Vous êtes sur la page 1sur 9

DD fever

By Gatut Wicaksono (04020013)

Main causes of fever


Infections (Bacterial, virus, TB, parasitic, rickettsia) are by far the most common cause of fever in children. Infection remains the likely diagnosis in a febrile child until proven otherwise. Noninfectious (collagen/vascular, malignancy, drugs, allergy, recent immunization, periodic fevers).

Diagnosis that fever is caused by an infection is supported by the following:


Underlying conditions predisposing to infections (e.g., Immunocompromised status, splenectomy, sickle cell anemia, neonates and young infants, intravascular catheters) Fever of 40C or greater, presence of chills, diurnal fluctuation of fever A focus for infection (e.g., tonsillitis, pneumonia). In case of fever without a focus, the diagnosis can usually be rapidly established by laboratory means (e.g., UTI, malaria) Short duration of fever occuring, for example, in viral infections Rapid response to antibiotics in bacterial infections Concomitant herpes labialis Leukocytosis >20,000 in bacterial and leukopenia < 5,000 in viral infections High procalcitonin (PCT) levels. PCT is low in viral infections and inflammatory diseases, for example, connective diseases and neoplasma

Diagnosis that fever is not caused by an infection is supported by the following:


History (e.g., recent vaccination, drug intake) Persistent or insidious fever of low degree (<39.5C) Associated pruritic rash, multiple joint involvement Negative bacterial cultures in blood, stool, urine, and CSF Absence of chills and diurnal rhythm of fever Exclusion of an infection by history, physical examination, and laboratory tests Fever not responding to antibiotics but responding to steroids Absence of leukocytosis and left shift, presence of antinuclear factor (ANF)

DDX
Relapsing Fever (Borrelia)

Perbedaan (Tipe demam)


characterized by periods of fever lasting 29 days, separated by afebrile periods of 27 days

Gejala
sudden onset of high fever, lethargy, headache, photophobia, nausea, vomiting, myalgia, and arthralgia Additional symptoms: abdominal pain, a productive cough, and mild respiratory distress

Pemeriksaan
thin or thick blood smears stained with Giemsa or Wright's stain.

Terapi
Oral or parenteral tetracycline is the drug of choice

DDX Enteric fever, or typhoid fever

Perbedaan (Tipe demam) The incubation period is usually 714 days, but it may range from 330 days

Gejala Depend on age:


SCHOOL-AGED CHILDREN AND ADOLESCENTS fever, malaise, anorexia, myalgia, headache, and abdominal pain develop over 23 days Unremitting and high fever within 1 wk, often reaching 40C INFANTS AND YOUNG CHILDREN (<5?YR) Mild fever and malaise,& Diarrhea NEONATES Vomiting, diarrhea, and abdominal distention

Pemeriksaan Culturing the Salmonella strain Polymerase chain reaction Widal test

Terapi Third -generation cephalosporins Chloramphenicol Ampicillin Amoxicillin Trimethoprim sulfamethoxazole

Daftar Pustaka
A. Sahib El-Radhi,James Carroll,Nigel Klein.2009.Clinical Manual of Fever in Children. Springer: Verlag Berlin Heidelberg Powell,Keith R.2003.Nelson Textbook of Pediatrics 17th edition:Fever.Elsevier Science:USA

Vous aimerez peut-être aussi