"Red" and "white" fever. What's the Difference? Fever in children - symptoms, treatment Why does a child have white fever

The meaning of fever depends on the clinical context, not peak temperature; some minor diseases cause a high temperature, while some serious pathologies cause only a slight increase in temperature. Although the parental assessment is often skewed by fear of fever, the history of home temperature measurements should be taken into account, as well as the temperature taken in the hospital.

Normal body temperature fluctuates during the day by 0.5 ° C, and in a child with a fever by as much as 1.0 ° C.

Fever occurs in response to the release of endogenous pro-inflammatory mediators called cytokines. Cytokines stimulate the production of prostaglandins by the hypothalamus, which corrects and raises the set temperature.

Fever plays an important role in fighting infections and, although uncomfortable, does not require treatment in an otherwise healthy child. Some studies even show that lowering the temperature can prolong certain diseases. However, fever increases the metabolic rate and stress on the cardiopulmonary system. Therefore, fever may be harmful to children with pulmonary or cardiac risks or neurological disorders. It can also be a trigger for febrile seizures, a usually benign condition, in children.

The central pathogenetic link of fever is the increased production of cytokines (endogenous pyrogens) - interleukins 1 and 6, interferon β, tumor necrosis factor. The latter, indirectly through prostaglandins, induce the thermoregulatory center (bottom of the third ventricle) to increase heat production and reduce heat transfer. Fever is always the body's response to an infectious or non-infectious (immune) inflammatory process. Clinically, fever can proceed either according to the "white" (cold) or "pink" type (warm). White fever occurs in the presence of circulatory disorders leading to centralization of blood circulation. In this case, the rectal temperature exceeds the axillary temperature by more than 1°C. With pink fever, the skin is hyperemic, the limbs are hot to the touch.

hyperthermia(D) - an increase in body temperature that occurs without a restructuring of temperature homeostasis, that is, the body's thermoregulation function is insufficient to maintain body temperature within homeostasis. This occurs either as a result of a discrepancy between the degree of influence of external factors and the capabilities of the body (overheating), or due to a malfunction of the thermoregulation center (CNS damage).

Gradations of body temperature increase:

• subfebrile (not exceeding 38 ° C);
• febrile (moderate - 38.1-39 ° C, high - 39.1-41 ° C);
• hyperpyrexic (above 41 ° C).

According to the nature of the temperature curve, the following types of L are distinguished:

• constant, at which daily fluctuations in body temperature do not exceed 1 ° C, which is typical for typhoid fever and lobar pneumonia;
• remitting, occurring with fluctuations in body temperature within a day from 1 to 1.5 ° C, without reducing it to normal numbers. This type of fever occurs in infectious diseases;
• atypical, proceeding without any regularity, which is most often found in banal viral infections;
• hectic, characterized by a daily range of body temperature exceeding 3 ° C. At the same time, there is a rapid rise in body temperature and a lytic decrease in it. These episodes can be repeated 2-3 times a day. Characteristic of septic conditions;
• intermittent, manifested by alternation during the day of high and normal body temperature. Normalization of temperature can occur either in the morning or in the evening. In the latter case, one speaks of inversion. This type is typical for purulent infection, as well as for systemic variants of the course of immunopathological diseases ( rheumatoid arthritis, systemic lupus erythematosus, etc.);
• recurrent, characterized by alternating febrile attacks for 2-7 days with periods of normal body temperature lasting 1-2 days. This type is characteristic of malaria, periodic illness, and immunopathological diseases.

In most cases, in practice, the cause of the increase in body temperature can be established in the first days of the child's illness. If the elevated body temperature persists for at least 7 days, and its cause remains unclear, then we can talk about a fever of unknown origin (FUN). This diagnosis is appropriate only in cases of documented confirmed increase in body temperature (possibility of simulation and aggravation), the cause of which is not established as a result of routine examination. In this case, fever should not be accompanied by distinct local symptoms, that is, an increase in body temperature should be the only or almost the only symptom.

Causes of fever in children

The causes of fever vary depending on whether it is acute (<7 дней) или хронической (>7 days). The response to antipyretics and the height of the temperature are not directly related to the etiology of the disease or its severity.

Acute. Most acute fevers in infants and young children are due to infection. The most common:

• SARS or gastrointestinal intestinal infections(most common reasons)
• some bacterial infections.

However, potential causes vary with the age of the child. Newborns (infants<28 дней) и маленькие дети имеют ослабленную иммунную защиту и, следовательно, подвержены большему риску инфекций, в том числе перинатальных. Общие перинатальные инфекции включают вызванные стрептококками группы В, Escherichia coli, Listeria monocytogenes, и вирусом простого герпеса; эти организмы могут вызывать бактериемию, пневмонию, менингит или сепсис.

Children with fever under 3 years of age are at particular risk of occult bacteremia (pathogenic bacteria in the blood but no focal symptoms or signs). The most common causative agents of occult bacteremia are Streptococcus pneumoniae and Haemophilus influenzae, and vaccination against both pathogens is now widespread in the US and Europe, making occult bacteremia less common.

Rare noninfectious causes of acute fever include heat stroke and ingestion of toxic substances (eg, anticholinergic drugs). Some vaccines can cause fever for several days (for whooping cough) and even 1 or 2 weeks (for example, for measles) after administration. These fevers usually last from a few hours to a day. Teething does not cause fever.

Chronic. Chronic fever involves various possible reasons including autoimmune diseases, collagen vascular diseases (eg, juvenile rheumatoid arthritis, inflammatory bowel disease), cancer (eg, leukemias, lymphomas), and chronic infections (eg, osteomyelitis, tuberculosis). In addition, spontaneous fever and cases with unexplained etiology are possible.

The most common causes include:

• benign infectious causes (long-term viral diseases, recurring diseases).

Collagen vascular disease, autoimmune disease, and cancer are much less common.

The most common causes of LDL in children of the first year of life

• generalized infections.
• Septicemia and septic conditions.
• Localized infections with a tendency to septic flow.
• Pyelonephritis, pneumonia.
• Thermoregulatory disorders.
• Transient subfebrile condition.

Diagnosis of fever in children

Story. The medical history should note the degree and duration of fever, the method of measurement, and the dose and frequency of antipyretics (if any). Important accompanying symptoms that suggest serious illness include poor appetite, irritability, lethargy, and changes in crying (eg, duration, nature). Associated symptoms that may indicate a cause include vomiting, diarrhea (including blood or mucus), cough, difficulty breathing, limb or joint involvement, and copious or foul-smelling urine. The drug history should be reviewed for signs of drug-induced fever.

Factors predisposing to the development of infection have been identified. In newborns, these factors include prematurity, late rupture of membranes, maternal fever, and positive prenatal tests (usually for group B streptococcal infection, cytomegalovirus infection, or sexually transmitted diseases). For all children, predisposing factors include recent exposure to infection (including family and caregiver), long-term medical devices (eg, catheters, ventriculoperitoneal shunts), recent surgery, travel, and environmental exposure (eg, ticks, mosquitoes). , cats, farm animals).

Review of systems should note symptoms suggestive of possible causes, including runny nose and congestion (viral infections of the upper respiratory tract), headache (sinusitis, Lyme disease, meningitis), ear pain or waking at night with signs of discomfort (otitis media), cough, or shortness of breath (pneumonia, bronchiolitis), abdominal pain (pneumonia, gastroenteritis, urinary tract infections, abdominal abscess), back pain (pyelonephritis), and a history of swelling and redness of the joints (Lyme disease, osteomyelitis). Look for repeated infections (immunodeficiency) or symptoms suggestive of chronic disease, such as poor weight gain or loss (tuberculosis, cancer). Some symptoms may help refocus the assessment on noninfectious causes, which include palpitations, sweating, and heat intolerance (hyperthyroidism), recurrent or cyclical symptoms (rheumatoid, inflammatory, or hereditary disease).

History of past illnesses. Note previous fevers or infections and known conditions predisposing to infection (eg, congenital heart disease, sickle cell anemia, cancer, immunodeficiency). Identify a family history of autoimmune disorders or other hereditary conditions (eg, familial dystonia, familial Mediterranean fever). Vaccination history is reviewed to identify patients at risk of developing vaccine-preventable infections.

Physical examination. Vital signs are revealed, rejecting deviations in temperature and respiratory rate. Children who appear ill should also have their blood pressure measured. To obtain accurate values, the temperature should be measured rectally. Any child with cough, tachypnea, or shortness of breath needs pulse oximetry.

The general appearance of the child and his reaction to the examination are important indicators. A child with a fever who is overly accommodating or lethargic is more alarming than a child who refuses to communicate. However, the irritability of an infant or child who cannot be soothed is also a concern. A child with a fever who does not look well, especially after the temperature has dropped, is of great concern and requires in-depth evaluation and constant monitoring. However, children who feel more comfortable after antipyretic therapy do not always have benign disorders.

Examination reveals signs of causative disorders.

Warning Signs. The following data are of particular concern:

• age less than 1 month;
• lethargy, apathy or toxic manifestations;
• respiratory failure;
• petechiae or purpura;
• inconsolability.

Interpretation of results. Although serious illness does not always cause high fever and many cases of serious fever are the result of self-limiting viral infections, temperature >39°C in children under 3 years of age indicates a higher risk of occult bacteremia.

Acute fever in most cases has an infectious nature, mainly viral. History taking and examination are adequate approaches for making a diagnosis in older children who are otherwise healthy and do not have toxic manifestations. It's usually viral. respiratory disease(recent contact with a sick person, runny nose, wheezing or cough) or gastrointestinal (contact with a sick person, diarrhea and vomiting). Other results also suggest specific causes.

However, in infants under 36 months of age, the possibility of occult bacteremia, as well as the frequent absence of focal symptoms in neonates and young children with severe bacterial infection, require a different approach. The score depends on the age group. Accepted categories: newborns (<28 дней), маленькие младенцы (1-3 мес) и младенцы более старшего возраста (3-36 мес). Независимо от клинических данных новорожденные с лихорадкой требуют немедленной госпитализации и исследования для исключения опасных инфекций. Маленькие младенцы могут нуждаться в госпитализации в зависимости от результатов лабораторного скрининга и, вероятно, будут взяты под дальнейшее наблюдение.

Chronic fever can be caused by a variety of reasons. However, some symptoms suggest the presence of specific diseases: chronic migratory erythema, intermittent swelling of the joints and pain in the neck - Lyme disease; intermittent headaches with a runny or stuffy nose - sinusitis, weight loss, high risk of contact with a source of infection and night sweats - tuberculosis; weight loss or difficulty gaining it, heart palpitations and sweating - hyperthyroidism; weight loss, lack of appetite and night sweats are cancer. Certain conditions (eg, granulomatous diseases) may present with nonspecific symptoms and have a history of repeated infections (eg, pneumonia, skin infections, abscesses, sepsis).

Testing. Testing depends on the course of the fever, whether acute or chronic.

In acute fever, the direction of testing for infectious causes depends on the age of the child.

All febrile children under 3 months of age require a WBC count with differentiation under a microscope, blood cultures, analysis, and urinalysis (urine is obtained by catheterization, not in an open reservoir). Lumbar puncture is mandatory for children up to 28 days old; Expert opinions on the need for research in children aged 29 days to 2 months differ. x-ray chest, stool smear for white blood cells, stool culture, and acute phase testing (eg, ESR, C-reactive protein) are done depending on symptoms and degree of suspicion.

Children aged 3–36 months with fever who appear well and can be closely monitored do not require laboratory tests. If the child has symptoms or signs of specific infections, doctors should order appropriate tests (eg, chest x-ray if hypoxemia, dyspnea, or wheezing is present; urinalysis and culture if foul-smelling urine is detected; lumbar puncture if abnormal behavior or meningism is present). If the child appears ill or has a temperature >39°C but has no localized findings, blood cultures and urine tests should be treated in the same way as a lumbar puncture.

For children older than 36 months, referral for testing for fever should depend on history and examination; screening blood cultures and leukocyte counts are not indicated.

In chronic fever, the direction of testing for noninfectious causes should depend on history, physical examination, and suspected disorders (eg, thyroid stimulating hormone [TSH] and thyroxine [T4] if thyrotoxicosis is suspected); detection of antinuclear antibodies and Rh factor in suspected juvenile idiopathic arthritis).

Children without focal symptoms should have initial screening tests, including:

• complete blood count with differential analysis and urine culture;
• ESR ( C-reactive protein also taken into account, although one of these indicators is not necessarily preferable to the other);
• Mantoux test for tuberculosis screening.

Elevated ESR suggests inflammation (infection, tuberculosis, autoimmune disorders, cancer) and further testing may be done. If the white blood cell count is normal, slow infection is less likely; however, if infection is suspected based on clinical findings, serological testing for possible causes (eg, Lyme disease, cat scratch disease, mononucleosis, cytomegalovirus) and blood cultures may be done. Imaging studies may be useful in detecting tumors, accumulations of purulent contents, or osteomyelitis. The type of test is determined by specific needs. For example, head CT is used to diagnose sinusitis; CT and MRI are used to identify tumors and metastases, and bone scans are used to detect osteomyelitis.

Aspiration bone marrow may be done to check for cancer, such as leukemia.

Features of examination of children with ANP

Confirmation of the fact of LNP. Thermometry in our country is traditionally carried out in the axillary region, where the temperature should be at least 0.6 °C and not more than 1 °C lower than in the rectal region. The difference between the left and right armpits should not exceed 0.3 °C. An increase in body temperature is considered documented if it was measured by a medical professional.
Anamnesis. They find out the duration and nature of L, establish its connection with previous diseases or medications. It is important to establish whether the body temperature was measured by the parents or independently by the child without adult supervision.

Analyze the data of the survey, including the results of the Mantoux test for Last year. Find out the fact of contact with animals (toxoplasmosis, toxocariasis, brucellosis). Evaluate the effectiveness of previously used antipyretics, their effectiveness is typical for inflammatory diseases and absent in thermoregulatory disorders. The effectiveness of previously used antibiotics testifies in favor of the bacterial origin of L.

Objective examination. A thorough examination of all organs and systems is necessary.

Laboratory methods of examination. Screening:

• clinical blood test;
• general urine analysis. It should be borne in mind that microhematuria and microproteinuria may not be caused by the disease, but by the fever itself;
• biochemical tests: ACT, sialic acids, C-reactive protein, fibrinogen, total protein, proteinogram.

If the results of the obtained analyzes do not deviate from the reference ones, thermometry is carried out after three hours, followed by an aspirin test: thermometry is carried out in the armpit every 3 hours during the day with parallel counting of the pulse. In violation of thermoregulation, the tolerance of elevated body temperature is satisfactory, during sleep, the body temperature is always normal, there is no parallelism between the value of body temperature and pulse rate.

When present in the body inflammatory process fever affects the patient's well-being, during sleep it often persists and higher body temperature corresponds to a higher pulse rate and vice versa, that is, there is parallelism. On the second day, aspirin is prescribed at a daily rate of 0.2 g per year of the child's life, dividing this dose into 3-4 doses ..-In parallel, continue thermometry, counting the pulse is not necessary.

With thermoregulatory dysfunction, a complete or even partial antipyretic effect is not observed, while in the inflammatory process, a distinct antipyretic effect of aspirin is noted. To exclude an accidental coincidence of self-normalization of body temperature and the effect of aspirin, thermometry is continued for a day after aspirin is discontinued. If thermometry data testify in favor of thermoregulatory dysfunction, it is advisable to conduct neurosonography and EEG recording, followed by a consultation with a neuropathologist.

If, according to these indicators, signs of an inflammatory process are revealed, then hospitalization in a diagnostic institution is indicated. In case of impossibility of hospitalization, the examination is expanded:

• sowing urine for flora;
• blood culture for flora;
• tuberculin tests;
• Ultrasound of organs abdominal cavity, small pelvis, retroperitoneal space, heart;
• chest x-ray, paranasal sinuses nose, tubular bones;
• serological tests and tests for the detection of pathogens for identification (3-hemolytic streptococcus, salmonellosis, yersiniosis, viral hepatitis, infectious mononucleosis, cytomegalovirus infection, brucellosis, toxoplasmosis, toxocariasis, malaria. According to indications - studies of bone marrow, cerebrospinal fluid, tissue biopsy specimens. If a particular pathology is suspected, it is advisable to consult specialists: an ENT specialist, an infectious disease specialist, a phthisiatrician, a nephrologist, a cardiologist, a pulmonologist, a hematologist, a neuropathologist, an oncologist.

Prolonged fever in a child with an unidentified diagnosis usually worries parents, so in most cases it is advisable to hospitalize the child or send him to a diagnostic center.

Treating a fever in a child

Treatment is directed at the underlying disorder.

Fever in an otherwise healthy child does not necessarily require treatment. Although an antipyretic may provide comfort, it does not change the course of the infection. In fact, fever is an integral part of the inflammatory response to infection and may help a child fight it. However, antipyretics are most commonly used to relieve discomfort and reduce physiological stress in children with a history of cardiopulmonary, neurological, or febrile seizures.
Antipyretic drugs that are commonly used include:

• acetaminophen,
• ibuprofen.

Acetaminophen is generally preferred because ibuprofen reduces the protective effect of prostaglandins in the stomach and, if used for a long time, can lead to the development of gastritis. The use of one antipyretic at the same time is preferred, however, some clinicians alternate between 2 drugs for the treatment of high fever (eg, acetaminophen at 6 am, 12 and 6 pm and ibuprofen at 9 am, 3 and 9 pm). This approach is not recommended because caregivers may become confused and inadvertently exceed the recommended daily dose. Aspirin should be avoided as it increases the risk of developing Reye's syndrome in the presence of certain viral illnesses such as influenza and chickenpox.

Non-drug approaches to fever include placing the child in a warm or cool bath, applying cool compresses, and undressing the child. Service personnel should be warned not to use a cold water bath, which is uncomfortable and, by causing shivering, can paradoxically raise body temperature. As long as the temperature of the water is slightly colder than the baby's temperature, a bath provides temporary relief.

What should be avoided. Rubbing the body with isopropyl alcohol is strongly discouraged because the alcohol can be absorbed through the skin and cause intoxication. There are many folk remedies, ranging from harmless (like putting onions or potatoes in your socks) to uncomfortable (like scratching your skin with a coin and staging jars).

Today we will tell you about what is white fever The child has. You will also learn what symptoms are characteristic of this condition, why it occurs, how it is diagnosed and treated.

general information

Fever is called the protective reaction of the sick organism, directed against the causative agent of the virus or infection. In medical practice, this condition is usually divided into white and rose fever.

Accompanied by spasms of blood vessels, which subsequently lead to chills. Such an indisposition is extremely difficult for kids to endure. Therefore, at the first signs of the disease, all measures should be taken to eliminate white fever and transfer it to pink. By the way, the latter condition is characterized by active heat transfer, as a result of which the risk of overheating of the patient is significantly reduced.

White fever in a child: symptoms

Experts have identified three stages of this condition. According to them, they proceed according to certain symptom complexes.

Treatment of the patient should be prescribed only by an experienced pediatrician, in accordance with all febrile manifestations.

White fever in a child proceeds as follows:

• The baby quickly rises in body temperature.
• Heat levels are stabilizing.
• Body temperature drops sharply or gradually decreases to normal values.

Other signs

The baby also exhibits the following symptoms:

• signs of apathy;
• lack of appetite;
• synchronous vasodilation;
• dehydration and arrhythmia;
• pale skin;
• labored breathing;
• lips with a hint of cyanosis;
• cold feet and hands.

It should be especially noted that white fever in a child is not a disease, it is a symptom of an illness that needs to be treated.

The identified signs indicate the activation of immunological protection, which is typical for a healthy organism. Through such mechanisms, early treatment by folding a foreign protein.

It cannot be said that, at elevated temperature body quite quickly and successfully begins a kind of preventing the reproduction of all pathogenic microorganisms and foreign viruses. After this, spontaneous inhibition of their vital activity occurs, and then the attenuation of the activity of inflammatory foci.

Causes

Why does white fever occur in a child? The reasons for this condition may be different.

If a baby up to three months of age suffers from such a condition, then this can be a rather severe infection. In this case, hospitalization of the child and inpatient observation is necessary.

Other probable causes

Why can a child develop white fever? Komarovsky E. O. suggests that such a condition may be associated with:

• virus infection;
• acute period of infection;
• the first day of the onset of acute respiratory diseases (including the upper respiratory tract);
• insufficient and inadequate treatment of microbial or bacterial infection of the systems of the child's body;
• somatic acute and chronic diseases baby.

It should also be said that, for medical reasons, such a fever can be a harbinger of pharyngitis, rhinitis, bacterial diseases such as otitis media, pneumonia, tonsillitis, inflammation of the middle ear or adenoiditis.

How to diagnose?

There are many ways to diagnose the disease that causes white fever. To do this, you should contact an experienced pediatrician.

Rubella, meningococcemia, scarlet fever, allergic reactions on antipyretic drugs, the baby may develop a rash.

Causes of a feverish state, which are accompanied by catarrhal syndrome, can be rhinitis, pharyngitis, bronchitis, bacterial inflammation in the middle ear, severe forms pneumonia and sinusitis.

From streptococcal and viral tonsillitis, as well as infectious mononucleosis and scarlet fever, fever almost always occurs, accompanied by tonsillitis.

At obstructive bronchitis, laryngitis, bronchiolitis, asthma attacks and inspiratory dyspnea fever manifests itself with difficulty breathing.

A similar condition of a small patient may occur due to brain disorders in encephalitis and meningitis.

Acute intestinal infections are fairly easy to diagnose if the baby has diarrhea and fever.

If your child has a stomach ache, fever, and constant vomiting, then these conditions may be associated with a urinary tract infection or inflamed appendicitis.

In arthritis, rheumatism, and urticaria, along with white fever, there is painful damage to the joints.

If the cause of the fever is any serious disease, and your child has become too irritable and sleepy, you should immediately consult a doctor. The same applies to symptoms such as impaired consciousness, unwillingness to take fluid, hypo- and hyperventilation of the lungs.

White fever in a child: what to do?

If your baby has a high temperature, and also has a fever, then he should be calmed immediately. The child needs to be explained that he should not be afraid, feel a sense of panic and fear. Experts recommend telling the baby that it is in this way that the protective reactions of his body are activated. Thanks to the fever and elevated body temperature, viruses and infections will go away very soon.

Before the doctor examines your baby, he should provide plenty of fluids. For this, warm fruit drinks, herbal decoctions, compotes and juices are ideal. Wiping the body with a damp sponge is also very effective.

After wiping, as well as fanning the patient, he should be well covered with a not very thick linen diaper. Also Special attention should be given to the nutrition of the baby. Fever should not lead to the exhaustion of the child and the exhaustion of his strength.

The food prepared by you should please the patient, but at the same time be quickly digested and be light.

Medications

How is white fever eliminated in a child? The treatment for this condition depends on the disease. If during the diagnosis process the baby was diagnosed with a bacterial infection, then he is prescribed an antibiotic. In this case, antipyretic drugs are not used. This is due to the fact that they can mask the lack of results of antibiotic therapy.

If the doctor nevertheless prescribed, then they should be chosen very carefully. Preference should be given to those drugs that are harmless to the child's body, and not strong and effective. After all, the stronger the drug, the more toxic it is. You should also pay attention to how convenient it is to use.

The most popular antipyretic drugs today are such medicines as: Efferalgan, Paracetamol, Nurofen, Panadol and others.

Before giving the drug to the patient, be sure to read the instructions, as well as set its dosage. By the way, very often a measuring cup or a spoon is attached to children's medicines. Such devices have a gradation scale, which greatly facilitates the calculation of the dosage.

Almost any disease in a child is accompanied by an increase in body temperature. This is a specific reaction of the body to changes in the internal environment under the influence of various factors, which include infectious agents. Also, hyperthermia can provoke a number of non-communicable diseases.

Even a slight increase in body temperature in a child should alert parents. At this moment, you need to carefully listen to the body in order to understand where it failed to work, and which organ needs help.

The concept of fever and its danger to the child's body

The child's body is a complex system where every organ and organ system (circulatory, lymphatic, nervous) work together, thereby supporting the life of a little man. Together they respond to various harmful stimuli. Fever also belongs to such specific reactions. Hyperthermia is characterized by a restructuring of the thermoregulation system, which leads to an increase in temperature. Thus, the body reacts to pathogenic factors of both external and internal origin.

Fever stimulates the immune response and helps fight pathogens. Elevated temperature can be the result of infectious, somatic ailments, blood diseases. Also, fever can often be caused by psychological disorders. Hyperthermia provokes the production of interferon, stimulates phagocytosis of foreign material and the formation of specific antibodies.

Despite the benefits of fever, it can cause many complications, including life threatening conditions, especially against the background of disorders of the heart and respiratory organs.

Fever is especially dangerous for young children. It can provoke convulsions, swelling of the brain.

Dangerous complications of hyperthermia:

• hypoxia - the result of an increase in the frequency of breathing by 2-3 times and a decrease in its depth;
• disturbance in the work of the heart - manifested as a result of an increase in the frequency of heart contractions, an increase in oxygen consumption by the cells of the heart muscle;
• indigestion - the intestines cease to function normally, appetite decreases, the secretion of the digestive glands decreases;
• dehydration is a consequence of large losses of water by the cells of the body;
• acidosis - protein breakdown with the formation of intermediate metabolic products, which are acids, they are carried throughout the body with the bloodstream;
• violation of microcirculation - manifested by a marble pattern of the skin, the limbs become cold, convulsions are possible (we recommend reading:).

Varieties and symptoms

Fever in a child is divided into several types according to a number of characteristics. Classification according to the duration of the flow:

• acute - up to 2 weeks;
• subacute - up to 6 weeks;
• chronic - more than 6 weeks.

According to the degree of increase in body temperature:

• subfebrile - up to 38 ° C;
• moderate - up to 39 ° C;
• high - up to 41 ° C;
• hyperthermic - above 41 ° C.

Types of fevers according to concomitant symptoms:

• long-term (constant) - the temperature fluctuates within 0.4 ° C per day;
• remitting - the temperature during the day can fluctuate widely, but the minimum values ​​\u200b\u200bare above the norm;
• intermittent - a wide range of temperatures from the normative to the highest value during the day;
• hectic - the temperature drops to normal, but after a couple of hours it again reaches its maximum values, accompanied by increased sweating;
• undulating - characterized by a gradual decrease and increase in temperature;
• return - the temperature alternately drops and rises at irregular intervals;
• biphasic - the disease may be accompanied different indicators temperatures;
• periodic - characterized by a recurrence of fever after a certain period of time.

White

White fever in a child does not respond well to the action of antipyretic drugs. This is a type of hypothermia in which there is an outflow of blood from skin. Symptoms of this type of hyperthermia:

• pale skin;
• cold extremities;
• violation of respiratory function;
• increased heart rate;
• lethargy or agitation;
• convulsions.

Red

In red fever, heat loss corresponds to heat production. Hyperthermia is accompanied by the following symptoms:

• the limbs are warm, moderately reddened, the skin is moist;
• slight increase in heart rate and breathing;
• no change in behavior.

Causes of white and red fever

Body temperature can change for a number of reasons:

Non-infectious causes of hyperthermia include the following pathologies:

• allergic reaction;
• tumors of various origins;
• head injuries and associated hemorrhages;
• vascular thrombosis;
• reaction to medications;
• metabolic pathologies;
• diseases of the endocrine glands.

First aid

With rose fever in a child, you should:

• undress the baby and provide him with an influx of fresh air, but at the same time protect him from drafts;
• give plenty of drink;
• provide local cooling by applying a wet cool bandage to the forehead and to the area of ​​​​large blood vessels;
• give an antipyretic (Paracetamol, Ibuprofen), and if after 30-45 minutes the medicine has not worked, then an antipyretic mixture can be injected intramuscularly;
• if the temperature does not subside, repeat the injection.

With white fever in children, it is necessary:

• give antipyretic medicine - Paracetamol, Ibuprofen;
• take orally or intramuscularly inject a vasodilator drug - Papaverine, No-shpu;
• every hour to monitor body temperature when it reaches 37 ° C.

If after all the manipulations the symptoms of pale hyperthermia do not go away, then urgent hospitalization of the child is indicated. Further therapy depends on the severity of the child's condition and the cause of white fever.

Indications for the use of antipyretics:

• temperature above 39°C;
• temperature above 38-38.5 ° C in children with heart disorders, past convulsive conditions, breathing problems, headaches and muscle pain, metabolic disorders;
• temperature 38°C - at the age of 3 months.

Features of treatment

With red fever, to increase heat transfer, it is recommended to expose the baby as much as possible, since warm clothes will only cause an increase in temperature. In order to avoid dehydration, you should provide your child with plenty of fluids, and it is recommended to drink the baby often, but in small portions. To improve heat transfer, you can apply a damp, cool towel to your forehead and to the area of ​​​​large blood vessels. It is undesirable to give a child an antipyretic if the temperature does not exceed 38.5-39 ° C.

Treatment mechanisms for pallid fever differ from pink hyperthermia because it is life-threatening and harder to bring down. It is necessary to warm the limbs of the child by putting on socks and covering him with a sheet or a thin blanket. When taking antipyretic drugs, drugs are simultaneously given or administered to dilate blood vessels and relieve their spasms. In this case, it is important to call a doctor for follow-up and treatment. In emergency cases, hospitalization is indicated.

Do not panic and bring down the child's low temperature. It is important to give the body the opportunity to cope with the infection on its own. However, at the same time, it is necessary to constantly monitor body temperature in order to prevent the consequences. In case of unsuccessful attempts to reduce body temperature with white fever, an urgent need to call a doctor - perhaps the child is in danger and needs emergency help.

It is not a disease, it acts as a protective reaction when in large numbers acute infectious and inflammatory diseases. Due to the high temperature, the production and release of interferon, an antiviral protein, increases.

Viruses lose their ability to attack and reproduce. But not always elevated temperature has positive influence on the human body.

Therapist: Azaliya Solntseva ✓ Article checked by Dr.

Characteristics of the disease

Not many parents know what white fever is, how it manifests itself and how dangerous it is. White fever is a significant increase in body temperature, reaching 39 or even higher degrees. White type fever, accompanied by an outflow of blood from the skin. It is as a result of the outflow and pallor of the skin that the fever got its name.

In this situation, an increase in temperature is not a protective function, but rather harms health. Fever carries the prerequisites for serious diseases. At the first symptoms, children need treatment, which should be aimed at eliminating the cause of the disease, and not the obvious symptoms (fever).

Help

First of all, at elevated temperatures, parents begin to knock it down with various antipyretic drugs, but in this case, the problem should be approached with all seriousness. It is necessary to determine the condition of the baby, how unwell he feels, take into account the accompanying symptoms.

What to do when you have a high fever (hot fever emergency):

1. It is important to provide the baby with complete rest and bed rest.
2. You should refrain from eating, do not force the baby to eat, this can further aggravate the situation.
3. If the baby still wants to eat, all fatty, salty, sour, fried foods should be excluded from his diet.
4. When eating, give preference to light broths, mashed potatoes or porridge (without butter).
5. Regularly give children warm drinks (tea, uzvar, compote, jelly), the liquid should enter the body in small portions, regularly, to make up for its loss through sweat or urine.
6. At high temperatures, you should not bathe children, even in warm water, you can only wipe them with a towel soaked in warm water.
7. At high temperatures, you should monitor the temperature in the room in which sick children are located, 25-27 degrees are considered optimal for babies, and 22-24 degrees for older children.

You can reduce the heat with warm compresses or rubbing the whole body, but only slightly and not for long. It is strictly forbidden to apply cold compresses or ice, you can cause vasospasm in a baby or an adult.

The well-known rubbing with vinegar or alcohol can have a negative effect on the body. Such substances, penetrating through the skin into the body of a child, can cause severe poisoning.

It is worth taking antipyretics only when the body temperature begins to rise rapidly, the thermometer shows above 38 degrees and the child's general well-being deteriorates greatly, he is shivering, his skin turns pale.

Not all parents know what better drug from the heat to give the baby, so you should first consult a pediatrician about this.

Doctors refuse to prescribe children different ages antipyretics, which include aspirin, analgin. They prefer syrups, suspensions, tablets, which include ibuprofen, paracetamol.

When you receive medicinal product the dosage according to the age of the child or his body weight should be followed. If the fever does not subside, the baby remains pale, convulsions occur, then parents should immediately call ambulance.

How does it manifest

Symptoms of white fever in a child may be different, occur individually or in combination. It depends on the cause of the fever.

The symptoms are:

• shortness of breath, as after running;
• high body temperature, high fever;
• apathetic state constant sleepiness, weakness and lethargy;
• unwillingness to eat, drink water;
• arrhythmia;
• fluid loss in the body;
• change in skin tone, becomes pale, and lips begin to turn blue;
• hands, feet go numb;
• small children become restless, capricious, cry regularly.

Doctors distinguish the main stages of white fever in children:

1. First stage. Body temperature rises sharply.
2. Second phase. Strong fever lasts for a long time (several days), antipyretic drugs do not help.
3. Third stage. Body temperature begins to drop sharply, rapidly.

Heat prevents the reproduction of viral cells, harmful microorganisms that are in the body of the baby. Due to this, after some time, there is an arbitrary attenuation of the symptoms caused by the inflammatory process.

White and red uniforms

Every parent is concerned about the difference between red and white fever. We analyzed white fever, it is characterized by a high body temperature and a light shade of the skin.

Red fever manifests itself in reverse - a red tint of the skin. The child's cheeks, the whole face and even the body turn red. It feels hot to the touch. A warm body indicates a good heat exchange in a child.

Parents should not wrap up the baby and cover, his skin needs fresh air for natural thermoregulation, excessive wrapping increases sweating. During red fever, the child should measure body temperature every half hour. If the indicators exceeded the mark of 38.5 degrees, then you should take a fever-reducing medicine.

Why does

Doctors consider the most common cause of white fever to be an infectious lesion of the body. It occurs due to the ingestion of fungal or viral infections. White fever indicates the progression in the child's body of acute respiratory viral infections, bronchitis, rhinitis, otitis media or an inflammatory process in the lungs, respiratory diseases.

In tropical countries, the cause of fever is often intestinal infections, poisoning. Pathogens enter the body through food, as well as airborne droplets.

White fever often develops against the background of vaccination (vaccination against influenza, measles, rubella). Fever is not uncommon for body poisoning, allergic reactions, and malignant formations or rheumatic diseases.

In adults

In an adult, hyperthermia manifests itself in the same way as in a child. Only the indicators on the thermometer can be higher and much more.

Hyperthermia is a protective reaction of the body to the introduction of various viruses. When pathogenic microorganisms enter the body, protective cells - leukocytes - are sent to the place of their localization.

Pathogenic microorganisms throw endogenous pyrogens into the blood - these are substances that are stimulators of leukocytes and macrophages, which provide a protective function of the body.

Pathogens provoke an increase in temperature, their presence increases the activity of the immune response. If in children the fever during hyperthermia increases to 38-39 degrees, then in adults, such indicators can be 40-41 degrees.

If the temperature long time keeps at around 40 degrees, then you should:

• immediately call an ambulance;
• if there are antipyretics in the home medicine cabinet, then you can try to bring down the fever with medications;
• in extreme heat, you should drink plenty of fluids;
• do not force food;
• observe bed rest.

Elevated temperature for a long time causes convulsions, not only in children, but also in adults. Therefore, you should not hesitate, you can reduce the heat at home in several ways, including alternative medicine, if there are no antipyretic drugs in the medicine cabinet.

How can I help you

For the treatment of hyperthermia, anti-inflammatory and antipyretic drugs should be prescribed. But often they are ineffective. Often, children of different ages are prescribed phenothiazines, their principle of action is aimed at dilating blood vessels, thinning the blood, and also normalizing the functioning of the sweat glands. These drugs have a sedative effect.

Pediatricians for white fever prescribe vasodilators ( a nicotinic acid 1 mg per 10 kg of baby weight). Vitamin of the PP group is recommended for use with preparations containing paracetamol. Nurofen is considered an effective antipyretic drug, it is available in the form of suppositories, syrup or tablets.

In the treatment of hyperthermia, one should not focus one's attention and direct all treatment to lowering the temperature and taking strong medications. Do not forget that the faster knocks down high heat medical preparation child, the more it has a negative effect on his body.

First aid for spasms is antispasmodic drugs that affect blood vessels (Papaverine, Dibazol). And No-shpa, considered the most famous antispasmodic, will be useless, its action is directed to the internal organs.

Fever-reducing drugs will begin to work only after the spasms are eliminated. When narrowing the vessels, you should carefully rub the arms and legs and the baby, this will improve blood circulation.

Children need to observe bed rest, move less. Parents can wipe it with a warm towel, but not a cold one. And do not forget that white fever is a symptom, not a disease.

With angina

Angina is a disease of an infectious nature, which in 9 cases out of 10 is accompanied by fever.

Doctors distinguish the following types of fever:

• 37-38 degrees - subfebrile fever;
• 38-39 degrees - febrile fever;
• 39-40 degrees - pyretic fever;
• 40-41 degrees - hyperperetic fever, there is a threat to the patient's life.

With angina, the first two of the varieties of heat occur. They do not last long and completely pass after 3-4 days. The fever persists with angina at that time, while purulent follicles are observed on the tonsils. As soon as the pus leaves, the body temperature returns to normal, and with it the general well-being of the patient.

If a sore throat is not diagnosed in time, then the body temperature lasts up to 10 days, which will subsequently cause serious complications in human health.

Consequences and complications

If the parents reacted in time, the temperature was brought down, then the prognosis will be favorable. Complications occur, but rarely, this happens as a result of ignoring characteristic symptoms, slowness in providing first aid.

With white fever, antipyretics can help, not earlier than after 2-3 hours. If the temperature has dropped even by half a degree, this is a good indicator. With a decrease from 39 degrees to 38, the child should not be given medication again, it is better to wait a while.

As a warning of hyperthermia, doctors recommend adhering to the following rules:

• observe personal hygiene, the baby should be taught to this from early childhood;
• avoid hypothermia, overheating of the body;
• avoid crowded places during epidemics;
• temper the child from childhood, but gradually;
• ventilate the rooms daily at home, do wet cleaning at least 2-3 times a week.

You should also not wrap up children not according to the weather, you should dress the same as yourself. With a fever in a baby, one should not expect that everything will go away by itself or "sin" on the teeth. Call an ambulance or call your local doctor who will help you figure out the cause and prescribe the right treatment.

I was prompted to write this post by an actively flourishing obscurantism, expressed in wiping children with water with vinegar or vodka at elevated temperatures. It is especially unpleasant that this obscurantism is still not only supported, but also spread by a fair amount of domestic pediatricians and other children's doctors. (Here one could write about the state of domestic municipal and not only pediatrics, and the degree of responsibility of doctors for their recommendations, citing personal examples from my life and the lives of friends, but I will not, because everyone understands everything and there are examples of their own, I think everyone has)

A bit of history. Vodka-vinegar rubbing was very common 30 years ago (and earlier, respectively), when we were small. Pharmacology and pharmaceuticals then were far from being developed as they are now, and our parents' entire arsenal of drugs to combat fever was analgin and amidopyrine, which were quite often ineffective. Therefore, the very notorious vodka-vinegar rubbing was often used.
It is quite certain that rubbing this thing is very effective, but, unfortunately, very few people know that this is quite harmful, and, under certain conditions of the child, it is simply dangerous for his life.

Let's start with these states.
Fever in children is of two types - white and pink (sometimes they say "red"). Now I will not carry a gag and quote one girl, pediatrician, who wrote very well about this on one of the forums ( ira_doc , you do not mind? :about)).

"In children, there are two types of fever - pink and white.
The division between them is according to the color of the skin, while the temperature figures can be the same.
"Pink" - a more favorable fever, with it the same amount of heat is produced by the body and is released into environment. At the same time, the child's skin is pink, moist and warm to the touch. General well-being is not disturbed or violated slightly.
"White fever" is caused by a spasm of peripheral vessels, while heat transfer is disturbed. Accompanied by chills, a pronounced deterioration in well-being, the child is lethargic, inactive, the skin is pale, the hands and feet are cold.
All questions about what numbers you need to lower the temperature above relate only to the “pink” fever. With "white" it is necessary to reduce.
In what other cases it is necessary to lower the temperature?
- children of the first 3 months of life - above 38 degrees;
- Children who have previously had febrile convulsions(convulsions that occur at high temperature) - above 38 degrees;
- previously healthy children with relatively unchanged health - above 38.5 degrees;
- in all other cases and for all other figures - as prescribed by the attending physician.

How to reduce?
A frequent question is whether it is possible to wipe a child, information from parents on this matter is usually the most contradictory, some “always wipe, and nothing”, others heard that “the doctor said, in no case wipe”. In case of “white” fever, it is in no case possible to wipe it, with “pink” fever, you can wipe it with water at room temperature, it is better not to add alcohol and vinegar.

What to reduce?
Most often start with paracetamol (Efferalgan) in age dosages. Quickly reduces the temperature, but the effect is not very long. Applied up to 4 times a day. For kids early age candles and syrup are used.
Ibuprofen (Nurofen) lowers the temperature for a longer time, but the effect is often more pronounced and lasting. It is used in age dosages up to 3 times a day.
At high temperatures it is possible combined application these two drugs, which is best carried out under the supervision of the attending physician.
Metamizole sodium(Analgin) is mainly used by brigades emergency care with inefficiency. Due to possible side effects Not recommended frequent use analgin, parents should not use it on their own.
Nimesulide (Nise, nimegesic, nimesil) is prohibited for children.

With "white" fever, the doctor may additionally prescribe antispasmodics to relieve spasm of peripheral vessels.

Yes, with any increase in temperature, it is better if the child is examined by a doctor, and if the increase persists for more than three days, an examination is mandatory. "

In general, quite exhaustive. I will only add why children with white fever should never be wiped.
As already mentioned above, with white fever, the child has spasms of peripheral vessels - the vessels of the skin. At the same time, the skin loses the ability to normally remove heat, and a picture is obtained when the child overheats inside, and the heat is not removed outside. Any rubbing (even with plain water) increases the spasm of the skin vessels, and can lead the situation into a direct threat to the life of the child. Why this happens is quite understandable if you know a little physics - water, and even more so water with vodka or vinegar, actively evaporates and cools the skin dramatically. Which only enhances the spam of blood vessels, as I said.

Now directly about vodka and vinegar, that is, why is it impossible to wipe children with rose fever with water with these substances (after all, in theory, you can wipe with pink fever?). Here again I will not bear the gag, but I will quote, this time, the famous pediatrician, Dr. Evgeny Olegovich Komarovsky.

"When the body temperature rises, everything must be done to ensure that the body has the opportunity to lose heat. Heat is lost in two ways - by evaporating sweat and by warming the inhaled air.
Two required steps:
1. Plentiful drink - so that there is something to sweat.
2. Cool air in the room (optimally 16-18 degrees).
If these conditions are met, the likelihood that the body itself will not cope with the temperature is very small.
Attention!
When the body comes into contact with cold, a spasm of skin vessels occurs. It slows down blood flow, reduces the formation of sweat and heat transfer. The skin temperature decreases, but the temperature internal organs increases. And it's extremely dangerous!
Do not use the so-called "physical methods of cooling" at home: ice packs, wet cold sheets, cold enemas, etc. In hospitals or after a doctor's visit, it is possible, because before that (before physical cooling methods), doctors prescribe special medications that eliminate spasm of skin vessels. At home, everything must be done to prevent spasm of skin vessels. That's why

Cool air, but enough warm clothes.

Particles of heat are carried away from the body during the evaporation of sweat and thus the body temperature drops. Several methods have been devised to speed up evaporation. For example, put a fan next to a naked child; rub it with alcohol or vinegar (after rubbing, the surface tension of sweat decreases and it evaporates faster).
People! You can’t even imagine how many children paid with their lives for these rubbing! If the child is already sweating, then the body temperature will drop by itself. And if you rub dry skin, this is crazy, because through the delicate baby skin, what you rub with is absorbed into the blood. Rubbed with alcohol (vodka, moonshine) - alcohol poisoning was added to the disease. Rubbed with vinegar - added acid poisoning.
The conclusion is clear - never rub anything. And fans are also not needed - the flow of cool air, again, will cause a spasm of skin vessels. Therefore, if you are sweating, change (change clothes) in dry and warm clothes, then calm down.

Here you go. Too detailed and clear. At the same time, they explained once again about vasospasm.

ADF from pitchforkgirl :
1. The inefficiency of paracetamol is often due to the wrong dosage of the drug. Permissible dosages are indicated, for example,.
2. Nimesulide is prohibited for use in children under 12 years of age.
3. Aspirin and Reye's Syndrome:
"Acetylsalicylic acid is not currently recommended for use in the treatment of fever in children, especially in cases of suspected viral disease. It is known that the use of aspirin in this category of patients can cause liver necrosis and the development of acute liver failure. This complication is known as "Reye's Syndrome (Reye)". At the moment pathogenic mechanism development of Reye's syndrome is unknown. The disease proceeds with the development of acute liver failure. The incidence of Reye's syndrome among children under 18 years of age in the United States is approximately 1:100,000, while the mortality rate exceeds 36%"

ADF 2 from inescher :
Clothes for the child should be selected, depending on his condition and the type of fever. With pink fever, the child needs to be dressed lighter and it is very desirable to remove the diaper - according to some reports, this alone can cause the temperature to drop by about a degree. When undressing a child, one should not forget that there should be socks on the legs and the degree of undressing should be adequate to room temperature (at +18 in the room, I won’t risk baring the child too much, for example).
With white fever in a child, paradoxically, you need to warm (especially the arms and legs) - heat partially relieves spasm of skin vessels. But at the same time, clothes should not create the effect of a thermos, they should "breathe".