Physician's perceptions of fever in children: Facts and myths

To ascertain the knowledge and attitude of physicians, regarding fever in children. A self-administered questionnaire was mailed to 600 randomly selected pediatricians, family practice physicians, emergency medicine physicians and general practitioners, who practice in Saudi Arabia. Appropriateness of responses to questions was determined on the basis of current medical literature. A rectal temperature of 38.0°C is generally accepted as indicative of fever in children. Of the 600 physicians surveyed, 419 [70%] completed and returned the questionnaire; 17% of the physicians were consultants, 28% specialists and 55% general practitioners. Fifty-eight% of the physicians had 10 years or more of experience. A rectal temperature of less than 38.0°C was considered to indicate fever by 38% of physicians. Nearly 84% of physicians would initiate antipyretic therapy at a temperature of 38.5°C or less and 56% cited a temperature of 40.0°C or less to be dangerous. Only 5% believed that fever was not dangerous, while the remaining cited the principal danger of fever to be convulsions [69%], brain damage [35%], or death [8%]. The responses to the main purpose of antipyretic treatment were to prevent convulsions [70%], to make the child comfortable [55%] and to prevent brain damage [29%]. Approximately 53% of physicians reported that the most serious consequences of febrile convulsions were brain damage, learning disability, epilepsy, or death. Only 26% of physicians agreed that a sleeping child with fever should be left undisturbed. Approximately 25% advised inappropriate dosage or administration intervals of paracetamol. Almost all physicians recommended sponging or bathing to reduce fever. All respondents try to educate parents regarding fever and its management. A significant number of the surveyed physicians have demonstrated a serious lack of knowledge of the nature, dangers and management of an extremely common health problem. Physicians differ substantially in their knowledge of, and attitude toward fever in children, which is perhaps attributed to their different background in medical education and clinical training

Parental perceptions of fever in children

Fever is a common medical problem in children which often prompts parents to seek immediate medical care. The objective of this study was to survey parents about their knowledge and attitude concerning fever in their children. Patients and The study involved the random selection of Saudi parents who brought their febrile children to the emergency rooms or walk-in clinics of four hospitals in Riyadh. Parents of 560 febrile children were interviewed using a standard questionnaire to obtain sociodemographic information and current knowledge of fever. Approximately 70% of the respondents were female, and the ages of the most were in the range of 20-40 years. More than 80% of the parents had two or more children. More than 70% of parents demonstrated a poor understanding of the definition of fever, high fever, maximum temperature of untreated fever, and threshold temperature warranting antipyresis. About 25% of parents considered temperatures less than 38.0°C to be fever, another 25% did not know the definition of fever, 64% felt that temperatures of less than 40.0°C could be dangerous to a child, and 25% could not define high fever. Another 23% believed that if left untreated, temperatures could rise to 42.0°C or higher, but 37% could not provide an answer, and 62% did not know the minimum temperature for administering antipyretics. Approximately 95% of parents demonstrated undue fear of consequent body damage from fever, including convulsion, brain damage or stroke, coma, serious vague illness, blindness, and even death. Parental misconceptions about fever reflect the lack of active health education in our community. Health professionals have apparently not done enough to educate parents on the condition of fever and its consequences, a common problem

battered child syndrome: does it exist in Saudi Arabia?

Child maltreatment is a common, serious, and under-reported medical problem which has become an increasingly important concern for paediatricians worldwide. Five boys and two girls, aged 5 months to 7 years, with convincing evidence of child abuse and/or neglect were seen by the author in a teaching hospital over a period of 4 years. These seven cases are described in order to alert individuals concerned with the welfare of children in Saudi Arabia that battered child syndrome may be commoner than currently thought. The acts of abuse were diverse in quality and planning. Three cases escaped early recognition and the victims were repeatedly abused. A high index of suspicion Is required for immediate and accurate diagnosis not only to prevent further damage to the defenceless child, but also to allow for effective intervention for parents who themselves are often in urgent need of care

Kawasaki syndrome in a Saudi child: a case report and review of the literature

Kawasaki syndrome is an acute febrile illness of the young children. It was first recognized and described in Japan by Kawasaki in 1967; however, Kawasaki syndrome has now been recognized throughout the world. Since the etiology of the illness is unknown and a specific diagnostic test is not available, the diagnosis is made on clinical grounds. Prolonged fever, injection of mucosa and conjunctivae, redness, edema and desquamation of extremities, skin rashes, and cervical lymphadenopathy make up the syndrome. The illness is usually self-limited in most children but serious complications can occur, including coronary aneurysms which may result in thrombotic occlusion and ultimately myocardial infarction. Although rational treatment is not available at present, early reports of recent therapeutic trials using high-dose intravenous gamma globulin [IVGG] in conjunction with aspirin have been encouraging. The following report describes the first Saudi boy who developed a prolonged febrile illness that fulfilled the classical diagnostic criteria of Kawasaki syndrome which was complicated by a persistent mitral valve regurgitation