Prolonged Fever in Korean Children: Review of 120 cases

ABSTRACT

Author reviewed the patients with temperature over 38.5 degress C for longer than two weeks and of undetermined etiology who were admitted and treated in Yonsei Medical Center during the period from Jan. 1974 to Aug. 1978. There have been 120 cases of prolonged fever in that period. The following results were obtained; 1. The children who were admitted with prolonged fever occupied 1.3% of total in-patients at the same period. 2. 16 cases were less than 1 year of age at admission and 64 were 1 to 6 years. So 2/3 of total cases were less than 6 years of age. The ratio of Male to Female was 1.61. 3. There Was no apparent difference in seasonal incidence. But from May to September slightly increased number was noted. 4. In 58 cases(48.3%), the fever persisted 2 to 3 weeks before admission and 27 cases lasted longer than a month. . Three patterns of fever were observed; intermittent type 75 cases(62.5%), daily spiking 32(26.7%) and constant 13(10.8%) 5. The final diagnoses as a cause of fever were as follows. Infections accounted for 81 cases(67.5%), malignancy 17(14.2%), collagen diseases 7(5.8%) and miscellaneous cause 1(0.8%). 14 cases(11.7%) remained undiagnosed at the cenclusion of their hospitalization. . Certain relationships between diagnosis and age were noted. Infection was the most common etiology in all age groups but 72.5% of these children were less than 6 years old. 71.4% of collagen diseases were older than 6 years. Malignancy had no age predilection. 6. Over 80% of all cases the diagnosis were made within a week and the fever disappeared in a week in 70% So most of them(75%) discharged within 2 weeks after admission. 7. Careful history suggested the final diagnosis in 84 cases(70%) and repeated physical examinations were helpful in 70 cases(58.3%) Abnormal findings in routine chest P-A were present in 47.5% Erythrocyte sedimentation rate was significantly increased in 26/34 cases(76.5%). 47 cases(39.2%) were anemic for age and all children with malignancy were anemic. Lumbar puncture, bone marrow aspiration, tissue biopsy and explo. Laparotomy were performed only in suspected cases. 8. Outcome on discharge were as follows; 90 cases(75.0%) were much improved, 21(17.5%) discharged without improvement and 9 cases(7.5%) expired.