Abstract Ref Number = APCP970
PROLONGED FEVER IN CHILDREN AT RSUP DR KARIADI, Simple Indicators for the Etiologies
Erna Mirani,MMDEAH Hapsari,Helmia Farida
Department of Pediatrics Faculty of Medicine Diponegoro University Dr Kariadi Hospital Semarang Indonesia Department of Pediatrics, Faculty of Medicine, Diponegoro University DrKariadi Hospital, Semarang, Indonesia
Background : Defining the etiology of prolonged fever can be challenging as many tests are required. This study aimed to describe the pattern of etiology of prolonged fever in pediatric patients hospitalized in Dr. Kariadi Hospital and to find simple indicators which associate with specific etiology, therefore, may simplify making the etiological diagnosis.
Material : This was a retrospective study on children with prolonged fever hospitalized in Dr. Kariadi Hospital during 2017. Patients with haematology/ oncology problems were excluded. Data were obtained from medical records, including demography, clinical presentation, laboratory tests (routine haematology test, C-reactive protein, blood and urine cultures, CMV serology) and radiology. Chi-square or Fischer exact was used for statistical analysis where appropriate.
Results : A total of 136 patients with prolonged fever were enrolled, 40 patients were excluded due to incomplete medical record. Girls (56.6%), age group of 0-1 year-old (34.4%) and 5-10 year-old (24.0%) were dominant. Forty-nine children (43,4%) had developed fever for 8-15 days, 42 (37,2%) for 16-30 days, 8 (7.1%) for 30-60 days and 14 (12.4%) for more than 60 days. Final diagnosis was established in 73.9% patients. The most common etiology of prolonged fever were urinary tract infection/ UTI (23,6%), bacteremia (22,8%), cytomegalovirus/ CMV infection (16.6%), bronchopneumonia (6.1%), and tuberculosis (4.3%). Leukocytosis significantly associated with bacteraemia (P=0.09). Microcephaly and seizure associated with CMV infection (P=0.000 and 0.001 respectively). Phymosis associated with UTI (P=0.004), but leukocyte count in urine did not (P=0.66).
Conclusions : The most common cause of prolonged fever in our hospital was urinary tract infection, bacteremia, and CMV infection. The presence of leucocytosis, microcephaly, seizure, and phymosis may help doctor to more efficiently plan a diagnostic work up.
Keywords: Prolonged Fever Children UTI Bacteriemia and CMV