Prolonged and recurrent fevers in children

摘要: Some children referred for prolonged fever are actually not having elevated temperatures; the approach here requires dissection of history and correction health misperceptions. Others have well-documented fevers associated with clinical, laboratory, or epidemiologic findings that should point to a specific diagnosis. "Fever-of-Unknown-Origin" (FUO) is clinical scenario daily ≥ 14 days defies explanation after careful history, physical examination, basic laboratory tests. The diagnostic meticulous diary, serial evaluations, vigilance appearance new signs symptoms, targeted investigations; pace work-up determined by severity illness. Approximately half FUO will self-limited illness never diagnosis made; other ultimately be found have, in order, infectious, inflammatory, neoplastic conditions. Irregular, intermittent, recurrent well-appearing child likely sequential viral illnesses. Monogenic autoinflammatory diseases considered those who do fit picture infections hallmarks immune deficiency. Stereotypical febrile illnesses recur clockwork periodicity raise possibilities cyclic neutropenia, if cycle approximately 21 days, periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome, most common childhood.