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a general characteristic of patients

In total under observation there were 127 children at the age from 6 months till 14 years with a long subfebrile condition from 21 days till 4th years hospitalised in infectious otdelenijamdgkb, RDKB, TSKB.

The age structure of children is presented in table 1.

Table 1

Age structure of children with a long subfebrile condition n=127

Age From 6 months

To

3 years

From 3лет

1 months

To

6 years

From 6 years 1 months

To

10 years

From 10 years 1 months till 15 years In total
With a subfebrile condition 42 (33 %) 28 (22 %) 28 (22 %) 29 (23 %) 127

(100 %)

Apparently from table 1, most often long subfebrile condition meets at children till 3 years of a life (33 %), in other age groups it becomes perceptible about identical distribution of children (on 22 % and 23 % accordingly). Boys was 84 (66 %), girls — 43 (34 %). In the literature

There are inconsistent data concerning sexual and age structure of children a long subfebrile condition. So, And. P.Brjazgunov [13] observed 540 children with a long subfebrile condition, among them was 48,1 % of boys and 51,9 % of girls, and in structure children from 6 till 16 years prevailed. In a series of observations N. [56] at girls chronic temperature conditions were observed by V.Rudkovskoj almost in 2 times more often, than at boys.

Presence of a subfebrile condition at children was established on the basis of body temperature measurement on a skin of an axillary hollow by the mercurial thermometer each 3 hours within 3 days. Reception of febrifuges, food intake, an exercise stress became perceptible. The table with average medical staff of unit and-or parents was by results filled.

127 children with a long subfebrile condition have arrived in a hospital with various diagnoses (tab. 2).

Table 2

Diagnoses of children c a long subfebrile condition at entering in a hospital (n=127)

The diagnosis
N = %
1 Long subfebrile condition of an obscure genesis 33 26 %
2 Fever of an obscure genesis 40 31,5 %
3 Thermoneurosis 4 3 %
4 Convalescent of a mononucleosis 2 1,6 %
5 Acute respiratory disease (ORZ), including: 35 27,5 %
+ Postinfectious subfebrile condition 7
+ Obstructive bronchitis 9
+ Pneumonia 2
+ gerpetichesky a keratitis 2
+ Rubella 1
+ The postvaccinal period 5
+ Lacunar quinsy 6
+ Purulent otitis 2
+ Acute appendicitis 2
6 Immunodefitsitnoe a condition 2 1,6 %
7 Acute pyelonephritis 1 0,8 %
8 Osteomyelitis of the right femur 1 0,8 %
9 Recurring gerpeticheskaja an infection 3 2,4 %
10 Syndrome of vegetative dysfunction 3 2,4 %
11 Cephalalgias of an obscure aetiology 2 1,6 %
12 Limfoproliferativnoe disease 1 0,8 %
IN TOTAL 127 100 %

These data testify to difficulties of etiological decoding of a long subfebrile condition at a pre-hospital stage, that substantially defines an urgency of our research

In the winter in a hospital 44 children (34,6 %), in the spring — 39 (30,7 %), in the summer — 16 (12,5 %), and in the autumn — 28 (22,2 %) have arrived.

The seasonal case rate, observable patients, with a long subfebrile condition is presented in a drawing 1.

Fig. 1. A seasonal case rate of children with a long subfebrile condition (n=127)

Apparently on fig. 1, a case rate in the winter in the spring and was approximately identical (time of frequent virus infections and stressful situations at school), recession, and in the autumn — case rate lifting in the summer became perceptible.

According to the anamnesis and the medical documentation, the first occurrence of a long subfebrile condition at 44 of 127 children (34,6 %) became perceptible after the transferred infection, including — in 14 of 44 (31,8 %) cases after acute respiratory diseases, in nine (20,4 %) — after quinsy, in five (11,4 %) — after a pneumonia, in five (11,4 %) — after a purulent otitis, in five (11,4 %) — after transferred by IT, in five (11,4 %) — after a chicken pox, at one (2,2 %) — after rotavirusnoj infections (tab. 3).


After bacterination the subfebrile condition is noted at 2 of 127 (1,6 %) children, after the transferred emotional stress — at 28 of 127 (22 %), are noted an accurate relationship of cause and effect at 53 of 127 (41,8 %) children (table 3).

Table 3

The reasons of occurrence of a long subfebrile condition, according to the anamnesis (n=127)

The reason Number of children (%)
After the transferred infection 44 (34,6 %)
After the transferred emotional stress 28 (22 %)
After bacterination 2 (1,6 %)
It is noted an accurate relationship of cause and effect 53 (41,8 %)
In total 127 (100 %)

Thus, the majority of children (58,2 %) at a pre-hospital stage had reasons of a long subfebrile condition.

At the analysis antenatalnogo the anamnesis it is established, that the pregnancy current has been complicated at 114 (90 %) mothers of sick children. Met abortion threat — at 114 (90 %), in 46 cases (36,2 %) — a prematurity, in 73 cases (57,5 %) — perinatalnoe a lesion is more often. A hypoxia in sorts in the anamnesis in 29 cases (22,8 %), requirement for artificial ventilation of the lungs — in 8 (6,3 %), ORVI — in 32 (25,2 %), an anaemia — at 42 (33 %).

At 30 children from 127 (23,6 %) in the anamnesis did not become perceptible the factors burdening a premorbidal condition. At 97 (76,4 %) children — it has been burdened by a various infectious and somatic pathology: at 63 (65 %) children were observed frequent ORVI, relapsing diseases of the top respiratory tracts and an ear, including: (anginas — at 6, an adenoid disease — at 21, a chronic otitis — at 4, tubinfitsirovanie — at 5,
Recurring gerpetichesky a stomatitis — at 3); the bronchial asthma is diagnosed for 5 children. At 65 (67 %) children a pathology GASTROINTESTINAL TRACT (chronic gastroduodenit, a chronic cholecystitis, dysfunction zhelchevyvodjashchih ways, a lambliasis), at 45 (46,4 %) children a pathology of cardiovascular system (vegetative dysfunction — 36, a functional cardiopathy — at 9, a congenital heart disease — at one child), at 16 (16,5 %) patients a pathology of endocrine system (a thyroid gland hyperplasia — at 6, adiposity — at 2, a subthalamic syndrome — at 8).hronicheskaja the infection of genitourinary system was in the anamnesis at three children. Among other accompanying conditions were: atopichesky a dermatitis (5), a children's cerebral paralysis (2), a histiocytic sarcoma in a stage of remission (1), an anaemia (12), an oligotrophy (3).

Considering stated, it is possible to conclude, that almost two thirds of children with a long subfebrile condition had the factors burdening a premorbidal condition in the anamnesis. Five children from 127 (4 %) were ill with IT 2-6 years prior to the present disease.

Depending on duration of a subfebrile condition children have been parted on 4 groups (tab. 4). For duration of rise in temperature accepted an interval of time from a clinical manifestation of a subfebrile condition till the inspection moment.

Table 4

Duration of a subfebrile condition at surveyed children (n=127)

N groups Duration of a subfebrile condition Number of sick (%)
1 From 2 ned. To 3 months 36 (28,3 %)
2 From 3 mes to 6 months 30 (23,6 %)
3 From 6 months to 12 months 30 (23,6 %)
4 More than 1 year 31 (24,5 %)

Children who had a subfebrile condition from 2 weeks till 3 months 36 (28,3 %) have made 1 group, from 3 months till 6 months — 30 (23,6 %) — 2 group, from 6
Month to 12 months — 30 (23,6 %) — 3 group, with a subfebrile condition lasting more of 1 year — 31 (24,5 %) — 4 group.

Characterising temperature curves, it is possible to notice, that at 59 (46,5 %) children it became perceptible the low subfebrile condition (37,2-37,5 s), at 62 children (48,8 %) was registered a high subfebrile condition (37,6-38 s). At 38 (29,9 %) — the subfebrile condition was observed mainly in the evening days. At 24 (18,9 %) rise of temperature after meal, an exercise stress, emotional experiences became perceptible. At 7 (5,4 %) children the temperature was

Subfebrile monotonous within day (37,3 С-37,9 s).

2.2.

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Scientific source Lebedeva Tatyana Mihajlovna. Clinico-pathogenetic value gerpesvirusov at long subfebrile conditions at children. The dissertation on competition of a scientific degree of the candidate of medical sciences. Moscow - 2014. 2014

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