by a normal reaction of the body to high temperature, that is, increased heart rate and respiration.
"White" or "pale" fever refers to a more serious situation, since it centralizes blood circulation and impairs microcirculation. Clinically, this is manifested by pallor of the skin, cooling of the extremities, cyanosis (blue discoloration) of visible mucous membranes is possible, a positive symptom of a "white spot".
"White" type of fever is dangerous because children may develop convulsive syndrome, damage to the central nervous system.
Causes of hyperthermic syndrome in children
Hyperthermia syndrome in children can occur for a number of reasons. The most common reason is, of course, infectious agents. Also, an excessive increase in temperature can lead to eDocrine diseases, metabolic disorders, nervous system damage and severe allergic reactions.
With improper child care, especially in the summer, hyperthermic syndrome can develop against the background overheating of the baby... Sometimes a rise in temperature is observed in response to transfusion of blood components.
Manifestation of hyperthermic syndrome
The increased body temperature in the baby should cause alertness! The febrile syndrome requires differentiation.
Very often in children, fever is combined with a number of other symptoms.
Fever with localized symptoms
Fever associated with local manifestations:
- combination of high fever with catarrhal symptoms typical for acute viral lesions of the ENT organs and the respiratory system (rhinitis, pharyngitis, tracheitis);
- fever with rash may be the main symptoms for scarlet fever, rubella, measles, meningococcemia, allergies;
- fever combined with inflammation of the tonsils characteristic of viral and bacterial lesions of the tonsils, infectious mononucleosis;
- fever with shortness of breath in a child, it may indicate damage to the larynx and lower respiratory tract (bronchitis with an obstructive component, bronchiolitis, asthmatic attacks against the background of a respiratory infection, pneumonia);
- fever combined with cerebral symptoms possible with febrile seizures, meningitis, encephalitis;
- fever with diarrhea typical for acute intestinal infections (more often for rotavirus infection);
- fever along with abdominal pain should alert the doctor. It is necessary to make every effort for a quick diagnosis, because surgical pathology (appendicitis) is possible;
- fever in combination with urination disorder, and also possible abdominal pain is characteristic of an infection of the genitourinary system;
- fever with joint involvement may suggest acute rheumatic fever, arthritis.
Fever with no visible site of infection
Fever without a visible focus of infection occurs in about 20% of cases. This concept consists in the absence of clinical manifestations, with the exception of fever, in a certain period of time.
Criteria for diagnosing this fever:
- the age group (up to 2 months of age), in which there is a single clinical symptom - fever above 38 ºC;
- children 3 months to 3 years of age with a fever over 39 ºC;
- absence of other clinical symptoms of the disease.
In the absence of a visible focus of infection in the presence of a high temperature, it is possible to assume the development of a viral infection in the body (influenza, herpes type 6.7, Epstein-Barr virus, enterovirus), the initial stage of bacterial infection (meningitis, infection of the genitourinary system, sepsis).
Fever of unknown origin
Fever of unknown origin is a diagnosis that can be made if all pathological conditions are excluded. Fever for no apparent reason can be observed in some infections (tuberculosis, infections of the central nervous system, as well as bones and joints, acquired secondary immunodeficiency syndrome, syphilis), autoimmune diseases (juvenile rheumatoid arthritis, systemic lupus erythematosus, vasculitis), oncological diseases (leukemia, lymphogranulomatosis, tumor of the kidneys, heart, liver).
Approaches to the diagnosis of hyperthermia syndrome in children
When identifying a child with fever, it is important to establish the type of fever, the type of temperature curve. It is necessary to carefully collect complaints and anamnesis. It is important to conduct a full examination of the patient, to assess the function of the respiratory, nervous and cardiovascular systems. The physician should try to establish a connection between fever and possible etiological factors.
It is important to correctly measure the body temperature. It is necessary to carry out the procedure from the moment the patient's condition worsens and repeat it periodically. The device is set to the minimum digits. The armpit, where the mercury medical thermometer is to be installed, must be dry and free of inflammatory changes. The temperature measurement procedure lasts 10 minutes, while it is important to create tight contact of the measuring device with the skin.
Treatment of hyperthermic syndrome in children
First aid
In most cases, the child's temperature rises at home, so parents should be able to provide first aid. But therapeutic measures are different, depending on the type of fever. Non-drug help for "pink" hyperthermia at the pre-medical stage is to exclude all conditions that may impede effective heat transfer.
It is necessary to undress the patient, for the purpose of cooling, put a wet towel at room temperature on the child's forehead. Give as much liquid as possible (water, compote, diluted fruit drink, tea).
Do not rub your child with vinegar, vodka and other liquids hazardous to the skin!
On the contrary, non-drug therapy for "white" fever should be aimed at warming the patient. The limbs can be rubbed with physical methods, and warm heating pads are also allowed. A plentiful drinking regime is also important.
Hospitalization of children with "white" fever, especially under the age of 3 years, with a history of seizures, pathology of the nervous, cardiovascular system, is required.
Drug therapy
Medical therapy should be selected by the doctor at the time of the call. The main drug prescribed for fever is antipyretics (antipyretics). Medicines from this group are prescribed in order to eliminate the existing discomfort, to prevent possible complications. Antipyretic drugs increase heat transfer due to the expansion of skin vessels and sweat production, and also reduce heat production.
There are also disadvantages in prescribing antipyretics. They mask the clinical symptoms of infectious diseases, as a result of which the establishment of the correct diagnosis is delayed. Therefore, antipyretics should be prescribed strictly according to indications: fever over 39 ºC, in the presence of shock, muscle and headache.
But one should not forget about the exceptions to the above criteria: the child's age is up to 3 years, then the appointment of antipyretics should be at a temperature above 38 ºC, in the presence of pulmonary and cardiovascular pathology (in this situation, you should not expect a temperature rise above 38.5 ºC) , as well as if there is a history of hyperpyrexia.
Medicines used in pediatric practice: Acetaminophen (from 1 month), Ibuprofen (from 3 months), Metamezole sodium (from 6 months).
Acetaminophen (Paracetamol, Panadol) should be used no more than 4 times a day, observing an interval of at least 4 hours. A single dose is 15 mg / kg.
A daily dose of more than 60 mg / kg is dangerous for children!
Ibuprofen (Nurofen) - a single dose of which is 6-10 mg / kg, the daily dose is 40 mg / kg. The frequency of admission should also not be more than 4 times a day.
Metamezole sodium (analgin) and diphenhydramine cannot be combined!
Other drugs that are used in the treatment of hyperthermic syndrome include nicotinic acid (a vasodilator drug prescribed to improve microcirculation with white fever).
Steroids may be prescribed to treat fever in certain autoimmune diseases. Non-steroidal anti-inflammatory drugs (Nimesulide, Diclofenac, Meloxicam, Indomethacin) are used for rheumatic diseases.
It is forbidden to use aspirin in children's practice!
Tactics after stopping an attack
After stopping the attack, tactics should be observant. During the examination, the doctor identifies the underlying disease and prescribes proper treatment. Children from the risk group are subject to hospitalization (the presence of "white" fever with an unfavorable background, the addition of convulsive syndrome, children with severe somatic pathology).
Why is hyperthermic syndrome dangerous?
High temperature is dangerous for a small organism, therefore, antipyretics should be used, but not neglecting the above rules. Possible complications: cerebral edema, dehydration, dysfunction of vital organs.
Dangerous is the appearance of febrile seizures against a background of fever. They occur in 2 - 4% of cases, more often at the age of 6 - 18 months. The presence of febrile seizures is an absolute indication for hospitalization, for the purpose of examination to exclude epilepsy. Confirmation of epilepsy implies prescription of anticonvulsants.
Forecast
In most cases, the prognosis for hyperthermic syndrome is favorable. Complications associated with fever significantly worsen the prognosis.
How to avoid the development of hyperthermic syndrome?
An increase in temperature is a normal reaction of the body to the action of pathogenic microorganisms. An unfavorable fact is the lack of response to pathological influences from the outside. Therefore, it will not be possible to avoid hyperthermia. It is important to start treatment on time and correctly during illness.
It is these actions that will help prevent possible complications and an inadequate response of the body to the pathogen. It is also necessary to single out children from the risk group who may develop an unfavorable course of the disease.
Conclusion
A child can get sick quite often, especially in kindergarten. A closed institution increases the risk of contracting various infections. Almost all acute diseases are accompanied by an increase in temperature.
Fever cannot be prevented. It is important to be able to provide first aid to a child during illness. A timely call to a specialist, a correctly diagnosed and appropriate treatment are factors that will ensure a favorable prognosis of hyperthermic syndrome, and also reduce the risk of complications.
