DIAGNOSIS AND TREATMENT: CHILDREN WITH FEVERS

Abstract

In the infant the temperature rises on the most trivial cause; it may be lumpy faeces in the intestine, it may be a slight coryza. I have seen cases where even some irritation of the skin seemed sufficient cause; as the child grows older, similarly but less often, constipation, some slight deviation from a customary diet, or even some unwonted excitement may be sufficient cause for a rise in temperature.1 Sir George Frederic Still STILL'S explanation of some of the causes of fever in the infant and child may not be acceptable to the contemporary practitioner, but none would doubt that the clinical thermometer has been both an instrument of great diagnostic value, yet often a source of undue parental anxiety. Ever since Traube in 1850 first recommended routine daily recording of the temperature of ill children, the normal diurnal variations of body temperature in infants and children remain of clinical interest-and at times misunderstanding. Parents and some physicians forget that no one temperature reading can be given as normal for all children at all times. BODY TEMPERATURE MEASUREMENT IN CLINICAL PRACTICE The internal temperature of the body can best be determined by a rectal thermometer. But, even rectal temperature readings may not be a true record of the body's deep temperature because of variations in the technic of using the thermometer. When, under experimental conditions, the thermometer is inserted 14 cm, the reading will be 0.3 to 2.4°F(0.2 to 1.3°C) higher than when it is inserted between 2 and 6 cm, as is the custom in clinical practice.