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Int. J. Mol. Sci. 2016, 17(4), 448; doi:10.3390/ijms17040448

Recurrent Fever in Children

1
Pediatric Medium Intensive Care Unit, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
2
Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Vera Sau-Fong Chan
Received: 3 February 2016 / Revised: 13 March 2016 / Accepted: 21 March 2016 / Published: 25 March 2016
View Full-Text   |   Download PDF [245 KB, uploaded 25 March 2016]

Abstract

Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time. View Full-Text
Keywords: autoinflammatory disorders; pediatric infectious diseases; periodic fever; recurrent fever autoinflammatory disorders; pediatric infectious diseases; periodic fever; recurrent fever
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Torreggiani, S.; Filocamo, G.; Esposito, S. Recurrent Fever in Children. Int. J. Mol. Sci. 2016, 17, 448.

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