Fever: how is "red" different from "white"? Fever in children: types and treatment Fever of three days in children.

Pale fever in children is not a pleasant condition. The topic remains controversial and discussed until now, and especially with regards to children's health. With all the abundance of information and its availability to people, many people continue to zealously bring down the temperature and choke the fever in the bud. The phenomenon of the phenomenon of strife, and they have distinctive features, so you need to be able to interpret them correctly and make adequate decisions on the case so as not to harm the baby. Not so long ago, we covered the topic and the algorithm for helping in such a situation. This time we will touch on white fever in children, consider how it differs from pink fever, and how to properly provide assistance in such a situation.

White fever in children, also called pale fever, is an adaptive reaction of the body aimed at destroying invasive agents. It is most often found in respiratory diseases And viral infections. The feverish state in this case should be considered as a payment for the termination and suppression of the disease on its initial stage, and bringing down the temperature leads to reverse reactions, and translates the disease into a long-playing and slowly current phase.

Symptoms of pale fever in children pretty definable to the naked eye:

  • elevated temperature, and its maximum values ​​are noted on the trunk and head, and the limbs remain cold
  • chills can often occur
  • the skin acquires a pale whitish hue and a network of vessels becomes visible on it
  • the baby becomes lethargic and apathetic, refuses to eat and drink, does not play and is naughty.

The temperature spread can be quite large: 37-41 °C. At the same time, one cannot talk about critical and safe parameters, they simply do not exist. It is far from always necessary to bring down high values, and not at all to the parameters of 36.6 ° С, a decrease already by 1-1.5 ° С gives the baby a significant relief of well-being. If we are talking about babies mainly under the age of one year, then values ​​\u200b\u200bin the region of 38.5 ° C can become hazardous to health, for older children we can talk about a threshold of 39.6 ° C, although these are all rather arbitrary values ​​\u200b\u200band cannot be tied to them, t .to. each organism is individual. If the temperature values ​​​​have reached the given values, then you can think about lowering them.

Start with elementary ways without resorting to drugs:

  • put a damp cloth on the forehead, wipe the neck and folds of the crumbs with water. If your feet are cold, wear socks
  • do not wrap the baby tightly, this disrupts the exchange with the environment, reduces sweating and makes the state of health even more difficult
  • let's drink extra (fruit drink, compote).

If after a few hours you have not noticed positive trends in improving the condition of the child, and the temperature continues to rise, then it makes sense to take antipyretics according to the instructions. It is allowed to use paracetamol and ibuprofen. These drugs work pretty quickly, and after 40-60 minutes your baby should feel relief. If the situation does not return to normal, you observe the same signs, and the temperature continues to rise, you notice convulsions in the baby - call ambulance and do not pull further, it can be fraught with serious complications. Pale fever in children it is more severe than red, and its symptoms are more painful and unpleasant, however, with the help offered correctly and on time, you can significantly reduce the risk of complications and stop the fever in 3-4 days. remember, that fever in children This is not a disease, but a protective reaction of the body.

Fever- one of the frequent symptoms of many childhood diseases. This is explained by the fact that an increase in body temperature is a protective reaction of the body, which occurs in response to exposure to pyrogenic stimuli.

Due to the wide availability of antipyretics medicines, doctors are increasingly faced with such problems as - uncontrolled use of drugs, overdose, complications and side effects which can affect the health of children.

Therefore, it is very important to understand what is a fever and in what cases it is necessary to prescribe antipyretics, and in which it is possible to do without them.

normal temperature body temperature is considered to be in the range of 36.4 -37.4 degrees (when measured in the armpit). In the morning, the temperature is slightly lower, the highest in the evening hours (these are daily temperature fluctuations, if they are within 0.5 - 1 degrees, this is normal).

If body temperature in the armpit above 37.4 degrees, then they are already talking about an increase in body temperature. (in oral cavity above 37.6°C; rectal - above 38°С)

Causes of fever

Infectious diseases are one of the most common causes of fever;

A fever of a non-infectious nature can be:

  • Central genesis - as a result of damage to various parts of the central nervous system;
  • Psychogenic character - disorders of higher nervous activity ( mental disorders, neurosis); emotional stress;
  • Endocrine genesis - thyrotoxicosis, pheochromocytoma;
  • Medicinal genesis - taking certain drugs (xanthine medicines, ephedrine, methylthionine chloride, some antibiotics, diphenine and others).

The most common cause of fever is infectious diseases, inflammation.

Types of fevers

Fever duration:

  • Ephemeral - from several hours to several days;
  • 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 (febrile) - up to 39 ° C;
  • High - up to 41°С;
  • Hyperthermic - over 41 ° C.

Also distinguish:

  • "Rose fever";
  • "Pale fever".

Clinical manifestations and symptoms of fever

It should be remembered that fever is a protective reaction of the body, it helps us fight the disease. Unreasonable suppression of fever can lead to a decrease in the intensity of the immune response and the progression of the disease. At the same time, this is a non-specific protective-adaptive reaction, and when compensatory mechanisms are depleted or in a hyperergic variant, it can cause the development pathological conditions such as hyperthermic syndrome.

In children with serious diseases of the cardiovascular, respiratory and nervous systems, fever can lead to decompensation of these systems and the development of seizures.

Therefore, a golden mean is needed in everything, and with an increase in body temperature in a child, a doctor's consultation is mandatory.

Fever is only one of the symptoms, so it is very important to establish the cause that led to the temperature increase. To do this, it is necessary to assess the magnitude of the rise in body temperature, its duration, fluctuations, and also compare the data with the child's condition and other clinical manifestations of the disease. This will help to make a diagnosis and choose the right treatment tactics.

Depending on the clinical manifestations distinguish between "pink fever" and "pale"

"Rose Fever"

In this type of fever, heat transfer corresponds to heat production, this is a relatively favorable course.

At the same time, the general condition of the child and well-being was not greatly disturbed. The skin is pink or moderately hyperemic in color, moist and warm (or hot) to the touch, the limbs are warm. The increase in heart rate corresponds to an increase in body temperature (for every degree above 37 ° C, shortness of breath becomes more by 4 breaths per minute, and tachycardia by 20 beats per minute).

"Pale (White) Fever"

This type is spoken of when, with an increase in body temperature, heat transfer does not correspond to heat production, due to impaired peripheral circulation. The fever takes on an unfavorable course.

At the same time, the child has a violation of the condition and well-being, chills persist for a long time, pallor of the skin, acrocyanosis (blue around the mouth and nose), and “marbling” appear. There is a strong increase in heart rate (tachycardia) and breathing (shortness of breath). The limbs are cold to the touch. The child's behavior is disturbed, he is lethargic, indifferent to everything, agitation, delirium and convulsions can also be noted. Weak effect of antipyretics.

This type of fever requires emergency care.

Also, emergency care requires hyperthermic syndrome, especially in young children. With hyperthermic syndrome, decompensation (exhaustion) of thermoregulation occurs with a sharp increase in heat production, inadequately reduced heat transfer and lack of effect from antipyretic drugs. With it, there is a rapid and inadequate increase in body temperature, which is accompanied by impaired microcirculation, metabolic disorders, dysfunction of vital organs and systems.

Fever Treatment

With an increase in body temperature, the question immediately arises: should the temperature be lowered?

According to the recommendations of the World Health Organization, antipyretic therapy in initially healthy children should be carried out when the body temperature rises above 38.5°C. But, if a child has a fever (regardless of the severity of the temperature increase), there is a deterioration in the condition, prolonged chills persist, myalgia appears, feeling unwell, pallor of the skin, manifestations of toxicosis, then antipyretic therapy should be prescribed immediately.

It should be noted that children from the risk group for the development of complications against the background of an increase in body temperature, antipyretic therapy is prescribed at lower rates. With "red fever" at temperatures above 38 ° C, with "white" - even at subfebrile temperature(above 37.5°C).

The risk group includes:

  • Children in the first three months of life;
  • Children with a history of febrile convulsions - that is, those who have previously had convulsions against the background of an increase in body temperature;
  • With pathology of the central nervous system;
  • FROM chronic diseases heart and lungs;
  • Children with hereditary metabolic diseases.

Urgent care

With "red fever"

Uncover the child, expose as much as possible and provide access to fresh air (avoiding drafts).

It is necessary to provide the child with plenty of fluids - 0.5-1 liter more than the age norm of liquid per day.

Antipyretic therapy should be started with physical cooling methods:

Cool wet bandage on the forehead;

Cold (ice) on the area of ​​large vessels (armpits, inguinal region, neck vessels (carotid artery));

Vodka-acetic rubdown - vodka, 9% table vinegar and water mixed in equal volumes (1:1:1). Wipe the child with a swab dipped in this solution and allow to dry. It is recommended to repeat 2-3 times.

If there is no effect, go to antipyretic drugs(by mouth or rectally).

In children, paracetamol is used (in syrup, in tablets, in suppositories - depending on age) in a single dosage of 10-15 mg per 1 kg of body weight.

Ibuprofen is prescribed in a single dose of 5-10 mg per 1 kg of the child's weight (read the instructions before use).

If within 30-45 minutes the temperature does not decrease, it may be necessary to administer an antipyretic mixture intramuscularly (done by medical professionals).

With white fever

With this type of fever, along with antipyretics, it is also necessary to give vasodilators orally or intramuscularly (if possible). Vasodilators include: no-shpa, papaverine (dosage 1 mg / kg orally).

Dashevskaya N.D. GOU VPO "Ural State Medical Academy" -,Department of Pediatrics FPC and PP, Roszdrav, Yekaterinburg

Definition: Fever (K ​​50.9) is a protective and adaptive reaction of the body that occurs in response to exposure to pathogenic stimuli and is characterized by a restructuring of thermoregulation processes, leading to an increase in body temperature, stimulating the body's natural reactivity.

Fever continues to be one of the most common reasons for seeking emergency care in pediatric practice. Fever worsens the condition of the child and causes concern to parents, and remains the main reason for the uncontrolled use of various drugs. 95% of ARVI patients receive antipyretic drugs at temperatures below 38°C, although in most children moderate fever (up to 38.5°C) does not cause serious discomfort.

  1. Infectious genesis - occurs frequently and develops on exposure to pyrogens of a viral or bacterial nature
  2. Non-infectious genesis (central, psychogenic, reflex, endocrine, resorption, medicinal genesis.

Classification:

Depending on the degree of increase in axillary temperature:

Subfebrile 37.2-38.0 C.

  • Low febrile 38.1-39.0 C.
  • High febrile 39.1-40.1 C.
  • Excessive (hyperthermic) over 40.1 C.

Clinical options:

  • "Red" ("pink") fever (accompanied by normal health and pink skin)
  • "White" ("pale") fever (there is a violation of well-being and condition, Chills, -a; m. A painful feeling of cold, often accompanied by muscle tremors of the body, due to spasm of blood vessels in a person, for example, with fever or some kind of injury .

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  • Hyperthermic syndrome (an extremely serious condition caused by pale fever in combination with toxic damage to the central nervous system)

Temperature reduction is necessary in the following cases:

  • in children up to 6 months. at body temperature over 38.0 C;
  • in children from 6 months to 6 years of age with a sudden increase in temperature over 39.0 ° C;
  • in children with diseases of the heart and lungs, potentially dangerous for the development of acute heart and respiratory failure, in children with convulsive syndrome (of any etiology), as well as in diseases of the central nervous system potentially dangerous for the development of this syndrome, at a temperature of 38.0 "C and above;
  • all cases of pale fever at a temperature of 38.0 C or more.

Temperature reduction tactics:

  1. Should not be used in any temperature reaction;
  2. It is not necessary to achieve normalization of temperature, in most cases it is enough to lower the body temperature by 1-1.5 ° C, which is accompanied by an improvement in the child's well-being; The decrease in temperature should not be rapid;
  3. Antipyretic drugs should not be prescribed for regular course intake and for children receiving Antibiotics - chemicals produced by microorganisms or their structural analogues, which already in very small concentrations are detrimental to other microorganisms or tumor cells.

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The choice of antipyretic agent:

As antipyretic drugs in children, it is recommended to use only:

Paracetamol(panadol, calpol, efferalgan) in children after the 1st month of life in a single dose of 15 mg/kg, daily 60 mg/kg.

Analgin(Metamizole) is prescribed only in emergency cases parenterally (0.1-0.2 ml of 50% solution per 10 kg of body weight intramuscularly only).

You can not prescribe aspirin, analgin (inside), nimesulide (nise).

Emergency care for "pink" fever.

  • - paracetamol inside in a single dose of 10-15 mg/kg.
  • - physical cooling methods: expose the child as much as possible, provide access to fresh air, wipe with a damp swab at a water temperature of at least 37.0 "C, let the child dry, repeat the procedure 2-3 times with an interval of 10-15 minutes, blow with a fan, use cool wet bandage on the forehead, cold on the area of ​​large vessels;
  • - intramuscular injection antipyretic drugs, if the desired result cannot be achieved within 30 minutes: 50% solution of metamizole sodium (analgin) 0.01 ml / kg for children of the first year of life, older than a year - 0.1 ml / year. Antihistamines appointed by appointment only.
  • - continue physical cooling methods if necessary.

Emergency care for "pale" fever.

  • - paracetamol or ibuprofen orally in a single dose.
  • - papaverine dihydrochloride or rotaverine hydrochloride (no-shpa) at an age dosage (papaverine dihydrochloride 2% - up to one year
  • - 0.1-0.2 ml, older than 1 year - 0.2 ml / year of life, no-shpa 0.05 ml / kg
    in/).
  • - Rubbing, -i; cf. 1. Movements (of the palms, towels, etc.) on the surface of the skin, made in order to cause a rush of blood or to force something. soak into the skin one And massage techniques. Options: straight, zigzag, spiral and circular rubbing with fingertips; possible rectilinear rubbing with the palm of the hand and the tubercle of the thumb; forceps (pinch or three fingers); comb-shaped with fingers clenched into a fist, etc. 2. A substance (ointment, gel, tincture) that is rubbed into the skin (usually for medicinal or cosmetic purposes).

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  • - if the desired result cannot be achieved within 30 minutes, intramuscular administration of antipyretic drugs: 50% solution of metamizole sodium (analgin) 0.01 ml / kg for children of the first year of life, older than a year - 0.1 ml / year in combination with clemastine (suprastin) 2%
  • - 0.1-0.15 ml for 1 year of life, but not more than 1.0 ml and papaverine dihydrochloride 2% - up to one year - 0.1-0.2 ml, over 1 year - 0.2 ml / year life.
  • - in the absence of effect within 30 minutes. - intravenous droperidol 0.25% - 0.1 ml / kg.

Usually, white fever in a child develops as a response of the body to an infectious infection. Doctors separate the red and white forms of fever. With the development of the latter, a spasm of blood vessels occurs, which leads to severe chills. It is quite difficult for children to carry it, so it is necessary to transfer it to the red form as quickly as possible. The second stage of fever is characterized by high heat transfer, minimizing the risk of overheating. Rose fever is more easily tolerated.

The most common cause of hyperthermia is infection, bacterial, viral, fungal or other lesions. In a continental climate, it is usually acute respiratory infections, bronchitis, pneumonia, otitis media. In hot areas, intestinal infections are also a common cause. Pathogens enter the body with food, in the process of breathing or during an injection.

White fever can be caused by the flu, measles, or whooping cough vaccine.

The development of fever for other, non-infectious reasons is not excluded. Chills can be observed due to allergic reactions, rheumatic phenomena, poisoning and malignant tumors.

Symptomatic picture

The name of the fever speaks for itself: the child becomes very pale, marbling of the skin is observed. Lips turn blue, hands and feet get cold. The pulse and respiration rate increase sharply, the pressure rises. The child is cold, he complains of chills. General state varies: the patient can be either completely lethargic or very excited. Convulsions and delirium are possible.

The fever progresses in three stages.

  1. The body temperature rises rapidly, as heat loss becomes much less than heat production.
  2. The temperature stabilizes, but remains elevated.
  3. Hyperthermia abruptly disappears or gradually decreases to normal levels.

White fever causes loss of appetite

As a rule, the doctor notes:

  • apathy;
  • pale skin;
  • lack of appetite;
  • uneven breathing.

Symptoms characterize the baby's immunity from the best side: this is a typical reaction for a healthy body. Defense mechanisms promote the denaturation of foreign proteins within the body, which speeds up recovery.

Hyperthermia stops the reproduction of viruses, bacteria or fungi. After that, uncontrolled suppression and destruction of inflammation begins in the body.

Diagnostics

The disease of scarlet fever or allergy to antipyretic drugs, in addition to the main symptoms, is manifested by a rash. Inflammation of the mucous membranes is characteristic of fever due to pharyngitis, otitis media, bronchitis or pneumonia.

Mononucleosis and tonsillitis, caused by streptococci or viruses, cause white fever, passing against the background of a sore throat. Bronchitis or bronchiolitis, asthma, laryngitis cause difficulty in breathing, its rigidity, unevenness. Activity disorders nervous system possible with meningitis or encephalitis. In the latter case, emergency medical attention is often needed.

Scarlet fever or an allergy to antipyretics causes a rash

Intestinal infections are often diagnosed due to the development of white fever, accompanied by diarrhea. With the appearance of vomiting and pain in the abdomen, most likely, we have to talk about inflammation of the appendix or organs genitourinary system. Fever with arthritis or rheumatism occurs along with damage to large joints.

If the cause of white fever is any serious illness, the child is too irritable and sleepy, he practically does not drink and breathes heavily, then he needs urgent hospitalization.

Parenting first steps

When the first symptoms of a fever appear, the baby should not experience fear and panic. Need to distract and calm him down interesting history or a fairy tale.

Before being examined by a pediatrician, it is important for the child to ensure plenty of fluids. It is better if it is natural juices and fruit drinks, herbal decoctions.

Proper nutrition is also important: the disease should not lead the baby's body to exhaustion. Food is needed not only healthy, quickly digestible, but also tasty. You need to do something that will definitely please the child.

Medical treatment

Treatment of the main symptoms is not limited to anti-inflammatory and antipyretic drugs. Often such treatment is ineffective and even meaningless. As a rule, children are prescribed phenothiazines, for example, "Diprazin". With the help of these funds, blood vessels expand, blood circulation stabilizes, the work of the sweat glands, and they also have a sedative effect.

Pediatricians recommend giving a child with white fever drugs to dilate blood vessels. Perfect for this a nicotinic acid- 1 mg per 10 kg of body weight. Vitamin PP is used in combination with Paracetamol or medicines containing it - Panadol or Calpol. As an effective antipyretic, Nurofen is used in the form of suppositories or syrup. But you should not focus on the treatment of lowering the temperature, the use of strong drugs. The more effective the antipyretic, the more harmful it is for the child's body.

Nurofen syrup is used as an effective antipyretic

Spasm is relieved with the help of antispasmodics - Dibazol or Papaverine. But "No-shpa" will not help much here, since its action is mainly aimed at internal organs. Antipyretics will not work until the spasm of the body is gone, so this is very important in the treatment of fever. Vasoconstriction - the main symptom of fever - can be reduced by rubbing the child's limbs and completely eliminating the cooling of the body.

Contraindications

A number of drugs for fever are prohibited. So, the list of contraindications includes:

  • "Aspirin", which can cause encephalopathy;
  • "Analgin" (due to the risks of anaphylactic shock);
  • "Nimesulide", which is a highly toxic agent.

Urgent care

Children with fever may need first aid. First of all, you need to block hyperthermia with the help of antipyretic drugs described above. Together with paracetamol, an antispasmodic that dilates blood vessels is used.

Within an hour, the temperature should drop at least a degree. Otherwise, you should immediately call a doctor.

In this case, you should not do everything possible to bring the body temperature closer to normal. Sudden changes are difficult to tolerate, especially by the children's body. The exception is infants and children with heart and central nervous system problems. For them, a temperature above 38 degrees is contraindicated.

ethnoscience

Each of us was sick in childhood and, probably, remembers the means tested by generations in the fight against high temperature and chills with fever.

  1. If we talk about tea with raspberries, then with a fever there is no difference what to drink. The released moisture in any case will increase the heat transfer of the body. As for jam, its effectiveness is not so great. The most beneficial effect on the body is a decoction of leaves, and not berries. It is better to add a few raspberry and strawberry leaves to the teapot, some linden flowers. So the effect will increase many times over.
  2. Another famous folk way- milk and honey. The combination is very tasty, although not many children like it. Honey will undoubtedly bring benefits: it not only heals, but also soothes, strengthens sleep. In turn, milk soothes the throat, reduces coughing.

So, the treatment of pale fever comes down to complex drug therapy in combination with the right diet and sleep.