Cold fever in a child what to do temperature. Pale fever in children

An increase in body temperature in children with influenza, ARVI, and colds is quite common occurrence. This suggests that immune system began to actively resist viruses that entered the body.

However, if a high temperature is accompanied by pale skin and cold extremities, this becomes dangerous symptom. In medicine there is a concept “ white fever at the child." We will talk about her.

Fever itself is not a disease. It is the body’s protective reaction to inflammatory or infectious foci.

In medicine, a distinction is made between red and white fever (red fever is often called pink fever). These two varieties have different symptoms and consequences, so actions to stabilize the child’s condition are also different.

Red and pink fever

Unlike white fever, red or pink fever is much milder and generally has a positive effect on the body.

This condition can be recognized by several symptoms:

• pink or red skin (it is because of this symptom that it was called “red fever”);
• hot extremities;
• damp skin;
• general condition the child is characterized as satisfactory.

With these symptoms, there is a danger of overheating child's body is absent, since along with an increase in body temperature, heat transfer also increases.

Pale fever

Pale fever is completely different. Main danger is that children not only develop a high temperature, but also their blood circulation is disrupted. Such changes lead to an imbalance between the production and loss of heat by the body.

As a result long stay in this condition there is a risk of peripheral vascular spasms. This is especially dangerous for life in childhood from birth to one year.

This is why the disease cannot be started.

It is important to identify such signs in time and take action. urgent measures.

Fever in children occurs for certain reasons, but this condition is almost always accompanied by the presence of various types of acute infections in the body:

• fungal;
• viral;
• bacterial.

Residents of continental climates often encounter such symptoms with acute respiratory infections, otitis media, bronchitis, and pneumonia. In places with hot climates, febrile conditions can become a symptom of intestinal infections. Such pathogens enter the body through digestive system(when eating food and water).

In some children, an increase in temperature and a violation of heat transfer appears during strong allergic reactions. Much less often, white fever occurs in cases of poisoning, rheumatic symptoms and oncology. These are the causes of white fever in a child that can trigger the disease.

Important! Similar manifestations are sometimes observed after a vaccine against a virus: whooping cough, measles or influenza.

Symptoms of white fever

You can guess what the symptoms of white fever are just from the name alone. The main symptom characterizing this condition is excessive pallor. skin. At the same time, this phenomenon has 3 stages:

1. A sharp increase in temperature associated with a violation of heat transfer.
2. Stabilization of temperature (however, it remains elevated).
3. Slow gradual decrease in body temperature, normalization of the condition.

The course of the disease is accompanied by the following main symptoms, namely:

• high temperature;
• pallor of the skin (the nasolabial triangle and the lips themselves acquire a bluish tint, blue circles appear under the eyes);
• “marbled” skin (this definition is used if a network of bluish blood vessels is visible through the skin);
• cold extremities of the child (palms and feet) even with high temperature; this is precisely the main symptom that distinguishes this condition from any other;
• headache;
• arrhythmia (the doctor may detect a rapid or altered heart rhythm);
• hallucinations (their appearance is possible at temperatures above 39 degrees);
• the occurrence of seizures (they often accompany high fever);
• lethargy, apathy, lack of appetite.

It is worth noting that some children, even in this state, remain increased activity, and therefore parents may have doubts. To determine whether a child actually has a cold (pale) fever, you can use the “pale test” test. It is often used by doctors. To do this, apply light pressure to the baby's skin. thumb. If this place on the child’s body has acquired a white tint, and the color for a long time is not restored, there should be no doubt.

Urgent Care

What to do if a child has white fever? First of all, don't panic. As soon as parents discover symptoms of this condition in their baby, they urgently need to take action:

• If the child is very small (under 1 year), then the best solution would be to call an ambulance. For older children, a pediatrician is called.
• Give antipyretics with caution. The fact is that certain types of medications are undesirable for fever.
• Before the doctor arrives, first emergency aid must be provided.

First of all, the child needs to be reassured, since fever, weakness and other symptoms can frighten children. Parents should read a fairy tale, hug their child, and spend as much time with him as possible. The baby should feel constant parental care and support. Doctors have long agreed that for quick recovery and recovery, not only drug treatment is important, but also a good emotional background.

Equal attention should be paid to adequate fluid intake. This could be warm sweet tea, compote, herbal infusions, fruit drink, natural juice, milk.

In this condition, the baby usually has a reduced or no appetite. For the same reason, you should exclude all heavy foods from the diet, include more vegetables and fruits, as well as those dishes that can please the child.

Important! In case of convulsions, you should call an ambulance as soon as possible.

Do's and Don'ts for White Fever

Treatment of white fever requires a special approach, since this condition is different from the usual and pink fever. It is quite rare, but parents should still know the rules of behavior for such symptoms in children. An error in treatment can lead to serious complications and even cost life.

What not to do

Below are 5 things you should not do:

1. If you have a body temperature and cold extremities, you cannot sharply reduce the temperature to 36.6 degrees by any means.
2. If, after the dose of antipyretic prescribed by the doctor, the temperature has not decreased, the amount of medicine cannot be exceeded. This will cause an overdose and poisoning.
3. Fever is often accompanied by chills. The child may shake, in which case the baby will complain of extreme cold. The use of a heating pad or heater during this period is strictly contraindicated. The baby should not be wrapped in a blanket (this will lead to a further increase in temperature.
4. Do not cool the patient's body. Thus, covering with a wet cold sheet is suitable for treating pink fever, but in the case of white fever, this method is dangerous.
5. Rubbing the body with alcohol-containing compounds is prohibited, as this leads to severe vasospasm.

What to do

To warm the baby's legs and arms, blood circulation in these parts of the body should be restored. To do this, perform a light massage. Massaging movements gradually restore blood flow in the tissues and promote a warming effect. You can consolidate the result with warm drinks.

To eliminate the risk of complications (the appearance of seizures, hallucinations), it is worth giving children antipyretics at a temperature of 38.5-39 degrees, and it is better to avoid some medications.

Important: doctors say that in this case you cannot use acetylsalicylic acid, nimesulide, or analgin. These medications may cause side effects.

When choosing the form of an antipyretic drug, you should give preference to syrups or tablets. After taking the suppositories, they may not give the desired effect due to impaired blood circulation and poor absorption.

Usually, treatment is not limited to antipyretics - doctors prescribe medications from certain groups. These could be the following:

• anti-inflammatory;
• antispasmodics;
• receiving others medicines depending on the cause of the disease.

Knowing the basic symptoms and principles of treatment, parents can easily cope with even such a serious manifestation of the disease as white fever.

In children under one year of age, diseases that they would easily endure at an older age can cause complications. A cold can cause white fever, a dangerous condition characterized by high fever and severe dehydration. Although fever is a positive sign for infections (it indicates that the body is fighting the disease), white fever in a child can lead to serious consequences.

What is white fever and why is it dangerous?

White, or pale, fever in medicine is a condition that occurs as a protective reaction of the body against a viral or bacterial infection. In itself, it is not an independent disease, but appears as a consequence of the body’s struggle against a specific disease.

There are 2 types of fevers - red and white. This name appeared because of the color of the skin when the temperature jumps - the skin turns red or pale. Among these species, the white type is more dangerous.

What is the danger for the child, since fever is a defensive reaction indicating that the body is fighting defeat? In 3% of cases, the appearance of such a symptom ends in febrile convulsions. If high body temperature is not brought down, it leads to damage internal organs and brain.

Causes of white fever in a child

The cause is almost any infection in a baby:

• viral;
• bacterial;
• fungal.

Often occurs in children who have caught ARVI and have not received timely treatment. The occurrence of symptoms is facilitated by acute respiratory diseases, bronchitis, pneumonia.

With the onset of the hot season, the risk of contracting intestinal infections increases, and cases of food poisoning. This can also provoke the occurrence of a feverish state.

Less common are cases where fever develops against the background of injuries, burns, malignant or benign tumors. Sometimes this can be a reaction to severe stress and emotional overstrain.

Symptoms of white fever

Pale fever goes through 3 stages of development:

• a sharp rise in body temperature;
• temperature freezing at one value, usually high;
• slow decrease in temperature indicators.

The child exhibits the following signs:

• bluish skin streaked with veins, which acquires a bluish tint around the eyes and near the nose;
• body temperature - about 39°C or higher;
• cold hands and feet at temperatures above 39°C (we recommend reading:);
• headache, lethargy, lack of appetite.

Not every parent knows how to independently determine what kind of condition is developing in their baby. The child does not necessarily have all the symptoms - he may remain active and not complain of headaches. Experienced pediatricians advise using a proven method - pressing the pad of your finger on the baby’s skin. If a white mark remains on the skin that does not disappear for a long time, then this is white fever.

What are the danger signs of white fever?

Fever is a protective reaction of the child's body to infection. The task of a doctor or parent is to help the child cope with this condition. If the following signs occur, you should immediately sound the alarm:

• hallucinations and delusions at temperatures above 39°C;
• disruptions in the functioning of the heart - arrhythmia, tachycardia;
• temperature over 40°C;
• febrile seizures.

The child’s body cannot cope with such manifestations on its own. When these extreme danger signs you should call your doctor immediately.

Emergency care for a child

If the baby is less than six months old, then for any symptoms you should call ambulance. The development of a dangerous condition in newborns occurs rapidly; the parent may not have time to react. Those signs that seem harmless for older children can be fatal for a baby a few months old.

What to do if you have febrile seizures? Parents will not have time to call a doctor, so it is important to react correctly themselves and provide emergency assistance. During an attack, place the child on his side and move his head back slightly - this will make breathing easier for him. If the baby clenches his jaws tightly, do not open them - this leads to damage.

Regardless of the patient’s age, call a doctor if the temperature exceeds 39°. You can give an antipyretic if the fever rises above this level and does not subside, but do not reduce the fever when it is relatively low temperatures 37.5°-38°, because this indicates that the body is fighting infection, and an artificially low temperature makes diagnosis difficult.

Before the doctor arrives, cover your child with a blanket, especially his legs and arms, but be careful not to overheat. Fever is characterized by dehydration, so give more water and warm tea.

Diagnostic methods

Diagnosis is carried out according to the symptoms described above and others characteristic features, for example, a white mark from pressing. Depending on concomitant illness Additional symptoms may appear:

• rash - rubella, measles, allergic reaction;
• shortness of breath, difficulty breathing, asthma attacks - asthma, bronchitis, pneumonia;
• diarrhea - intestinal infections and poisoning (we recommend reading:);
• abdominal pain, nausea, vomiting - genitourinary infection, appendicitis;
• joint pain - rheumatism, arthritis.

Only a pediatrician can correctly diagnose a fever and the disease that caused it. Parents should not engage in self-diagnosis; their task is to call a doctor in time.

Features of treatment

Treatment is prescribed only by a doctor. Self-medication is dangerous for the health and life of the baby. The pediatrician develops therapeutic regimens depending on the symptoms and illness that caused the fever.

Parents can also take the following measures:

Make sure your child is comfortable. He is scared and doesn't feel well, so it's a good idea to pamper him with his favorite food, but don't force your baby to eat if he refuses. Pay more attention to him, read a fairy tale and remain calm yourself - the parents’ anxiety is transmitted to the child.

Prognosis and possible complications in the child

If parents are attentive to the baby’s health and follow all the doctor’s instructions, then the prognosis for fever is favorable. Compliance with the rules of treatment will help the baby successfully cope with the disease.

Do not worry if your body temperature does not drop immediately when taking an antipyretic drug. Sharp decline heat is also harmful to the body, and it must subside gradually. The normal level is 38°C.

However, if parents do not pay due attention to the child’s condition, they do not call an ambulance critical situation, ignore the pediatrician’s prescriptions or engage in dangerous self-medication, complications may develop. The most dangerous condition is febrile seizures. They are expressed in muscle spasms, convulsions, an attack similar to epileptic seizure. Febrile seizures are dangerous for the central nervous system.

No less dangerous condition is hyperthermia at temperatures above 40°C. With such heat, extensive damage to internal organs occurs, which can lead to death.

How is white fever different from red fever?

The second type of fever that appears in response to an infectious disease is called red or pink. In medical circles it is believed that such fever is milder and less dangerous than pale fever.

The main difference between these two conditions is that with pink fever, heat loss corresponds to heat production. The body temperature does not rise above 37.5°C, there are no disruptions in the functioning of the heart, the skin becomes pink, the child is sweating. Such a fever is even beneficial for the body, as it helps it fight infection.

With pale fever, heat transfer does not correspond to heat production due to impaired peripheral circulation, so this condition is considered much more dangerous than red fever. A good sign is the transition of white fever to pink fever.

Preventive measures

Measures to prevent the occurrence of fever include preventing the diseases that cause it. First of all, you need to ensure that your baby:

If any illness occurs that can lead to the development of fever, you should:

• give as much fluid as possible - it will help with dehydration;
• ventilate the room - bacteria and viruses love damp, stuffy rooms;
• humidify the air - this has a beneficial effect on the respiratory tract;
• do not wipe the child with vinegar or alcohol;
• strictly follow the doctor’s instructions;
• If dangerous or unclear symptoms occur, call an ambulance.

Successful treatment is facilitated by good emotional state. In moments of weakness, the child especially needs the presence of his mother. Give your baby as much attention as possible, read a fairy tale, tell interesting story, and the baby will get better.

Everyone knows that fever has an important function protective function for the body - helps the immune system fight the invasion of foreign bacteria and viruses. However, some types of fever can be fatal to a child's body. One of these types is white fever. With it, the child has a high fever and cold extremities. If you want to know why this condition develops and how to help your baby, read this article.

What is it?

Fever itself is not considered a disease. It develops as a protective reaction against a large number of acute infectious and inflammatory diseases. The apparatus responsible for thermoregulation reacts with heat (to special substances that penetrate from the outside - pyrogens).

Usually they are not independent substances, but components of various pathogenic microorganisms and viruses. They act at the level of the brain - shifting the point in the center of thermoregulation, which is located in the hypothalamus.

Medicine is familiar different types fevers, however, all of them (regardless of the cause) are conventionally divided into red and pale, so designated by the main color of the skin during the disease. The second includes white fever.

The body needs high temperature because during illness it stimulates the production of interferons, proteins necessary for the processes immune defense. However, too high a heat becomes dangerous for the baby in itself.

White fever is accompanied not only by high temperature, but also by impaired blood circulation, as well as an imbalance between the body's production of heat and its release. Spasm of peripheral vessels develops, and this is very dangerous, especially for babies from birth to one year.

Symptoms and signs

White fever is a name that reveals the essence of the child’s condition as fully as possible. At high temperatures, the child looks pale, his lips and nasolabial triangle acquire a bluish tint, and bluish circles appear under the eyes. You may notice a bluish tint on the skin vascular network, and for this feature the skin with white fever is sometimes called “marbled”. Due to impaired blood circulation, the arms and legs become cold, almost icy.

Many kids feel quite cheerful even in high heat. In the case of white fever, everything is different - the child is very lethargic, all the symptoms of intoxication are evident, he is very weak.

The baby's pulse is rapid, and changes in heart rate may be observed. Children who can verbally express their complaints may complain of feeling cold and have severe chills. May be elevated blood pressure. At a temperature above 39.0 degrees, hallucinations, clouding of consciousness may occur, the child begins to delirium, and often has febrile convulsions.

The main and main symptom that allows you to distinguish white fever from any other is cold hands and feet. If parents notice this, they are obliged to provide emergency assistance to the child. If the temperature is above 39.0 degrees, you need to call an ambulance.

An additional diagnostic measure can be considered the “pale test”. If you lightly press the skin with your thumb, white fever leaves a light spot that cannot restore the natural color of the skin for a long time.

First aid

First aid for white fever is to warm the child’s limbs, restore vascular permeability, and ensure blood flow. To do this, it is strictly forbidden to use the popular methods of relieving fever - cold rubbing and wraps. This will only lead to an even greater loss of heat, and the baby’s condition will worsen. In case of pale fever, under no circumstances should you rub the child with alcohol, vodka, alcohol-containing compounds, or wrap him in a cold and wet sheet.

You should call an ambulance, and while waiting for the arrival of a team of doctors, rub the child’s arms and legs with light massaging movements, holding them between your palms.

You can use any heat source - a heating pad, a bottle of warm water. At the same time, antipyretic drugs are given.

For children, paracetamol-based drugs are considered optimal. Can be given in age dosage anti-inflammatory non-steroidal drug "Ibuprofen". Do not give two or more antipyretics at the same time. Aspirin and drugs based on it should be avoided, since taking it in childhood can provoke the occurrence of severe and very life-threatening Reye's syndrome for the baby.

If, with a normal fever, antipyretic drugs are given to children in different dosage forms(tablets, suppositories, syrups, powders), then for white fever it is worth limiting this list to tablets or syrups. Introduction rectal suppositories may be ineffective due to vasoconstriction.

To eliminate vascular spasm, you can give your child antispasmodic drugs. After a year - "No-shpu", up to a year – "Papaverine", but in a strict age dosage. If there is any doubt about the required amount of the drug, it is better to wait for the doctors to arrive.

When the temperature is high, the ambulance doctors give the children a “lytic” injection, which includes an antispasmodic (usually Papaverine), an anesthetic and an antipyretic "Analgin". Sometimes antihistamines are added to the lytic injection - for example, "Suprastin"(to reduce swelling of the mucous membranes and prevent the development of croup, edema and severe complications).

Before the ambulance arrives, it is imperative to provide warmth, but not to overheat the child, so that the fever does not begin to intensify. In addition, you should give your child plenty of warm drinks. This will help reduce the risk of dehydration and febrile seizures. If the child refuses to drink on his own, you need to use a syringe without a needle and infuse the drink dropwise (or give the baby something to drink using a teaspoon).

Forcing a child with white fever to eat is a parental crime. Firstly, the baby has absolutely no appetite, and secondly, the body needs strength to fight the infection that caused the fever, and not to digest food. That is why nature came up with everything so that when you are sick, appetite is one of the first to disappear and one of the last to appear.

Treatment

It is usually recommended to give antipyretics to children at a temperature of 38.5 to 39.0 degrees. However, in the case of white fever, assistance (including medication) cannot be delayed. Even if the thermometer has not yet approached 38.5, you still need to give an antipyretic and call an ambulance.

The most prompt response should be made to the appearance of so-called cold white fever in an infant, in a child under three years of age, in children with dysfunctions of the central nervous system, with neurological diagnoses, in children who have previously suffered from seizures at least once, as well as in children with diseases and defects cardiovascular system.

It should be noted that the temperature with white fever decreases after taking medications a little slower than with the red form of fever. Sometimes you need to wait more than an hour and a half. That is why it is best to immediately call a team of doctors.

IN specific treatment white fever is not needed. When the acute stage, which is dangerous from the point of view of convulsions and dehydration, has been stopped, the doctor will prescribe treatment that corresponds to the main diagnosis.

White fever usually accompanies the following diseases: ARVI, influenza, sinusitis, otitis media, bronchiolitis, pneumonia, pharyngitis, pyelonephritis, meningitis, chickenpox, measles. It is also an inadequate response of the child’s body to the post-vaccination period.

At viral infections the doctor will prescribe symptomatic treatment, to relieve symptoms of fever - antipyretics. At bacterial diseases he will prescribe antibiotics with simultaneous administration antipyretic drugs.

It is strictly forbidden to do inhalations (especially steam inhalations), rub the child with badger fat, make warming compresses (except for dry heat on the extremities in the acute stage), or practice cold and cool baths. All this is resolved after the temperature drops.

In this video, Dr. Komarovsky talks about emergency care at elevated temperature the child's body.

An increase in body temperature is known to be the body's protective response to an infection or virus.

But when the mark on the thermometer goes beyond 39, the benefit of such protection is significantly reduced. The state of hyperthermia becomes dangerous in itself, especially when it comes to young children. We will talk about white fever in a child in the article.

Concept and features

In medicine, fever is usually divided into white and pink, depending on the color of the skin during a temperature jump.

We can talk about white fever if the so-called white mark is noticeable.

This means that when you press on the skin, lasts for a long time white spot . This phenomenon is due to the fact that blood circulation is disrupted due to severe spasm.

Fever itself is not a disease; it indicates some kind of disease - and it is necessary to fight it. Susceptible to white fever in to a greater extent kids are considered early age, from 0 to 3 months.

This condition requires emergency qualified medical care, since failure to take timely measures can cause dire consequences.

Causes

Why does white fever occur in children? In most cases, this is due to an infection in the baby’s body, often this is the result of ARVI. But sometimes it is a reaction to injury, burn, swelling, hemorrhage, tumor.

Neurological and emotional stress can cause fever. Strong pain syndrome can also cause this condition.

5 main reasons white fever in children:

Fever in babies very dangerous— a convulsive syndrome is possible as a reaction to the still imperfect mechanisms of heat exchange processes in the baby’s body.

Therefore, children in this condition are urgently hospitalized, and treated and observed in the hospital.

What diseases does it accompany?

As already mentioned, this can respiratory infections VDP(upper respiratory tract). Any external attack on the baby’s body can be accompanied by white fever - be it microbial infection, burn or mechanical injury.

Babies cannot yet complain on their own, so if they have a fever, you need to immediately call a doctor - this may also be a harbinger of pneumonia.

The child is not taken to the doctor, but the local pediatrician is called, and maybe ambulance. The younger the baby, the faster complications develop, so you can’t hesitate.

Prevention

It is impossible to completely exclude the occurrence of fever. But if you take simple, understandable actions, stick to elementary rules, the risks of such conditions are significantly reduced.

Fever Prevention:

• child hygiene - always monitor and teach the baby himself;
• exclude hypothermia and overheating;
• during the cold season, do not take children to crowded places;
• temper and strengthen the child’s immunity;
• the house should be clean, fresh, and the air humid.

Do not listen to grandmothers and other relatives who suggest wiping your child with vodka or vinegar.

Exactly the same You can’t wrap up a child and force-feed him.

If you force a child to eat in this state, the body will spend a lot of energy digesting food instead of fighting the disease.

When it comes to babies, don’t wait for everything to go away on its own.

Fever is close critical conditions, therefore, urgently call a doctor and do everything that the specialist prescribes.

Tips for parents on using medications for fever in a child in this video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

Fever continues to be one of the leading reasons for seeking emergency care. medical care in pediatric practice.

It is noted that an increase in body temperature in children is not only one of the most frequent occasions visiting a doctor, but also the main reason for the uncontrolled use of various medications. At the same time, as antipyretic drugs for many years Traditionally, various non-steroidal anti-inflammatory drugs (salicylates, pyrazolone and para-aminophenol derivatives) have been used. However, in the late 1970s, convincing evidence emerged that the use of derivatives salicylic acid with viral infections in children may be accompanied by the development of Reye's syndrome. Considering that Reye's syndrome is characterized by an extremely unfavorable prognosis (mortality rate - up to 80%, high risk of developing serious neurological and cognitive impairments in survivors), in the United States in the early 80s it was decided to introduce a ban on the use of salicylates in children for influenza and ARVI and chickenpox. In addition, all over-the-counter medications that contained salicylates began to be labeled with a warning that their use in children with influenza and chickenpox may lead to the development of Reye's syndrome. All this contributed to a significant decrease in the incidence of Reye's syndrome in the United States. Thus, if before the restriction of the use of aspirin in children (in 1980), 555 cases were registered of this disease, then already in 1987 - only 36, and in 1997 - only 2 cases of Reye's syndrome. At the same time, data on serious side and undesirable effects of other antipyretics were accumulating. Thus, amidopyrine, often used by pediatricians in past decades, due to its high toxicity was also excluded from the nomenclature medicines. Convincing evidence that analgin (dipyrone, metamizole) may adversely affect bone marrow, inhibiting hematopoiesis, up to the development of fatal agranulocytosis, contributed to a sharp limitation of its use in medical practice in many countries of the world.

Serious analysis of results scientific research to study the comparative effectiveness and safety of various analgesics-antipyretics in children led to a significant reduction in antipyretic drugs approved for use in pediatric practice. Currently, only paracetamol and ibuprofen are officially recommended for use in children with fever as safe and effective antipyretic drugs. However, despite clear recommendations from the World Health Organization on the selection and use of antipyretics for fever in children, domestic pediatricians still often continue to use acetylsalicylic acid and analgin.

Development of fever
Before active implementation in medical practice antipyretic and antibacterial drugs, analysis of the characteristics of the course of the febrile reaction played an important diagnostic and prognostic value. At the same time, they highlighted specific features fevers in many infectious diseases ( typhoid fever, malaria, typhus, etc.). At the same time, S.P. Botkin, back in 1885, drew attention to the conventionality and abstractness of the average characteristics of fever. In addition, it is necessary to take into account the fact that the nature of the fever depends not only on the pathogenicity, pyrogenicity of the pathogen and the massiveness of its invasion or the severity of the processes of aseptic inflammation, but also on the individual age and constitutional characteristics of the patient’s reactivity and his background conditions.

Fever is usually assessed by the degree of increase in body temperature, the duration of the febrile period and the nature of the temperature curve:

Depending on the degree of temperature increase:

Depending on the duration of the febrile period:

It should be noted that currently, due to the widespread use of etiotropic (antibacterial) and symptomatic (antipyretic) drugs, early stages infectious disease, typical temperature curves are rarely seen in practice.

Clinical variants of fever and its biological significance
When analyzing the temperature reaction, it is very important not only to assess the magnitude of its rise, duration and fluctuations, but to compare this with the child’s condition and the clinical manifestations of the disease. This will not only make it much easier diagnostic search, but will also allow you to choose the right tactics for monitoring and treating the patient, which will ultimately determine the prognosis of the disease.

Particular attention should be paid to the clinical equivalents of the correspondence of heat transfer processes to an increased level of heat production, because depending on individual characteristics and background conditions, fever, even with the same level of hyperthermia, can occur differently in children.

Highlight "pink" and "pale" fever variants. If, with an increase in body temperature, heat transfer corresponds to heat production, then this indicates an adequate course of fever. Clinically this manifests itself "pink" fever. In this case, normal behavior and satisfactory well-being of the child are observed, the skin is pink or moderately hyperemic, moist and warm to the touch. This is a prognostically favorable variant of fever.

The absence of sweating in a child with pink skin and fever should raise suspicion of severe dehydration due to vomiting and diarrhea.

In the case when, with an increase in body temperature, heat transfer due to a significant impairment of peripheral circulation is inadequate to heat production, the fever acquires an inadequate course. The above is observed in another variant - "pale" fever. Clinically, a disturbance in the condition and well-being of the child, chills, pallor, marbling, dry skin, acrocyanosis, cold feet and palms, and tachycardia are noted. These clinical manifestations indicate a prognostically unfavorable course of fever and are a direct indication of the need for emergency care.

One of the clinical options for the unfavorable course of fever is hyperthermic syndrome. The symptoms of this pathological condition were first described in 1922. (L. Ombredanne, 1922).

In young children, the development of hyperthermic syndrome in the vast majority of cases is due to infectious inflammation accompanied by toxicosis. The development of fever against the background of acute microcirculatory metabolic disorders underlying toxicosis (spasm followed by capillary dilatation, arteriovenous shunting, platelet and erythrocyte sludge, increasing metabolic acidosis, hypoxia and hypercapnia, transmineralization, etc.) leads to worsening pathological process. Decompensation of thermoregulation occurs with a sharp increase in heat production, inadequately reduced heat transfer and lack of effect from antipyretic drugs.

Hyperthermic syndrome, in contrast to adequate (“favorable”, “pink”) fever, requires urgent use of a comprehensive emergency therapy.
As a rule, with hypertemic syndrome, there is an increase in temperature to high numbers (39-39.50 C and above). However, it should be remembered that the basis for distinguishing hypertemic syndrome into a separate variant of the temperature reaction is not the degree of increase in body temperature to specific numbers, but clinical features course of fever. This is due to the fact that, depending on the individual age and premorbid characteristics of children, concomitant diseases the same level of hyperthermia can be observed with different options course of fever. In this case, the determining factor during fever is not the degree of hyperthermia, but the adequacy of thermoregulation - the correspondence of heat transfer processes to the level of heat production.

Thus, Hypertemic syndrome should be considered a pathological variant of fever, in which there is a rapid and inadequate increase in body temperature, accompanied by impaired microcirculation, metabolic disorders and progressively increasing dysfunction of vital functions. important organs and systems.

In general, the biological significance of fever is to increase the body's natural reactivity. An increase in body temperature leads to an increase in the intensity of phagocytosis, an increase in the synthesis of interferon, an increase in the transformation of lymphocytes and stimulation of antibody genesis. Increased body temperature prevents the proliferation of many microorganisms (cocci, spirochetes, viruses).

However, fever, like any nonspecific protective-adaptive reaction, when compensatory mechanisms are depleted or in the hyperthermic variant, can cause the development of severe pathological conditions.

It should be noted that individual factors of aggravated premorbitis can have a significant impact on the development of adverse consequences of fever. Thus, in children with serious cardiovascular and respiratory systems fever can lead to the development of decompensation of these systems. In children with central nervous system pathologies (perinatal encephalopathy, hematocerebrospinal fluid syndrome, epilepsy, etc.), fever can trigger the development of an attack of convulsions. The age of the child is no less important for the development of pathological conditions during fever. How younger child, the more dangerous for him is a rapid and significant rise in temperature due to high risk development of progressive metabolic disorders, cerebral edema, transmineralization and impairment of vital functions.

Differential diagnosis pathological conditions accompanied by fever.
An increase in body temperature is a nonspecific symptom that occurs in numerous diseases and pathological conditions. When carrying out differential diagnosis, you need to pay attention to: