home Audience 2 Autoimmune pathologies in a child with prolonged subfebrile condition. Subfebrile temperature in a child. Why does subfebrile temperature occur

Autoimmune pathologies in a child with prolonged subfebrile condition. Subfebrile temperature in a child. Why does subfebrile temperature occur

In the practice of a pediatrician, there are often cases when the main complaint of parents is the presence of a fever in a child.

talk about the causes of subfebrile condition in children.

Prolonged subfebrile condition is an increase in temperature in the range of 37-38 degrees for 3 weeks.

Prolonged subfebrile condition is observed most common in children under 1 year of age (which is probably due to a reaction to the BCG vaccine), then there is a significant decline between the ages of 2 and 7 years And increase from 8 to 14 years , which 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 phenomena. This is due to the physiological characteristics of the female body, the ease of infection of the urogenital system, as well as the high frequency of psycho-vegetative disorders.

Most often, subfebrile condition is observed in children under the age of 1 year, then there is a significant decrease at the age of 2 to 7 years and an increase in the period from 8 to 14 years.

It should be borne in mind that prolonged low-grade fever is much less likely to be a manifestation of any organic disease, in contrast to prolonged fever with a temperature above 38 0 C. In most cases, prolonged low-grade fever reflects a banal autonomic dysfunction.

Conventionally, the causes of prolonged subfebrile condition can be divided into two large groups: infectious and non-infectious.

Infectious subfebrile condition found in such diseases. :

Tuberculosis, especially if the temperature increase is combined with general weakness, emaciation, sweating, loss of appetite, prolonged cough, unsuccessful fluorography and tuberculin tests, as well as the presence of contact with a patient with an open form of tuberculosis.
Focal infection (sinusitis, tonsillitis, cholecystitis, dental problems, etc.).
Toxoplasmosis, giardiasis.

Subfebrile condition may appear after an infectious disease ("temperature tail"), as a reflection of the syndrome of post-viral asthenia. In this case, the subfebrile temperature is benign, is not accompanied by changes in the analyzes and disappears on its own, usually within 2 months (sometimes the "temperature tail" can last up to 6 months).

Prolonged subfebrile temperature non-infectious nature may be due to somatic pathology, but much more often it can be explained by physiological causes or the presence of psycho-vegetative disorders.

Physiological causes. In many people, subfebrile temperature is constitutional in nature and is a variant of the individual norm. Subfebrile condition can develop against the background of emotional and physical (sports) stress, appear after eating, when in a hot room, after insolation. In women, subfebrile temperature is possible in the second half of the menstrual cycle, which normalizes with the onset of menstruation; rarely, subfebrile condition is observed during the first 3-4 months of pregnancy.

Causes of non-infectious subfebrile condition :

Endocrine disorders (thyrotoxicosis, pheochromocytoma, etc.).
Iron-deficiency anemia.
Rheumatic diseases.
Tumors.

According to some indications, distinguish infectious low-grade fever from non-infectious .

For infectious low-grade fever is characterized by poor temperature tolerance, daily physiological temperature fluctuations are preserved (normally morning temperature is 1 degree lower than evening temperature), a positive reaction to taking an antipyretic. And when non-infectious- the temperature is well tolerated, daily fluctuations are absent or distorted (morning temperature is higher than evening temperature), there is no reaction to antipyretic.

To find out the reason subfebrile conditions conduct a variety of laboratory and instrumental studies.

Consultations of an ENT doctor, a dentist, a cardiologist, a phthisiatrician, an infectious disease specialist, an endocrinologist, a hematologist, an oncologist are prescribed.

Elevated body temperature of the child is a matter of concern for many parents. An indicator of 36.3-37°Ϲ is considered normal, feverish - from 38°Ϲ. Subfebrile temperature is called from 37 to 38 ° Ϲ.

With diseases such as flu, colds, a rise in temperature to subfebrile numbers should not cause worries, because the body specifically raises it to fight the virus. But when such indicators are kept in the normal state of the child, without clinical manifestations of the disease, you need to look for the cause.

Causes of subfebrile temperature

Quite harmless, and not requiring treatment, causes include:

Too active behavior of the child. With violent games and unbridled fun, children can “jump” to the temperature. As a rule, it does not exceed 37.3°Ϲ and passes by itself within 2-3 hours.
Long crying, children's hysteria can also cause a short-term rise in temperature to the mark 37–37.5°Ϲ. At the same time, it decreases within 2-3 hours.
Overheating, too warm clothes.
in babies, it can also be accompanied by a mild fever.

In children after serious infections, such as a protracted ARVI, a "temperature tail" may be observed. It manifests itself in the fact that even after a completely cured disease, the temperature does not drop immediately, but remains at around 37–37.5°Ϲ for a few weeks. In this way, the body "protects" itself from the development of new infectious diseases. This condition is not dangerous, rather, it is exciting for parents.

Most often, infectious diseases lead to the occurrence of subfebrile temperature. It can be:

Accession to the underlying disease by a microbial or bacterial infection. These pathogens can occur at any time, even on the road to recovery.
Complication of chronic infections of the upper and lower respiratory tract, such as tonsillitis, sinusitis, frontal sinusitis, bronchitis.
Inflammation of the urinary system.
Diseases of the gastrointestinal tract.
ENT diseases.
Tuberculosis in open or closed form.
Viral hepatitis, HIV.
"hidden infections" such as Einstein-Barr, cytomegalovirus.

Long-term, from 2 weeks, fever for no apparent reason is called subfebrile condition. This condition can be asymptomatic or with symptoms such as weakness, anemia, fatigue, headache.

Subfebrile condition not associated with infections is caused by:

Malignant neoplasms in children are very rare. Their symptoms depend on the location of the tumor and size. Anemia manifests itself in the form of weakness, fatigue, and a decrease in the level of hemoglobin in the blood.

Diagnosis of the causes of subfebrile temperature

Correct temperature measurement

Diagnosis of the causes of subfebrile condition begins with accurate temperature measurement. To do this, you need to monitor its performance 3 times a day - in the morning, afternoon and evening. This is due to the fact that this indicator does not stay at the same level, but changes in accordance with daily biorhythms. The lowest temperature in humans is observed at night and in the early morning - this is 36.2–36.4 ° Ϲ. During the day it rises to 36.6°Ϲ, and in the evening it can reach 36.8°Ϲ.

It is necessary to carry out the measurement with the same thermometer, but before that it is worth checking its readings with another in order to exclude the possibility of errors. It is better to write down the indications - these data will be useful to the doctor.

"Drug" causes of subfebrile condition

Some medications have the side effect of a persistent fever. Here is their list:

Drugs against the treatment of Parkinson's disease.
Medicines based on thyroid hormones.
Antihistamines.
Narcotic painkillers.
Antipsychotics.
Antibiotics.
Adrenaline, norepinephrine.
Antidepressants.

If you do not see the reasons for the temperature, which rises for more than two days in a row, and did not use provocative medications, you should consult a doctor.

Examination of the body

The very first tests that the pediatrician will refer to will be a blood and urine test. They will help to make a detailed picture of the disease. By the level of ESR in the blood, it will be seen whether the inflammatory process is going on in the body. The hemoglobin level will confirm or disprove anemia. Urinalysis will show the state of the genitourinary system.

If inflammatory processes in the body are not detected, the doctor may examine your child for:

Allergy, by analyzing venous blood for immunoglobulin E (Ig E).
A smear for enterobiasis (pinworms).
Feces for "eggworm" or blood for antibody titers to helminths (ELISA method).
Glucose level (if diabetes is suspected).
Throat swab for hidden staphylococcal infections.
Blood for Einstein-Barr virus, cytomegalovirus, hepatitis A, B and C.
Abdominal ultrasound.
Autoimmune diseases.

Treatment of subfebrile temperature is the elimination of the causes that caused it. If it causes discomfort in your child, you can reduce it with the usual antipyretics, but only with the permission of the doctor!

Photobank Lori

Subfebrile is called body temperature up to 38 degrees. Prolonged subfebrile condition can be a symptom of a sluggish inflammatory process (pyelonephritis, myocarditis,), an allergic or infectious-allergic disease, anemia, and some other serious diseases. Therefore, the first thing to do with a long subfebrile temperature is to comprehensively examine the child.

The examination plan usually includes a clinical blood test, urinalysis (not only general, but also cumulative samples and a study of daily urine, as well as an analysis for sterility), radiography of the paranasal sinuses and lungs, tuberculin tests, a biochemical blood test with the definition of rheumatic tests, ECG, Ultrasound of internal organs, stool tests for eggs of worms. According to the results of the analyzes, consultations of the necessary specialists are carried out.

The temperature of any healthy person changes during the day. In children, it is even slightly higher. Especially increases in the afternoon when the child is active. I measured mine a couple of times just out of curiosity. In the evening it is always around 37.5. The child is perfectly healthy.

Sometimes, and only in older children, to identify the nature of subfebrile condition, doctors conduct an aspirin test: they record the temperature when taking aspirin according to a certain scheme.

Parents can also participate in the survey. Firstly, 24-hour temperature monitoring is necessary, when it is measured every 3-4 hours, including the sleep period (at least 24 hours). Secondly, daily measurement of blood pressure on both arms is desirable - this procedure is also easy to master on your own. Thirdly, it is sometimes advised to simultaneously examine the parents themselves and other family members in order to identify foci of latent infection that can support subfebrile condition in a child.

If, according to the results of the analyzes, no pathology is revealed, special attention should be paid to the state of the autonomic nervous system. Often subfebrile temperature is observed in infants and school-age children with autonomic dysfunction syndrome. It also happens in children with neurosis - there is even the term "thermoneurosis" - therefore, with prolonged subfebrile condition and no changes in the analyzes, a neurologist's consultation is mandatory. Sometimes subfebrile temperature accompanies metabolic disorders: it happens in schoolchildren and delayed sexual development. Such children with hypothalamic-pituitary syndrome are observed by both a neurologist and an endocrinologist.

In some children, subfebrile body temperature is maintained not by increasing heat production, but by reducing heat transfer. This happens with spasm of peripheral vessels, and, above all, capillaries. Such subfebrile condition is characterized by the fact that during sleep the body temperature is normal. It increases with physical activity and emotional stress on the child. In summer, subfebrile condition often disappears in such children.

Treatment for prolonged subfebrile condition is largely determined by its nature. With chronic inflammation detected, the main process is treated, and the temperature returns to normal. With hypothalamic syndrome, a neurologist can prescribe drugs that improve nutrition and microcirculation of the brain, strengthen the vascular wall and have a calming effect.

With subfebrile conditions of a neurogenic nature, a phytotherapeutic technique is used (author - doctor N.L. Menshikova), combining the intake of infusion. It was traditionally believed that subfebrile temperature is a contraindication for their implementation. Now they recommend an individual approach to the child: sometimes vaccinations are allowed on a commission basis after a clinical examination.

Hello! Son is 11 years old. We belong to the category of frequently ill children from early childhood. From the age of two, there were frequent sore throats. After having outgrown, apparently, he gets sick often, but mostly quite easily, that is, SARS without complications and antibiotics, within five days. From early childhood, he suffers from a dry cough, especially in the morning, mainly if he gets up early. It's better during the holidays. The cough is often barking. The ENT and the pediatrician at the clinic will usually state that it is allergic. Passed a full examination in the department of pulmonology, allergology. Excluded asthma. Tests for the investigated allergens are all negative (however, the list of allergens, in my opinion, is quite primitive, standard). Despite the negative allergy tests, the child is considered an allergic person, immunoglobulin E is slightly elevated. The last 5 weeks have been suffering from subfebrile temperature. The numbers fluctuate in the range of 37-37.6. Passed the general analyzes of a blood, urine, biochemistry. Cytomegalovirus was found, leukocytes are slightly reduced, everything else is normal. We accept polyoxidonium. As prescribed by the ENT doctor, they washed the tonsils. The temperature returned to normal for a week. Then it resumed again. The local pediatrician, after consulting with a neurologist, advised me to measure the temperature, both in the usual way and rectally, during the week. Explaining this by the fact that if the rectal temperature is normal, that is, up to 37.5, and the usual armpit temperature is elevated, then it is most likely of a neurogenic nature. I was skeptical, not believing how such a temperature difference is possible. But within a week I discovered that, indeed, despite the jumps in armpit temperature, the rectal temperature, not only was higher (as I assumed), it was either lower - 36-36.7, or approximately the same as normal (and only twice). But still lower by 0.1-0.2 degrees. I don't know what to think. The pediatrician triumphantly declares that we have one road to neurologists, psychologists, and we need to change schools (We take the child far, by 7.30 and until 16 o'clock). The child gets tired, studies well, but goes to school with difficulty and goes with great reluctance. In fairness, it must be said that it is true that the drop in temperature fell on a week of holidays. And it resumed on the second day after going to school. My son has no problems with teachers, classmates, studies. Neither in his words, nor in the words of the class teacher. The ENT insists that it is chronic tonsillitis and that the tonsils may have to be removed. He advises not to drag the child to other doctors, it makes no sense - only torturing. How much can you believe this? How to be? Advise, please, to what experts to address, what analyzes still to hand over?

Probably, if you conduct a survey on the topic: “What increase in body temperature causes you the most discomfort?”, then 39.5C will most likely not lead. And not even 38.5C, but 37.2-38 degrees.

Headache and body aches, chills and tinnitus disturb. But the worst thing is that there is practically nothing you can do to help yourself. After all, antipyretic, as it were, is not very appropriate to drink. Anesthetics only help for short periods of time. And soluble preparations in the form of tea, although they relieve the main symptoms for some time, but cause such drowsiness (at times even suspicious calmness) that the performance, for which the medicine was taken, turns out to be at zero ...

What can we say about small children who cannot explain their indisposition using only whims, crying, irritability and refusal to eat? In addition, parents themselves, often enduring such conditions exclusively “on their feet”, understand that there is an explanation for subfebrile temperature and their method of “treatment” is categorically inapplicable for a small organism ...

subfebrile temperature- this is pathological hyperthermia in the range of 37-38 degrees Celsius. Often acts as a residual phenomenon after viral and colds. And also it can be symptom of an inflammatory process in the body, which does not enter the active phase, but cannot be eliminated on its own.

If you do not pay attention to this situation for a long time, you can allow all sorts of complications, many of which will cause serious harm to the patient's health.

However, there are cases when such thermometry results for a particular person are considered the norm. Moreover, he feels absolutely normal, and the test results are impeccable. This category also includes small kids age up to one year.

This is explained by the fact that their thermoregulation system is not yet stable and, basically, adapts to the external conditions of the habitat. That is why young newly-made mothers are not recommended to wrap up too much or, on the contrary, easily dress their babies, since it will not take much time to overheat / hypothermia.

Concerning older children, especially of preschool and school age, then with such temperature fluctuations, especially in the evening and for no apparent reason, one must be very careful:

First, carefully examine your child and pass the necessary tests,
Secondly, follow the dynamics of temperature at different times of the day.
Thirdly, for several days, conduct thermometry for the rest of the family.

All these manipulations can help you find the cause of subfebrile temperature. Or put up with this state of affairs if this pathology is inherited from one of the relatives or is associated with active pastime / games.

Causes of subfebrile temperature

There is an opinion that the norm of body temperature indicators ends with a mark of 36.9C. Anything higher, including 37 degrees for a long time, can only be associated with some kind of sluggish inflammatory process. No wonder this concept is translated from Latin as "temperature close to fever."

Considering that a slight increase in temperature within the range of 37-37.5C may not bother the youngest patient at all, then his parents, after a maximum of two to three weeks, will probably raise the alarm and turn to the doctor.

What awaits them at the reception?

If the baby no more than one year, his tests are within the normal range, and there are no visible symptoms of any disease, most likely, mom and dad will be calmed down and sent home. In extreme cases, they will advise you to reconsider the degree of warming of the baby during walks and sleep.
Aged 2-7 years there is a decrease in body temperature to 36.2-36.8 degrees Celsius. It stays that way under all conditions. The exception is active games, hereditary moments and all sorts of ailments that require immediate intervention. Especially when it comes to inflammatory processes. Then the doctor prescribes a series of tests and studies to the patient (OAC, OAM, coprogram, fluorography, ultrasound, electrocardiography).
Children from 8 to 15 years again fall into the subfebrile risk group, as the probability of combining childhood and adult ailments increases significantly. An important role is played by the puberty of adolescents, the establishment of the menstrual cycle in girls.

37.2 and Komarovsky

Often, parents, kissing a child at night, note a slightly hot forehead, measure the temperature and ... see 37C. It is likely that after this, round-the-clock thermometry begins, trips to doctors, the delivery of endless tests and a feverish intake of medicines from each prescription.

During this time, the child begins to feel only worse, is already afraid of bottles and pills. And the temperature stays...

It asks: a why a child all this chemistry if the test results are normal? If he eats well and plays merrily? If he is comfortable with such a temperature? Of course, this does not include cases in which the disease is still detected, and leaving it without treatment is fraught with serious complications.

Therefore, before stuffing your baby with half of the purchased pharmacy, check the state of the air in the house, remember when the child last emptied himself, draw parallels between thermometer readings and active games. And most importantly, evaluate objectively the way the baby is dressed. Perhaps the cause of subfebrile condition is very close ...