Causes of Prolonged Subfebrile Fever in Children

Abstract

Background and aims. Subfebrile prolonged fever of unknown origin in children is a multicausal syndrome. Some children referred for pediatrician with prolonged fever are actually not having elevated temperatures, others have well-documented fevers associated with clinical, laboratory, or epidemiologic findings that should point to a specific diagnosis. Sometime the reasons of fever remain unknown. This study aimed to analyze the causes of subfebrile fever in children. Methods. A retrospective analysis of cases of subfebrile prolonged fever in children, consulted in Outpatient Department of Children of Kaunas Clinical Hospital in 2013. Children with daily fever ≤ 38,0°C lasting for ≥14 days were included into the study. Results. Medical records of 43 patients with subfebrile prolonged fever were analyzed. Patients age ranged from 5 months to17 years (mean 9.35±5.32y); 27 (62.8%, p>0.05) of them were >7 years old; 17 were boys and 26 were girls. Fever mean was 37.42°C and in average lasted for 82.5 days. Final diagnosis was reached in 37 children (86.05%). The most common cause (55.8%) of prolonged subfebrile fever was upper respiratory tract infection (tonsillitis, otitis, etmoiditis, adenoiditis), followed by latent tuberculosis infection (21%), lower respiratory tract infections 4.65% (bronchitis), mononucleosis 4.65%, one case of urinary tract infection and toxocariasis. Some patients had few infections. Conclusions. 1.The most common cause of prolonged subfebrile fever was upper respiratory tract infection and latent tuberculosis infection. In 13,95% of cases the causes remained unknown. 2. Prolonged subfebrile fever was more common between school age patients.