here we speak about some causes of fever and how we can approach to it.

1. 1- Etiology of the fever.
2- approach to fever.
BY: mina sam eskander (1090)

2. Etiology of the fever1- infection.
2- disease of the nervous system.
3- certain malignant neoplasm.
4- Blood diseases such as leukaemia , embolism, and thrombosis.
5-Heat stroke from exposure to hot environment
6- Dehydration.
7- Surgical trauma and crushing injuries.
8- Skin abnormalities that interfer with heat loss.
9-Allergic reaction to foreign proteins and pyogens.

3. A- According to categories of fever
1- Fever of short Duration.
2- Fever without localizing signs (without a Source or Focus).
3- Fever with unknown origin (FUO).
1-
infection
B- According age group
1- Fever in infants younger than 3 months old.
2- Fever in infants younger than 3 years old.

4. 1- Fever of short Duration
• accompanied by localizing signs and symptoms, in which a
diagnosis can be established by clinical history and physical
examination

6. 2- Fever without localizing signs
(without a Source or Focus)
• frequently in a child younger than 3 years old, in which a history and PE
(physical examination) fail to establish a cause, although a diagnosis of occult
bacteremia may be suggested by laboratory studies, the presence of a positive
blood culture.
organisms
1- Streptococcus pneumoniae: is responsible for 2/3 to¾ of all cases
2- Neisseria meningitidis, Haemophilus influenzae type b, and salmonellae
account for most of the remaining cases.

7. 3- Fever with unknown origin (FUO)
• which defines fever for more than 14 days without an identified etiology
despite history, physical examination, and routine laboratory tests or after 1
week of hospitalization and evaluation.
Etiology of FUO
• Infections 30-40%
• Autoimmune 7-10%
• Malignancy 2-5%
Infectious Causes of FUO in children
• Infectious mononucleosis: (EBV)
• Infection of the upper or lower respiratory tract
• Urinary tract infection
• Osteomyelitis
• Cat scratch disease
• CNS viral or bacterial infection
• Tuberculosis

8. Most febrile illnesses in this age group are caused by:
• common viral pathogens.
• but serious bacterial infections :-
bacteremia (caused by S. pneumoniae, Hib, nontyphoidal Salmonella,
group B streptococcus, or N. meningitidis),
UTI (Escherichia coli)
pneumonia (S. aureus, S. pneumoniae, or group B streptococcus),
meningitis (S. pneumoniae, Hib, group B streptococcus,
meningococcus, herpes simplex virus [HSV],enteroviruses)
bacterial diarrhea (Salmonella, Shigella, E. coli)
B- According age group
1- Fever in infants younger than 3 months old.

9. 2- Fever in infants younger than 3 years old.
• child younger than 3years old with decrease in localizing signs of infection.
• Although most of these children have self-limited viral infections.
• some have occult bacteremia (bacteremia without an identifiable focus)

10. 2- disease of the nervous system
1- Viral meningitis and encephalitis
• Infections in the brain and spinal cord can cause dangerous
inflammation with a range of symptoms, including:
Fever
Headache
Seizures
Change in behavior or confusion
2- Tumor

11. 3- certain malignant neoplasm
• . The pathophysiology of tumor-induced fever may be due to several
mechanisms of which include release of cytokines from tumor cells or
infiltrating mononuclear cells (e.g., tumor necrosis factor and interleukin-1)

12. 4-Dehydration
Causes of dehydration fever
• In neonate
1- Delayed breast milk production.
2- excessive sweating.
3- Over clothing especially in hot weather.
.In childhood
Mainly gastroenteritis.

13. • Personal History:
– Age
– Occupation
– Place of origin .Travel History.
– Habits: Consumption of
Unpasteurized Dairy Products.
2- approach to fever.
• Underlying Diseases:
– Splenectomy
– Surgical Implantation of
Prosthesis
– Immunodeficiency
– Chronic Diseases:
• Cirrhosis
• Chronic Heart Diseases
• Chronic Lung Diseases

14. • Drug History:
• Antipyretics
• Immunosuppressants
• Antibiotics
• Family History:
• TB in the Family
• Recent Infection in the Family
Associated Symptoms:
• Shaking chills
• Ear pain, Hearing loss
• Visual and Eye Symptoms
• Sore Throat
• Chest and Pulmonary Symptoms
• Abdominal Symptoms
• Back pain, Joint or Skeletal pain

15. • Physical Examination:
– Vital Signs
– Neurological Examination.
– Skin Lesions ,Mucous Membrane
– Eyes
– ENT
– Lymphadenopathy
– Lungs and Heart
– Abdominal Region
(Hepatomegaly ,Splenomegaly)
– Musculoskeletal
• LABORATORY STUDY:
• Assess the extent and severity of the
inflammatory response to infection.
• Determine the site(s) and
complications of organ involvement.
• Determine the etiology of the
infectious disease.