In the practice of pediatricians, there are cases when the main complaint of parents is the presence of a fever in a child.
Pediatrician Maria Savinova will talk about the causes of subfebrile in children.
A prolonged low-grade fever is called a temperature increase in the range of 37-38 degrees for 3 weeks.
Long subfebrile observedmost often in children under the age of 1 year(which is probably related to the reaction to the BCG vaccine), then significantdecline in age from 2 to 7 yearsandincrease from 8 to 14 yearsthat is associated with the presence of intense "critical" phases of growth and development.
Interestingly, among adults, in 70-80% of cases, prolonged subfebrile condition occurs in young women with asthenia symptoms. This is due to the physiological characteristics of the female body, the ease of infection of the urogenital system, as well as the high incidence of psycho-vegetative disorders.
Most often subfebrile is observed in children under the age of 1 year, then there is a significant decrease in the age from 2 to 7 years and an increase in the period from 8 to 14 years
It must be borne in mind that a long subfebrile condition is much less often a manifestation of some organic disease, in contrast to a prolonged fever with a temperature above 380C. In most cases, prolonged subfebrile temperature reflects banal autonomic dysfunction.
Conventionally, the causes of long-term subfebrile condition can be divided into two large groups: infectious and non-infectious.
Infectious subfebrile conditionoccurs with such diseases:
The subfebrile condition can appear after the transferred infectious disease (“temperature tail”), as a reflection of the post-viral asthenia syndrome.In this case, low-grade fever is benign in nature, is not accompanied by changes in the analysis and passes on its own, usually within 2 months (sometimes the “temperature tail” can last up to 6 months).
Long subfebrile temperaturenon-infectious natureIt may be due to somatic pathology, but much more often it can be explained by physiological reasons or by the presence of psycho-vegetative disorders.
Physiological causes. For many people, low-grade fever is constitutional in nature and is a variant of the individual norm. The subfebrile condition can develop on the background of emotional and physical (sports) loads, appear after eating, when in a hot room, after insolation. In women, low-grade fever is possible in the second half of the menstrual cycle, which normalizes with the onset of menses; rarely fever occurs during the first 3-4 months of pregnancy.
Causes of non-infectious subfebrile:
According to some signs you candistinguish infectious subfebrile from non-infectious.
Forinfectioussubfebrile condition is characterized by poor temperature tolerance, daily physiological temperature fluctuations are maintained (normally, the morning temperature is 1 degree below evening temperature), a positive reaction to the admission of antipyretic. And atnoninfectious- the temperature is well tolerated, diurnal fluctuations are absent or distorted (morning temperature is higher than evening), the reaction to the antipyretic is absent.
To find out the reasonsubfebrile conduct a variety of laboratory and instrumental studies.
Consultations of the ENT doctor, dentist, cardiologist, TB specialist, infectious diseases specialist, endocrinologist, hematologist, oncologist are appointed.
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The diagnosis of “thermoneurosis” should be made only after exclusion of pathological conditions that can give subfebrile temperature (infectious, tumor, endocrine, immunological and other processes).
Subfebrile temperature in case of thermoneurosis is either monotonously kept at the same level during the day, or has a perverted character (morning temperature is more than evening temperature).Although some patients complain of general malaise, in general they tolerate low-grade fever satisfactorily, while maintaining physical and intellectual activity.
Antipyretic drugs have almost no effect on subfebrile in thermoneurosis, but they have a good effect in the treatment of sedatives. However, in most of these patients, and without treatment, low-grade fever can return to normal in the summer or during the rest period (regardless of the season).