A DIFFERENCE OF 5-DEGREES-C BETWEEN EAR AND RECTAL TEMPERATURES IN A FEBRILE PATIENT

A 4-year old boy with a history of seizures triggered by fever present ed at an emergency department (ED) with tachycardia, skin vasoconstric tion, and a rectal temperature of 42.2 degrees C. However, his ear tem perature (as repeatedly measured in two ears, by two experienced nurse s, and with two infrared thermometers) was between 36.4 degrees C and 37.6 degrees C. Antipyretic therapy resulted in skin vasodilation, a r apid decrease of rectal temperature, restoration of heart rate, and di sappearance of the difference between the two temperatures. Seizures d id not occur. This case shows that infrared ear thermometry cannot be recommended in EDs as the procedure of choice for detecting fever in s mall children, especially when they are vasoconstricted. Copyright (C) 1997 by W.B. Saunders Company.