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2016 ; 17
(4
): 448
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Recurrent Fever in Children
#MMPMID27023528
Torreggiani S
; Filocamo G
; Esposito S
Int J Mol Sci
2016[Mar]; 17
(4
): 448
PMID27023528
show ga
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.