ASSOCIATION OF HYPERPYREXIA WITH SERIOUS DISEASE IN CHILDREN

In a prospective study over 7 years, 105 consecutive pediatric patients with hyperpyrexia (temperature greater than or equal to 41.1 degrees C [106 degrees F]) were evaluated to determine the incidence, sensitive indicators, and types of illnesses encountered. The incidence of hyperpyrexia in a large urban pediatric emergency department was 0.36 per 1,000 visits or approximately one in 2,759 visits. In patients with temperature greater than or equal to 41.1 degrees C, 65 (61.9%) had a serious illness. Pneumonia (33 lobar, three interstitial, two clinical) was the most common diagnosis (36.2%),followed by probable viral illness in 20 (19.0%) of the patients. Bacteremia (6.7%) and bacterial meningitis (5.7%) were less commonly found. Four (3.8%) patients died. The admission rate was 62.9%. Eighteen patients (17.1%) also had seizures. Sensitive indicators to help distinguish those with serious illness, with the exception of clinical appearance, were not found. Pneumonia is commonly found in children with hyperpyrexia. Temperature greater than or equal to 41.1 degrees C was associated with a high rate of serious disease.