Fevers

Question 1

Give examples of non- infectious causes for a fever?

Answer 1

• Vaccinations
• Drugs
• IBD
• CT disease
• Cancer

Question 2

What is considered fever in a child

Answer 2

Not necessarily > 38 degrees

Change in body temperature which is different from normal diurnal variation changes

Question 3

How would you measure fever In a child< 4months

Answer 3

Axillary electronic thermometer

Question 4

How would you measure fever in a child 4 weeks to 5 months

Answer 4

Infrared tympanic membrane thermometer

Question 5

What should be asked about when assessing possible source of an infection?

Answer 5

• Previous patterns on infection
• Any contacts with possible infection
• Travel history
• Potential food/ water contamination
• Vaccination history
• Personal/family history of immunocompromise

Question 6

What are really important signs of fever to identify

Answer 6

• Neck stiffness, photophobia
• Non blanching rash
• Not using limbs/ joints– osteomyelitis

Question 7

What investigations would you routinely consider

Answer 7

• FBC
• Blood culture
• Urine culture
• CRP
• LP
• EEG
• Blood gas

Question 8

When would you consider an X-ray

Answer 8

Unknown source

• Red features
• Temp over 39 degrees
• WCC over 20x10*9
• Child > 3 months

Question 9

Can you use paracetamol and ibuprofen in young children?

Answer 9

YES

Question 10

Which broad spec antibiotics would you give without knowing cause of infection?

Answer 10

if < 3months: cefotaxime + amoxicillin

if> 3months: cefotaxime

Question 11

Common presentation of febrile convulsions?

Answer 11

• 6 months to 5 years
• Does not usually last more than 3- 6 mins
• Tonic clonic movement
• Usually recovers within 1 hour
• Fever around the time of seizure

Question 12

Differentials for a febrile convulsion

Answer 12

• Epileptic seizure
• rigors
• Hypoglycemia
• Poisoning
• Brain injury following trauma
• Permanent neuro disorder

Question 13

Which medications would you give to a child who is suffering from a complex febrile seizure?

Answer 13

• Rectal diazepam

- Buccal midazolam

Question 14

How would a complex febrile seizure present?

Answer 14

> 15 minutes

Would reoccur again within 24 hours

Question 15

What information would you want to give the parent?

Answer 15

• very common
• not likely to be epilepsy
• Doesn’t usually mean increased risk of epilepsy
• 50% will have recurrences
• Teach about use of antipyretic