• Childhood Kidney Diseases
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• v.12 no.1
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• pp.70-77
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• 2008

Purpose: Urinary tract infections(UTIs) are not uncommon findings in febrile pediatric patients and approximately one third of patients with UTI may have renal scars. This research was intended to establish the relationship between duration of fever and renal scars. Methods: The medical records of 143 patients were reviewed retrospectively. Inclusion criteria were as follows: 1) fever as defined by an axillary temperature $\geq37.5^{\circ}C$, 2) accurate history of fever duration and the use of antibiotics 3) no previous history of UTI and 4) positive urine culture. We observed whether the longer fever duration could be associated with the development of initial renal defects and subsequent renal scars, increased C-reactive protein(CRP), leukocytosis and the presence of vesicoureteral reflux(VUR). Results: 1) Patients with longer fever duration after antibiotics showed more frequent initial renal defects(P=0.014). However, fever duration before antibiotic use was not associated with the development of initial renal defects(P=0.244). 2) Incidence of renal scar increased with fever duration before antibiotic use(P=0.006) and fever duration after antibiotic use(P=0.015). 3) CRP correlated with the fever duration after antibiotic use(r=0.287, P=0.003). 4) There was no relationships between fever duration and VUR(P>0.05). Conclusion: Our data suggest that fever duration before/after antibiotic use is significantly associated with the increased development of renal scars in pediatric UTI.

• Childhood Kidney Diseases
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• v.21 no.2
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• pp.107-113
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• 2017

Purpose: This study aimed to evaluate the relationships between 99mTecnicium-dimercaptosuccinic acid (DMSA) scan findings and clinical parameters including age and fever duration. Methods: The positive rates for abnormal DMSA scans were analyzed according to the age of patients, fever duration prior to admission, and total fever duration. DMSA scan findings were divided into 3 categories: single defect, multifocal defects, and discrepant defects. We evaluated the detection rates of vesicoureteral reflux according to DMSA scan lesions. Results: Among a total 320 cases, 141 (44.1%) had abnormal DMSA scans. The infant group (0-1 year of age) had a shorter total fever duration, and a lower C-reactive protein (CRP) value and DMSA positive rate (39.8% vs. 60.6%, P=0.002) compared to children group (2-15 years of age). Patients with abnormal scans had a longer total fever duration and higher CRP compared to those with normal scans. The positivity rate of abnormal scans did not differ between the patients with a short fever duration prior to admission of ${\leq}2$ days and those with longer fever duration of ${\geq}3$ days. However, patients with longer total fever duration had a higher rate of abnormal DMSA scans (P=0.02). Among cases with a single defect, multifocal defects, and discrepant defects, vesicoureteral reflux was observed in 22.4%, 60% and 70.6% of cases, respectively (P=0.004). Conclusion: Although DMSA scan has limitations in early diagnosis, DMSA scan findings may aid in the prediction of the severity of systemic inflammation and detection of vesicoureteral reflux.

• Clinical and Experimental Pediatrics
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• v.61 no.5
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• pp.160-166
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• 2018

Purpose: This study aimed to analyse laboratory values according to fever duration, and evaluate the relationship across these values during the acute phase of Kawasaki disease (KD) to aid in the early diagnosis for early-presenting KD and incomplete KD patients. Methods: Clinical and laboratory data of patients with KD (n=615) were evaluated according to duration of fever at presentation, and were compared between patients with and without coronary artery lesions (CALs). For evaluation of the relationships across laboratory indices, patients with a fever duration of 5 days or 6 days were used (n=204). Results: The mean fever duration was $6.6{\pm}2.3days$, and the proportions of patients with CALs was 19.3% (n=114). C-reactive proteins (CRPs) and neutrophil differential values were highest and hemoglobin, albumin, and lymphocyte differential values were lowest in the 6-day group. Patients with CALs had longer total fever duration, higher CRP and neutrophil differential values and lower hemoglobin and albumin values compared to patients without CALs. CRP, albumin, neutrophil differential, and hemoglobin values at the peak inflammation stage of KD showed positive or negative correlations each other. Conclusion: The severity of systemic inflammation in KD was reflected in the laboratory values including CRP, neutrophil differential, albumin, and hemoglobin. Observing changes in these laboratory parameters by repeated examinations prior to the peak of inflammation in acute KD may aid in diagnosis of early-presenting KD patients.

• Child Health Nursing Research
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• v.18 no.4
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• pp.164-169
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• 2012

Purpose: The purpose of this study was to compare the effectiveness for infants of antifebrile therapy using a hypothermia blanket or rectal antipyretics following open heart surgery. Methods: This was a retrospective study and 174 infants who had open heart surgery at P University Hospital, and whose body temperature body temperature exceeded $37.2^{\circ}C$ were included in the study. The assessment tool was composed of 32 items was used for assessment of fever therapy, physiological indexes and antifebrile duration. Physiological indexes included systolic blood pressure, diastolic blood pressure, heart rate, pH, $PaCO_2$, $PaO_2$, $HCO_3{^-}$, $SaO_2$, and $K^+$ and the antifebrile duration was minutes from having a fever until BT returned to normal levels. Results: The antifebrile duration with the hypothermia blanket was shorter than with rectal antipyretics. There were significant differences in the physiological indexes with either type of antifebrile therapy, but drop in BT was greater with the hypothermia blanket than rectal antipyretics. Conclusion: The results of this study indicate that a hypothermia blanket is a non-invasive, non-drug and safe antifebrile therapy. Therefore, a hypothermia blanket can be applied to infants with a fever following open heart surgery.

• The Journal of Pediatrics of Korean Medicine
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• v.35 no.3
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• pp.53-66
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• 2021

Objective The purpose of this study is to evaluate whether herbal bath shortens the duration of pediatric fever. Methods Databases, such as Medline, EMBASE, Cochrane library, OASIS, KISS, KMBASE, CNKI, Wanfang Med Online were used to search randomized controlled trials. Those trials that included children younger than 18-year-old were evaluated for the clinical efficacy of herbal bath in fever by analyzing 'body temperature (BT) drop start time' and 'time to return to normal BT'. Results 12 studies or 1306 participants were analyzed in the study. When applying herbal bath in combination with the controlled treatment, 'BT drop start time' was decreased by 0.11 hours, and 'time to return to normal BT' was decreased by 10.94 hours compared to the controlled group. When comparing herbal bath with tepid bath, 'time to return to normal BT' was reduced by 8.19 hours in herbal bath group. In regards to safety, 3 studies out of 12 studies mentioned about its adverse events: 2 studies did not have any adverse events, and a minor needle-shaped bleeding had occurred in one of the studies. Conclusion Use of herbal bath as a treatment of fever in children was associated with shortened duration of fever. However, cautious interpretation is necessary due to its limited safety data.

• Childhood Kidney Diseases
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• v.9 no.1
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• pp.56-63
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• 2005

Purpose : Development of renal scarring is associated with delayed diagnosis and treatment of urinary tract infection(UTI). This study was performed to clarify how soon treatment should be started to Inhibit renal scarring after onset of UTI and the factors associated with renal scarring in children with a first episode of febrile UTI. Methods : We retrospectively reviewed 163 patients with a first episode of febrile UTI under the age of 2 years from April 2000 to Ap,il 2004. All patients had a DMSA renal scan and voiding cystourethrogram done in the diagnostic period, 6 months after which a follow-up renal scan was done. After patients wet-e divided into 2 groups according to the duration of fever prior to start of treatment, the duration of fever after start of treatment, and total duration of fever, initial and follow-up DMSA scan findings were analyzed among the different groups. We compared the factors associated with renal scars between the groups with and without renal scars. Results : The initial DMSA renal scan identified abnormal finding in 23% of the patients who were treated $\leq$24 hr from the onset of disease and in 43% of those with fever more than 24 hr. Renal scars developed in 33% of patients who were treated $\leq$24 hr and 38% of those with fever >24 hr prior to treatment. Renal scars developed in 34% of patients with remission of fever $\leq$48 hr after treatment and ill 50% of those with fever >48 hr after treatment. The risk for renal scars was significantly higher in children who had total duration of feyer >72 hr(67%) than in those with shorter duration(19%). In children with renal scars, VUR was most highly associated with an increased risk of renal scar formation. Conclusion : Although children with a first episode of febrile UTI are treated within 24 hr after onset of the fever, renal damage cannot be prevented completely and it is mainly associated with VUR. (J Korean Soc Pediatr Nephrol 2005;9:56-63)

• Journal of Medicine and Life Science
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• v.19 no.2
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• pp.46-56
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• 2022

The incidence of fever complicating percutaneous coronary intervention (PCI) is rare. However, little is known regarding the cause of fever after PCI. Therefore, this study aimed to determine the clinical characteristics of patients with acute myocardial infarction (AMI), with or without fever, after PCI. We enrolled a total of 926 AMI patients who underwent PCI. Body temperature (BT) was measured every 4 hours or 8 hours for 5 days after PCI. Patients were divided into two groups according to BT as follows: BT<37.7℃ (no-fever group) and BT ≥37.7℃ (fever group). The 2 years clinical outcomes were compared subsequently. Fever after PCI was associated with higher incidence of major adverse cardiac events (MACE) (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.07-2.28; P=0.021), all-cause death (HR, 2.32; 95% CI, 1.18-4.45; P=0.014), cardiac death (CD) (HR, 2.57; 95% CI, 1.02-6.76; P=0.049), and any revascularization (HR, 1.69; 95% CI, 1.02-2.81; P=0.044) than without fever. In women, prior chronic kidney disease, lower left ventricular (LV) ejection fraction, higher LV wall motion score index, white blood cell count, peak creatine kinase-myocardial band level, and longer PCI duration were associated with fever after PCI. Procedures such as an intra-aortic balloon pump, extracorporeal membrane oxygenation, continuous renal replacement therapy, central and arterial line insertion, and cardiopulmonary resuscitation were related to fever after PCI. Fever after PCI in patients with AMI was associated with a higher incidence of MACE, all-cause death, CD, and any revascularization at the 2 years mark than in those without fever.

• Clinical and Experimental Pediatrics
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• v.59 no.2
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• pp.54-58
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• 2016

Purpose: We evaluated the characteristics of patients with Kawasaki disease (KD) who presented with only fever and cervical lymphadenopathy on admission, and compared them with the characteristics of those who presented with typical features but no cervical lymphadenopathy. Methods: We enrolled 98 patients diagnosed with KD. Thirteen patients had only fever and cervical lymphadenopathy on the day of admission (group 1), 31 had typical features with cervical lymphadenopathy (group 2), and 54 had typical features without cervical lymphadenopathy (group 3). Results: The mean age ($4.3{\pm}2.1$ years) and duration of fever ($7.5{\pm}3.6$ days) before the first intravenous immunoglobulin (IVIG) administration were highest in group 1 (P=0.001). Moreover, this group showed higher white blood cell and neutrophil counts, and lower lymphocyte counts after the first IVIG administration as compared to the other groups (P =0.001, P =0.001, and P =0.003, respectively). Group 1 also had a longer duration of hospitalization and higher frequency of second-line treatment as compared to groups 2 and 3 (group 1 vs. group 2, P =0.000 and P =0.024; group 1 vs. group 3, P =0.000 and P =0.007). A coronary artery z score of >2.5 was frequently observed in group 1 than in group 3 (P = 0.008). Conclusion: KD should be suspected in children who are unresponsive to antibiotics and have prolonged fever and cervical lymphadenopathy, which indicates that KD is associated with the likelihood of requiring second-line treatment and risk of developing coronary artery dilatation.

• Journal of Korean Neurosurgical Society
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• v.63 no.4
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• pp.487-494
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• 2020

Objective : To analyze the incidence and characteristics of delayed postoperative fever in posterior cervical fusion using cervical pedicle screws (CPS). Methods : This study analyzed 119 patients who underwent posterior cervical fusion surgery using CPS. Delayed fever was defined as no fever for the first 3 postoperative days, followed by an ear temperature ≥38℃ on postoperative day 4 and subsequent days. Patient age, sex, diagnosis, laminectomy, surgical level, revision status, body mass index, underlying medical disease, surgical duration, and transfusion status were retrospectively reviewed. Results : Of 119 patients, seven were excluded due to surgical site infection, spondylitis, pneumonia, or surgical level that included the thoracic spine. Of the 112 included patients, 28 (25%) were febrile and 84 (75%) were afebrile. Multivariate logistic regression analysis showed that laminectomy was a statistically significant risk factor for postoperative non-pathological fever (odds ratio, 10.251; p=0.000). In contrast, trauma or tumor surgery and underlying medical disease were not significant risk factors for fever. Conclusion : Patients who develop delayed fever 4 days after posterior cervical fusion surgery using CPS are more likely to have non-pathologic fever than surgical site infection. Laminectomy is a significant risk factor for non-pathologic fever.

• The Journal of Internal Korean Medicine
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• v.24 no.2
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• pp.409-414
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• 2003

Fever is an elevation of body temperature to a level above normal to greater than $37.2^{\circ}C$. Fever of Unknown Origin is usually defined in adults as continuous fever at least 3 weeks duration with daily temperature elevation above $101.5^{\circ}F(38.3^{\circ}C)$ and remaining undiagnosed after 1 week of intensive study in the hospital. Diagnoses for Fever of Unknown Origin fall into three general categories: infectious disease, connective tissue disease, neoplasm. We experienced a cases of Fever of Unknown Origin which occurred after subarachnoid hemorrhage and intracerebral hemorrhage. As for treatment, we used Cheongleejagamtang-gami(淸離滋坎湯加味). Fever of Unknown Origin was improved within 5 days of the admission.