| Prolonged Fever in Korean Children: Review of 120 Cases. |
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Ho Seong Kim, Dong Goo Lee, Dong Soo Kim |
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Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea |
| 소아의 장기열
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김호성, 이동구, 김동수 |
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연세대학교 의과대학 소아과학교실 |
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Received: 9 May 1990 • Accepted: 24 July 1990 |
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| Abstract |
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The authors reviewed the 120 patients with prolonged fever whose temperature was over 38.5°C and
of undetermined etiology, who were admitted in Y야isei Medical Center from March 1982 to March
1989. The results were as follows;
1) The children admitted with prolonged fever were 0.3% of total in-patients at the same time.
2) 20 cases were less than 1 year of age on admission and 39 were between 1 and 6 years.
The ratio of male to female was 1.5:1.
3) There was no remarkable seasonal variation, but prolonged fever was prevalent in summer time
(from May to October).
4) In 87 cases (72.5%), the fever persisted 2 to 3 weeks before admission and in 21 cases (17.5%)
lasted longer than a month.
Three patterns of fever were observed; intermittent type in 75 cases (62.5%), daily spiking in 28
cases (23.3%) and constant in 17 cases (14.2%).
5) Infections accounted for 72 cases (60%), malignancy for 16 cases (13.3%), collagen diseases for
10 cases (8.3%) and miscellaneous cause for 2 cases (1.7%). Twenty cases remained undiagnosed.
Infection was the most common etiology in all age groups. Seventy percent of collagen diseases
were in older age group than 6 years old. Malignancy had no age predilection.
In infections, sepsis accounted for 23 cases, tuberculosis for 9 cases, infective endocarditis for 6
cases. These three consisted of 52.8% of all infections. Compared to previous reports, tuberculosis and
typhoid fever showed a decreasing tendency.
6) The involved organs were as follows; multiple organs accounted for 41 cases (34.2%),
hematopoietic system for 13 cases (10.8%), respiratory system for 12 cases (10.0%). The involved
organs had no age predilection.
7) Fifty six point seven percent of all cases were diagnosed within a week and defeverscent period
was a week in 27.5%. Thirty point eight percent of all cases was discharged within 2 weeks of
admission.
8) Careful history taking and repeated physical examination were helpful in 76 cases (63.3%).
Routine CBC, urinalysis, chest P-A were helpful in 25 cases (20.8%). Among 120 bacterial culture
studies, 35 cases (29.2%) were positive on blood culture, 12 cases (10.0%) on urine culture, 15 cases (12.
5%) on stool culture. More specific studies were considered according to the progress of the disease
and were absolutely helpful for more accurate diagnosis.
9) The outcome were as follows; 89 cases (74.2%) were improved, 22 cases (18.3%) discharged
without improvement and 9 cases (7.5%) expired. |
| Key Words:
Prolonged fever |
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