Temperature In Children Research Articles

Streptococcal Pharyngitis

Forty-four children with a clinical diagnosis of streptococcal pharyngitis had throat cultures performed at the initial evaluation and were assigned by randomization to receive either oral penicillin or a placebo for 72 hours. The treating physician, who remained blind to the treatment regimen, recorded the child's temperature and assessed the presence and severity of other signs and symptoms initially and at 24, 48, and 72 hours. The throat culture was positive for group A β-hemolytic streptococci in 26 (59%) of the initial study group, and most of these children developed a fourfold or greater titer rise in antistreptococcal antibodies in their serum, confirming the diagnosis of streptococcal pharyngitis. Statistically significant clinical improvement was observed in the group of 11 children who were later shown to have been taking penicillin compared with the group of 15 who had taken the placebo. Significant differences in the presence and degree of fever and severity of symptoms persisted in the placebo-treated group for 48 hours. We conclude that early penicillin treatment of children with streptococcal pharyngitis significantly alters the acute clinical course of the disease. (<i>JAMA</i>1985;253:1271-1274)

The significance of admission temperatures in children presenting for ENT operations

The significance of admission temperatures in children presenting for ENT operations

Inaccuracy of the Clinitemp Skin Thermometer

The Clinitemp Fever Detector (Clinitemp) is a newly marketed thermometer consisting of plasticencased thermophototropic esters of cholesterol that change color over a specific short-range of temperature. The manufacturer states that the instrument can identify fever by measuring skin temperature in children. On the basis of a patient's report of one inaccurate Clinitemp, we undertook to investigate the accuracy of this thermometer. One hundred fifty-two children presenting to the Children's Hospital Emergency Room had their temperature taken with two thermometers, an electronic thermometer that had been checked for accuracy with a National Bureau of Standards thermometer and the Clinitemp. Clinitemps, purchased over a two-month period from three pharmacies, were tested on different children. Thirteen of thirty children (43%) with fever (rectal temperature greater than or equal to 38.3 C (101 F) or oral temperature greater than or equal to (37.8 C) (100 F) identified by the electronic thermometer, were correctly classified as having fever using the Clinitemp. When fever was defined to include children with a rectal temperature greater than or equal to 38.0 C (100.5 F) or an oral temperature of greater than or equal to 37.4 C (99.5 F), the Clinitemp correctly identified 13 (32.5%) of 40 children with fever. There appears to be an appreciable risk that someone with a serious illness may delay seeking medical attention on the basis of a normal temperature as measured by the Clinitemp.

VIREMIA IN HYPERPYREXIC CHILDREN

Sixty-three children between the ages of 4 months and 16 years were studied because of temperatures of 39.5°C (103°F) or greater without an obvious source of infection. No child had received antibiotics for at least two weeks prior to this evaluation. Every child had bacterial cultures of blood, pharynx, cerebro-spinal fluid (CSF) and urine. In addition, viral culture of pharynx, stool and buffy coat was obtained. Fifty-nine children had their CSF cultured for viruses. Viruses were recovered from 25 children (39.5%). Fourteen children had viruses isolated from their pharynx, 10 from feces, 4 from CSF and 10 from the blood. Several children had viruses cultivated from multiple sites. Cytomegalovirus was discovered in the buffy coat culture of a single child. Mumps virus was recovered from the blood and pharynx of 2 siblings. One of these children developed parotitis 5 days after culturing. The only symptom in the other child was the initial febrile episode. Echoviruses were retrieved from cultivation of buffy coats in 7 additional children. One child was carrying echovirus in his pharynx and stool as well as blood. The recovery of viruses from the blood of hyperpyrexic children is demonstrated. Echoviruses were the most frequently isolated viruses from buffy coat cultivation. Viremia should be considered in the evaluation of high temperatures in children.

Heat Stroke in Infancy-Reply

In Reply.--The primary purpose of our article on heat stroke was to emphasize two points: (1) that it is potentially dangerous to leave children in parked automobiles during hot summer months, and (2) that dehydration is important in the pathogenesis of heat stroke and that reexpansion of intravascular volume should be a part of initial treatment.1 In the patient presented, fluid and electrolyte replacement was not initiated at the first hospital and was delayed for another two hours in route to Vanderbilt Hospital. In spite of continuous sponging and antipyretics, the child's temperature remained elevated and other organs (particularly the central nervous system) showed signs of impairment. As stated in the case report, most blood chemistry studies, other than those given, were normal at the time of admission (Na, 144 mEq/liter; K, 4.9 mEq/liter; urea, 23 mg/100 ml; glucose, 98 mg/100 ml). No bicarbonate was given although the.... Language: en

Routine Temperature Taking

I also assure Dr. Sarshik that he is not alone in his thought about routine temperature taking in pediatrics. I was accepted as a correspondent member of Colombia's National Medicine Academy in 1966 with an essay on this subject, in which I stated that during my 24 years of practicing pediatrics I never routinely took temperatures of children in my office. Besides, I criticize routine rectal temperature taking because of hygienic and esthetic reasons, and possible psychological damages during the anal phase.

Growing Pains: Concerning the Taking of Rectal Temperatures

The publication Growing Pains is a jointly sponsored book of the American Academy of Pediatrics and the American Medical Association. One needs to assume that the instructions therein are fostered and approved by both of these bodies. I have objection to the portion of the book which nicely orients the mother to what is expected at her office visits-pages 222 on. Under measurements at each visit up until 5 years of age, it is stated that the child's temperature is taken.

Measurements of oral temperature in children

Summary Forty afebrile children had oral temperaturesmeasured in an environmental temperature of 66 to 78° F. The optimum placement time which would adequately reflect the body temperature was 10 minutes. Boys required a longer time than girls to register their temperatures accurately, and children in the 10 to 12 year age group required slightly longer than those in the 7 to 9 age group.

Pulmonary nodules, fever, and hepatosplenomegaly in a 2-month-old child

Dr. George F. Zinninger: These roentgenograms were taken of a 2-month-old white girl, who was admitted to the hospital with a chief complaint of cough of two days' duration and diarrhea of approximately one week. The three siblings at home were all well and the family history was essentially normal. The child was pale and lethargic. Physical examination of the chest was unremarkable, but hepatosplenomegaly was noted. The child's temperature was 103.6 F (39.8 C) rectally. The white blood cell count (WBC) was 16,600/cu mm, with 58% polymorphonuclear leukocytes; the hematocrit reading was 28%. A trace of protein was present in the urine along with 3 to 5 WBC. The findings from a lumbar puncture were normal and a few pneumococci were recovered from the sputum. Roentgenograms (Fig 1) were taken the day of admission. They were interpreted as showing patchy infiltrates in the upper-lung fields along with hepatosplenomegaly. The

Pulmonary Nodules, Fever, and Hepatosplenomegaly in a 2-Month-Old Child

Dr. George F. Zinninger: These roentgenograms were taken of a 2-month-old white girl, who was admitted to the hospital with a chief complaint of cough of two days' duration and diarrhea of approximately one week. The three siblings at home were all well and the family history was essentially normal. The child was pale and lethargic. Physical examination of the chest was unremarkable, but hepatosplenomegaly was noted. The child's temperature was 103.6 F (39.8 C) rectally. The white blood cell count (WBC) was 16,600/cu mm, with 58% polymorphonuclear leukocytes; the hematocrit reading was 28%. A trace of protein was present in the urine along with 3 to 5 WBC. The findings from a lumbar puncture were normal and a few pneumococci were recovered from the sputum. Roentgenograms (Fig 1) were taken the day of admission. They were interpreted as showing patchy infiltrates in the upper-lung fields along with hepatosplenomegaly. The

A MOTHER'S PARADOXICAL RESPONSE TO ADVICE.

Advice physicians give to mothers about their children should affect the way these mothers handle their children, and much of the time it does. Many mothers do respond readily and appropriately when told to take their child's temperature, to give aspirin, to put a sick child to bed, to change a formula, to start solid foods, to bring the child in for a shot, etc. But some mothers do not follow the advice they get. Often they have what seems to them a good reason. The physician's advice may conflict with the mother's past experience, or with the advice they have already received from other authorities, especially from their mothers, their grandmothers, their friends, and from baby books and articles. In other cases, however, there is no obvious reason, and they may not even be aware of not following advice. They seem simply to blot it out by forgetting it;

Taking Children's Temperatures

Taking Children's Temperatures

Taking Children's Temperatures

Taking Children's Temperatures

POINTS FROM LETTERS: Taking Children's Temperatures

POINTS FROM LETTERS: Taking Children's Temperatures

Taking Children's Temperatures

Taking Children's Temperatures

Taking Children's Temperatures

Taking Children's Temperatures

POINTS FROM LETTERS: Taking Children's Temperatures

POINTS FROM LETTERS: Taking Children's Temperatures

Taking Children's Temperatures

Taking Children's Temperatures

Taking Children's Temperatures

Taking Children's Temperatures

Taking Children's Temperatures

Taking Children's Temperatures