Pale fever in a child with high fever. High temperature in a child and cold extremities: what to do? When to lower the temperature

Almost any disease in a child is accompanied by an increase in body temperature. This is a specific reaction of the body to changes in the internal environment under the influence of various factors, which include infectious agents. Also, hyperthermia can provoke a number of non-communicable diseases.

Even a slight increase in body temperature in a child should alert parents. At this moment, you need to carefully listen to the body in order to understand where it failed to work, and which organ needs help.

The concept of fever and its danger to the child's body

The child's body is a complex system where every organ and organ system (circulatory, lymphatic, nervous) work together, thereby supporting the life of a little man. Together they respond to various harmful stimuli. Fever also belongs to such specific reactions. Hyperthermia is characterized by a restructuring of the thermoregulation system, which leads to an increase in temperature. Thus, the body reacts to pathogenic factors of both external and internal origin.

Fever stimulates the immune response and helps fight pathogens. Elevated temperature can be the result of infectious, somatic ailments, blood diseases. Also, fever can often be caused by psychological disorders. Hyperthermia provokes the production of interferon, stimulates phagocytosis of foreign material and the formation of specific antibodies.

Despite the benefits of elevated temperature, it can cause many complications, including life-threatening conditions, especially against the background of disorders of the heart and respiratory organs.

Fever is especially dangerous for young children. It can provoke convulsions, swelling of the brain.

Dangerous complications of hyperthermia:

• hypoxia - the result of an increase in the frequency of breathing by 2-3 times and a decrease in its depth;
• disturbance in the work of the heart - manifested as a result of an increase in the frequency of heart contractions, an increase in oxygen consumption by the cells of the heart muscle;
• indigestion - the intestines cease to function normally, appetite decreases, the secretion of the digestive glands decreases;
• dehydration is a consequence of large losses of water by the cells of the body;
• acidosis - protein breakdown with the formation of intermediate metabolic products, which are acids, they are carried throughout the body with the bloodstream;
• violation of microcirculation - manifested by a marble pattern of the skin, the limbs become cold, convulsions are possible (we recommend reading:).

Varieties and symptoms

Fever in a child is divided into several types according to a number of characteristics. Classification according to the duration of the flow:

• acute - up to 2 weeks;
• subacute - up to 6 weeks;
• chronic - more than 6 weeks.

According to the degree of increase in body temperature:

• subfebrile - up to 38 ° C;
• moderate - up to 39 ° C;
• high - up to 41 ° C;
• hyperthermic - above 41 ° C.

Types of fevers according to concomitant symptoms:

• long-term (constant) - the temperature fluctuates within 0.4 ° C per day;
• remitting - the temperature during the day can fluctuate widely, but the minimum values ​​\u200b\u200bare above the norm;
• intermittent - a wide range of temperatures from the normative to the highest value during the day;
• hectic - the temperature drops to normal, but after a couple of hours it again reaches its maximum values, accompanied by increased sweating;
• undulating - characterized by a gradual decrease and increase in temperature;
• return - the temperature alternately drops and rises at irregular intervals;
• biphasic - the disease may be accompanied by different temperature indicators;
• periodic - characterized by a recurrence of fever after a certain period of time.

White

White fever in a child does not respond well to the action of antipyretic drugs. This is a type of hypothermia in which there is an outflow of blood from the skin. Symptoms of this type of hyperthermia:

• pale skin;
• cold extremities;
• violation of respiratory function;
• increased heart rate;
• lethargy or agitation;
• convulsions.

Red

In red fever, heat loss corresponds to heat production. Hyperthermia is accompanied by the following symptoms:

• the limbs are warm, moderately reddened, the skin is moist;
• slight increase in heart rate and breathing;
• no change in behavior.

Causes of white and red fever

Body temperature can change for a number of reasons:

Non-infectious causes of hyperthermia include the following pathologies:

• allergic reaction;
• tumors of various origins;
• head injuries and associated hemorrhages;
• vascular thrombosis;
• reaction to medications;
• metabolic pathologies;
• diseases of the endocrine glands.

First aid

With rose fever in a child, you should:

• undress the baby and provide him with an influx of fresh air, but at the same time protect him from drafts;
• give plenty of drink;
• provide local cooling by applying a wet cool bandage to the forehead and to the area of ​​​​large blood vessels;
• give an antipyretic (Paracetamol, Ibuprofen), and if after 30-45 minutes the medicine has not worked, then an antipyretic mixture can be injected intramuscularly;
• if the temperature does not subside, repeat the injection.

With white fever in children, it is necessary:

• give antipyretic medicine - Paracetamol, Ibuprofen;
• take orally or intramuscularly inject a vasodilator drug - Papaverine, No-shpu;
• every hour to monitor body temperature when it reaches 37 ° C.

If after all the manipulations the symptoms of pale hyperthermia do not go away, then urgent hospitalization of the child is indicated. Further therapy depends on the severity of the child's condition and the cause of white fever.

Indications for the use of antipyretics:

• temperature above 39°C;
• temperature above 38-38.5 ° C in children with heart disorders, past convulsive conditions, breathing problems, headaches and muscle pain, metabolic disorders;
• temperature 38°C - at the age of 3 months.

Features of treatment

With red fever, to increase heat transfer, it is recommended to expose the baby as much as possible, since warm clothes will only provoke an additional rise in temperature. In order to avoid dehydration, you should provide your child with plenty of fluids, and it is recommended to drink the baby often, but in small portions. To improve heat transfer, you can apply a damp, cool towel to your forehead and to the area of ​​​​large blood vessels. It is undesirable to give a child an antipyretic if the temperature does not exceed 38.5-39 ° C.

Treatment mechanisms for pallid fever differ from pink hyperthermia because it is life-threatening and harder to bring down. It is necessary to warm the limbs of the child by putting on socks and covering him with a sheet or a thin blanket. When taking antipyretic drugs, drugs are simultaneously given or administered to dilate blood vessels and relieve their spasms. In this case, it is important to call a doctor for follow-up and treatment. In emergency cases, hospitalization is indicated.

Do not panic and bring down the child's low temperature. It is important to give the body the opportunity to cope with the infection on its own. However, at the same time, it is necessary to constantly monitor body temperature in order to prevent the consequences. In case of unsuccessful attempts to reduce body temperature with white fever, an urgent need to call a doctor - perhaps the child is in danger and needs emergency help.

Fever is called a protective reaction of the body in response to exposure to pathogenic stimuli. Its task is to stimulate the immune system to fight bacteria and viruses. An increase in temperature is considered an indicator that the body is trying to defeat the disease itself. The fever may be red or white. The difference lies in the symptoms and first aid rules. Any rise in temperature is bad, but white fever in children is very dangerous and requires special attention from parents when their child is sick.

Why does body temperature rise?

Body temperature rises when a pathogenic bacterium or virus enters the body. Fever allows you to stimulate all the defenses of the child's body, thereby accelerating the healing process.

White fever in children most often occurs due to respiratory viral infections that every child suffers from. In such cases, it is called "fever of infectious origin." But there are non-infectious causes of fever in a child:

• trauma, swelling, hemorrhage;
• problems of a psychological nature (neurosis, emotional overstrain, etc.);
• taking medications;
• pain syndrome of any origin;
• failure in the endocrine system;
• allergic reaction;
• (calculi that exit the urinary tract injure the mucous membrane, as a result of which the body temperature rises).

The above factors that can provoke a fever are considered the main ones. But there are others.

How to identify white fever?

Red and white fever in children proceed in different ways, of course, the symptoms will also be different. But, as mentioned above, the latter type is considered more dangerous for the child's body. Therefore, it is so important to be able to determine what kind of condition is currently observed in the baby. After all, it depends on which method of struggle should be chosen.

If the child's skin is pink and moist, and the body is hot, then in this case we can talk about red fever. The limbs will be warm - you should pay special attention to this. Rapid breathing and pulse are observed.

White fever in children is more severe. The child is put pale, you can even see the vascular network. Sometimes this condition of the skin is called "marble".

The lips become blue, blue can be observed in the nail beds. Cold extremities, when the whole body is hot, is the main symptom of white fever. If you press on the skin, then a white spot remains on the body, which does not go away for a long time.

In white fever, the difference between rectal and axillary temperature is 1 ° C or more.

Dangerous symptoms!

This type of fever can manifest itself as very dangerous symptoms that every parent should be aware of. It's about convulsions. If you do not react in time to the condition of the child, do not bring down the temperature, then the occurrence of seizures in most cases is inevitable.

The child changes behavior. He is lethargic, does not want anything, refuses to eat. Against the background of a convulsive state, the baby may begin to rave.

When to bring down the temperature?

Many parents, having discovered the slightest increase in body temperature in their child, begin to panic, get all kinds of antipyretics and give them to their child. But when is it necessary to do this, and when is it not?

As a general rule, children need to bring down the temperature only in cases where the thermometer shows 38.5 ° C or more. But does this apply to every child and every case? The answer is no! White fever in children requires immediate intervention, even if the body temperature has not reached 38.5 ° C. Especially it concerns:

• newborns under three months of age;
• children who have previously had a convulsive state;
• children with CNS disorders;
• patients who have chronic diseases of the heart muscle or lungs;
• those who have metabolic problems.

Parental responses to white fever

Everyone should know what to do if white fever occurs in children. Emergency assistance is as follows:

• call an ambulance - the first thing to do if you have symptoms of white fever;
• apply dry heat to the limbs (this can be a heating pad or a bottle of warm water);
• cover the child if he refuses to get dressed (but do not overdo it, the main thing is that the body is warm, and not even warmer);
• give more warm tea, compote or water to drink;
• it is forbidden to wipe the child with alcohol and acetic solutions, because this can lead to spasm.

Medicines

Which of the medicines can be used if white fever occurs in children? Treatment consists in the use of such drugs:

1. "Paracetamol". It is recommended to use no more than 3-4 times a day. The general course of treatment is 3 days.
2. "Ibuprofen". Reception frequency - every 8 hours.
3. "No-shpa." A drug that helps to remove vasospasm, which is very important in this condition.
4. group of phenothiazines. These include the drugs "Propazin", "Pipolfen", "Diprazin". The dosage should be prescribed only by a doctor.
5. Rectal suppositories with analgin and diphenhydramine, for example, Analdim.

If an ambulance was called, then, as a rule, the child will be given an injection based on one of the following drugs "Analgin", "No-shpa", "Dimedrol". The dosage depends on the age of the child.

Before using each drug, you need to read the instructions attached to it in detail.

What is the danger?

An increase in body temperature to high levels sometimes causes dangerous consequences. The internal organs overheat very much, the brain suffers. Therefore, it is so important to bring down the temperature of children.

Why is white fever dangerous in a child? The main danger lies in the development of febrile seizures. This happens in 3% of all cases. Seizures adversely affect the central nervous system and its development.

Dehydration is another factor to pay attention to. With any increase in body temperature, you need to give the child a drink to prevent dehydration.

It is forbidden!

When white fever is prohibited:

• wrap the child in a warm blanket, put on warm clothes;
• excessively humidify the air in the room;
• wipe the body with acetic and alcohol solutions (it threatens to develop dangerous consequences);
• put the child in a bath with cool water;
• self-medicate if the child's condition is critical;
• neglect medical attention.

Now you know how to bring down the temperature in white fever in a child. It is important to take into account all the nuances of assistance, because if something is done wrong or contrary to the rules, then the harm done to the child's body can be irreparable. It's best to call an ambulance right away. The doctor will give an injection to the child and give recommendations about further actions.

Fever is caused by the action of exogenous (microbial, viral) pyrogens, which, acting on tissue or blood macrophages, stimulate their release of secondary (endogenous) pyrogens. It is believed that the main endogenous pyrogens are interleukin-1 (IL-1) and tumor necrosis factor (TNF). Less important is leukocyte interferon (a).

Fever has 3 stages: incrementi (increase), fastigii (plateau) and incrementi (decrease). The decrease in temperature can be critical and lytic. With a rapid drop in high body temperature (minutes, hours), collapse is possible.

Body temperature can be subfebrile (up to 37.5 ° C), febrile (high - 37.5-38.5 ° C), hyperthermic (hyperpyrexia - above 38.5 ° C).

Fever can be classified according to the duration and severity of individual attacks of fever:

1. fever reaction,
2. hyperthermic syndrome (Ombredanna),
3. malignant hyperthermia.

A febrile reaction suggests the presence of a relatively short episode of an increase in body temperature (from several minutes to 1-2 hours) and is not accompanied by a significant deterioration in the health of the comb. The skin is usually pink and moist. The temperature in some cases (may be high 39-40 ° C), but, as a rule, is easily affected by antipyretics. This reaction is called "pink" or "red" hyperthermia. Heat production predominates in its genesis.

Hyperthermic syndrome is characterized by fever, torpid to treatment with antipyretic drugs, pallor of the skin (or pallor with the presence of acrocyanosis), deterioration in well-being, sometimes impaired consciousness, behavior (lethargy, agitation).

Causes of fever in children

Most often, acute fever in a child of the first year of life and early age is infectious, mainly acute respiratory viral infections (ARVI) or gastrointestinal infections. Bacterial infections, usually otitis media, pneumonia, urinary tract infections, are less common but can sometimes be very severe (eg, meningitis). Newborns are susceptible to infections caused by group B Streptococcus, Escherichia coli, Lysteria monocytogenes, herpes simplex virus, infection with which occurs perinatally.

Children younger than 2 years (especially younger than 3 months) are at risk for the development of cryptogenic bacteremia, that is, the presence of pathogenic bacteria in the blood of a febrile child without signs of local damage. The most commonly causative organisms are Streptococcus pneumoniae and Haemophylus influenzae; Haemophilus influenzae vaccination is now widely available in the US and Europe, resulting in less frequent occurrence of septicemia.

Rarely, noninfectious causes of acute fever include heat stroke and poisoning (eg, with anticholinergics). Some vaccines (eg pertussis vaccine) can cause fever every other day or even 1-2 weeks later, cause a vaccine-associated disease (eg measles) after vaccination. This fever in children usually lasts from several hours to one day. Teething does not cause fever.

Chronic fever in children may indicate a variety of causes, from autoimmune diseases (eg, juvenile rheumatoid arthritis, non-specific inflammatory bowel disease) to cancer (eg, leukemia, lymphoma), as well as chronic infections (osteomyelitis, UTI).

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What should I do if my child has a fever?

The survey differs by age group and focuses on identifying the source of infection or causes of non-communicable diseases. Acute fever in a child under 3 months of age requires careful evaluation, regardless of other signs and symptoms, because severe infections (eg, sepsis, meningitis) may occur without other clinical manifestations.

Anamnesis

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Inspection

It is extremely important to assess the general condition and appearance of the child. A febrile feverish child with signs of intoxication, especially when the temperature has already dropped, requires careful examination and further observation. In all febrile children, special attention should be paid to examining the eardrums, pharynx, chest, abdomen, lymph nodes, skin, and checking for meningeal signs. Petechiae or purpura often indicate a severe infection.

Laboratory and instrumental examination

All febrile children should have a blood test to determine the number of leukocytes and leukocyte formula, blood cultures, urinalysis and urine cultures. A lumbar puncture is mandatory for children under 2 months of age; about the need for this procedure in children aged 2-3 months, opinions are different. It is advisable to conduct a chest x-ray, determine the number of leukocytes in feces, sow feces, determine acute phase indicators (for example, ESR, C-reactive protein, procalcitonin).

Febrile children aged 3 to 24 months who are in good health may need careful observation, and laboratory tests are not necessary. If there are symptoms of a specific infection, appropriate investigations should be ordered (eg, chest x-ray if hypoxemia, dyspnea, or wheezing is present; urine culture and urine culture if foul-smelling urine is present). If the child has symptoms of intoxication, but there are no local symptoms, a complete blood count, blood cultures, and urine and cerebrospinal fluid tests should be ordered.

Examination of children older than 2 years is determined by history and examination results; monitoring of blood cultures and leukocyte counts is not indicated.

Each mother, repeatedly faced with an increase in temperature (or, as this condition is also called, hyperthermia) in her baby, does not know whether to bring it down or not. In addition, she does not fully understand how to help the child without harming his body.

Fever is one of the most common symptoms of various childhood illnesses. Hyperthermia is a protective reaction of the body in response to exposure to pathogenic stimuli, stimulating the body's immune reactivity. Therefore, the uncontrolled and unreasonable prescription of antipyretics by overly caring parents often leads to a decrease in the baby's resistance to various infectious agents.

A constant level of body temperature allows the body to maintain the optimal activity of all biological processes in organs and tissues, which is achieved by maintaining a balance between heat production and heat loss and is regulated by the thermoregulation center located in the hypothalamus.
An increase in body temperature can be caused by both infectious and non-infectious agents. Some microorganisms (streptococci, diphtheria bacillus, gram-negative organisms) themselves produce pyrogens that can cause hyperthermia. Others - viruses, rickettsia, spirochetes - stimulate the synthesis of pyrogens by the body into which they enter.
The cause of non-infectious fever can be the pathology of the central nervous system (trauma, hemorrhage, tumors), endocrine diseases, psychogenic factors, taking certain medications, overheating.

An increase in temperature activates the production of interferon, the synthesis of antibodies, an increase in the activity of phagocytes, an increase in the antitoxic function of the liver, and the secretion of corticosteroid hormones. All these mechanisms significantly inhibit the reproduction of viruses and bacteria. It is known that at temperatures above 39°C, most viruses lose their virulent properties. Thus, hyperthermia has a pronounced protective character.
Usually, in the absence of background diseases, the child normally tolerates an increase in body temperature up to 39 ° C, however, high fever disrupts the normal functioning of the baby's organs and systems and can cause life-threatening conditions: febrile convulsions, toxic encephalopathy, etc.

Types of fever in children
According to the degree of increase in body temperature, the following types of fever are distinguished:
- subfebrile - 37.2 - 38 ° C;
- febrile:
1. moderate - 38.1 - 39 ° С,
2. high - 39.1 - 41 ° С;
- hyperperitic - 41.1 ° C and above.

The duration of the fever can be:
- ephemeral - from several hours to several days;
- acute - up to 2 weeks;
- subacute - up to 6 weeks;
- chronic - more than 6 weeks.

By clinical course it is necessary to distinguish pink and pale fever. In the first type, the state and behavior of the child is slightly disturbed, the skin is pink, moist, hot, the limbs are warm. This fever is more common in children and is more benign. The level of heat transfer in this case corresponds to the level of heat production.
The second type is characterized by a severe general condition of the child, behavior is disturbed, lethargy, capriciousness or, conversely, excitement appears. Chills, pallor and dryness of the skin, marble pattern, cold hands and feet, acrocyanosis (bluish tint of lips and nails), increased heart rate and blood pressure are pronounced. Pale fever occurs when there is an imbalance between heat production and heat loss. Against its background, such formidable complications as febrile convulsions and toxic encephalopathy can appear.

Febrile convulsions
Febrile seizures are called convulsions that occur against the background of an increase in body temperature (usually 39-40 ° C) in acute infectious and inflammatory diseases. This condition usually develops against a background of pale fever and indicates brain hypoxia (lack of oxygen), significantly worsening the child's condition. Most often, febrile convulsions are observed in infants of the first year of life, less often in children under 5 years of age. Their duration is usually 4-5 minutes, and a short-term loss of consciousness is possible, and they stop with a decrease in body temperature and usually do not require the appointment of anticonvulsants.

Hyperthermic syndrome- this is a pathological variant of fever, in which heat production increases sharply and heat transfer decreases. High values ​​of body temperature are accompanied by a significant deterioration in the child's condition. Severe pallor, marble skin pattern, bluish tint of fingers and toes appear, the difference between skin and rectal temperatures increases (more than 1 ° C), which indicates the centralization of blood circulation. This formidable condition is characterized by a progressive dysfunction of the vital organs of the child, as well as the lack of effect of antipyretic therapy.

Basic principles for the treatment of fever in children
The issue of prescribing antipyretic drugs for a child should be approached very carefully. This is done based on the severity of clinical signs, the presence of background diseases and the well-being of the baby.
We must not forget that fever is a protective reaction of the body, and a decrease in body temperature leads to a decrease in the baby's own defenses, its natural resistance to infections.

With the development of hyperthermia in a child, it is necessary to provide him with peace, ventilate the room in which he is located, and humidify the air. The room temperature should not exceed 21°C. In this state, the baby needs to be given a sufficient amount of warm liquid, as the body begins to lose it through the skin and respiratory tract. For each increased temperature degree, an additional intake of water is required at the rate of 10 ml per 1 kg of body weight of the child, and this is in addition to the fact that there is a natural (physiological) rate of its consumption.

Do not forget about the physical methods of cooling the body. The baby should be undressed and lightly wiped with warm water. You can put a wet bandage on your forehead. The use of cold is not allowed due to the fact that it can lead to spasm of skin vessels, a decrease in heat transfer and an increase in body temperature. Wiping a child with alcohol-containing solutions and vinegar is also not recommended due to their absorption from the surface of the skin, leading to intoxication, because the peripheral vessels expand during fever.
Medications should be prescribed taking into account the degree of fever, its type and the presence of risk factors in the child.

Risk factors for complications associated with fever in children include:
- the age of the child up to 3 months,
- history of febrile convulsions,
- diseases of the central nervous system,
- severe diseases of the circulatory system,
- hereditary metabolic pathologies.

Thus, according to WHO recommendations, in the absence of the above factors, antipyretic drugs should be prescribed to a child with hyperthermia above 38.5 ° C. However, if his general condition is disturbed, there is pallor of the skin, chills (i.e. white fever), they should be resorted to immediately. When the fever is pink, antipyretics are given when the body temperature rises above 38 ° C, and when it is pink - 37.5 ° C. Such recommendations are not a dogma, and they must be followed according to the situation.

When choosing an antipyretic for a baby, preference should be given to a safer one. Currently, non-steroidal anti-inflammatory drugs with antipyretic, analgesic and anti-inflammatory properties are used in the treatment of children. However, now some drugs from this group, such as aspirin and analgin, are prohibited for use as antipyretic drugs for fever caused by a viral infection. After taking them, children can develop very serious complications associated with a violation of the blood coagulation system. Analgin adversely affects erythrocytes and platelets, and also inhibits bone marrow hematopoiesis, and the use of aspirin causes the development of Reye's syndrome in a child, the lethality of which is 50%.

In pediatric practice, preference is given to drugs containing paracetamol and ibuprofen. But when prescribing any medication to a baby, one should still strictly observe the therapeutic dosages and not exceed them.
Children with pale fever, hyperthermic syndrome and febrile convulsions require urgent hospitalization.