Les fièvres prolongées de l'enfant : à propos de 110 cas

Abstract

Incidence of prolonged fever varies between 0.4 to 3% of all paediatric hospital-stay. The first problem to face in prolonged fever is its etiologic diagnosis. The purpose of this study is to precise the epidemiologic and etiologic profile of prolonged fever in children in our region. Patients and methods It's a retrospective study in 110 children with prolonged fever enrolled in the general paediatrics department of Sahloul university hospital in Sousse (Tunisia) between 1 st June 1993 and 31 May 2005. Results There were 66 boys ands 44 girls (sex-ratio = 1.5) aged 3 months to 14 years (mean age = 4 years and 4 months). The incidence of prolonged fever was 0.76%. The mean fever duration was 25 days. Fever was isolated in 31.8 % of cases and particularly associated to digestives signs in 29% of cases and arthralgia in 13.7% of cases. Hospital stay was 17 days on average. Prominent causes were dominated by infectious diseases (58.2%) with predominance of general infections notably of visceral leishmaniosis, followed by inflammatory diseases (15.4%) with predominance of Kawasaki disease, and neoplasms (2.7%). Fever of unknown origin was seen in 23.6% of cases. Conclusion Infectious and inflammatory diseases dominate the causes of prolonged fever in child. We noted in this study the relative high frequency of visceral leishmaniosis and Kawasaki disease. The diagnosis approach should be based on complementary exams of first and second stage.