ASSOCIATION OF HYPERPYREXIA WITH SERIOUS DISEASE IN CHILDREN

In a prospective study over 7 years, 105 consecutive pediatric patient s with hyperpyrexia (temperature greater than or equal to 41.1 degrees C [106 degrees F]) were evaluated to determine the incidence, sensiti ve indicators, and types of illnesses encountered. The incidence of hy perpyrexia in a large urban pediatric emergency department was 0.36 pe r 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 ill ness in 20 (19.0%) of the patients. Bacteremia (6.7%) and bacterial me ningitis (5.7%) were less commonly found. Four (3.8%) patients died. T he admission rate was 62.9%. Eighteen patients (17.1%) also had seizur es. Sensitive indicators to help distinguish those with serious illnes s, with the exception of clinical appearance, were not found. Pneumoni a is commonly found in children with hyperpyrexia. Temperature greater than or equal to 41.1 degrees C was associated with a high rate of se rious disease.