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Pediatrics – Fever in a Neonate, Fever in a Child
Whiteboard Animation Transcript
with Hosanna Au, MD
https://medskl.com/module/index/fever-in-a-neonate-fever-in-a-child

Fever is a common feature of many disease processes. It is an elevation in body temperature mediated by the hypothalamus as a physiologic response to an insult. In children, fever most commonly results from infectious, inflammatory, or malignant processes. By far, the most common cause of fever in children is infection.

Although there are various locations where a child’s temperature can be measured, in neonates and young children, a rectal measurement is most definitive, whereas an oral temperature is best in older children. A fever is generally defined as any temperature ≥38ºC (100.4ºF) using oral or rectal thermometers.

Contrary to popular belief, fever in itself is not harmful, but rather signals caretakers and physicians to search for an underlying process that can be harmful. The goal in evaluating a febrile infant or child is to identify the underlying cause of the fever.

Infants and children with the following features are at a high risk for developing serious bacterial or viral infections (such as meningitis or bacteremia) or serious viral infection and warrant a full septic workup:

Ill-appearing infant or child, regardless of age.1,2

Fever in all neonates younger than 28 days regardless of clinical appearance.1,2

Any neonate with findings suggesting HSV infection upon examination (e.g. mucocutaneous vesicles, seizures, or focal neurologic findings), especially those with maternal risk factors for vertical transmission.1,2

Infants up to 3 months of age with clinical and/or laboratory factors that are high risk for serious bacterial infections.1,2

Strongly consider a full septic workup in unimmunized infants.1,2

A full septic workup includes a complete blood count with differential, blood cultures and sensitivity, urinalysis, urine culture and sensitivity, cerebrospinal fluid analysis and cerebrospinal fluid culture and sensitivity or viral studies. Other investigations may be required depending on the clinical presentation such as a throat culture, chest x-ray if there are respiratory symptoms or stool microbiological studies if gastrointestinal symptoms are present.

The main reason for treating a fever is to reduce discomfort in the child. Children should wear light-weight clothing and drink lots of fluids. Medications such as acetaminophen or ibuprofen will help keep the child comfortable and reduce any associated pain. Caregivers should be notified not to use aspirin because of its association with Reye’s syndrome.

It is important to determine the cause of the fever and treat the underlying condition. In the case of infection, management may include empiric broad spectrum antibiotics or antivirals, or narrow spectrum antimicrobials to target a specific infection.
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A fever in an infant must be taken seriously. In this episode, Dr. Sanjay Wazir, Neonatologist, and Pediatrician from Cloudnine Hospitals, Gurugram is answering all your queries regarding fever in newborn. #FeverInNewborn #FeverInChildren

Excerpts:-
Newborn babies may have a fever because they are actually sick or they may have a fever because they may have been over-covered. So, the fever
could be because of the baby or it could be environmental. Now, The first thing is to measure
the baby’s temperature and during that process you can use an axillary temperature or a rectal
thermometer. Anyone you use make sure of one point. Do not add plus one or minus 1 as the
common convention in most homes to add to the axillary temperature. So most cases in baby’s are taken based on axillary temperature. So if the axillary temperature is more than 100 degrees.
look at the hands and feet of the baby.

If the hands and feet are warm then most likely you are over covering the baby and then the best thing is
to uncover the baby. But if the baby’s hand and feet are very cold and especially if the baby does not look very good
then in that case probably the baby has a genuine fever.

Once you have the baby fever you have paracetamol drops. The dose of which is based on the weight.

and for that dose, you should consult your pediatrician or maybe have asked him in the previous visit.
But not more than one or 2 doses you should give for fever. and then it is important if the newborn has a fever you go to the doctor to find out the cause of fever because children may have an infection sepsis that may progress rapidly and you may not get enough chance for them to go back and treat adequately. So it’s important that you give only
1 or 2 doses of crocin or paracetamol and then show to your doctor to decide the future course of .

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https://www.epicnaturalhealth.com/13-health-benefits-of-lemongrass-you-need-to-know/
If you enjoy cooking your own recipes, you may have seen lemongrass floating around in a few of them recently. Although you might be more familiar with it as a candle scent, lemongrass is actually a natural herb that we’ve been using in our cooking for as long as records date back. You’re most likely to find it in sweet teas and Thai dishes, as well as dishes including meat, seafood, and vegetables.
It can be tempting to simply cut out lemongrass and other “finicky” ingredients that add flavour but not substance to a dish, but by doing so, you’re really missing out on what the herb has to offer. Found in Asia, Africa and Australia, lemongrass is a fantastic source of nutrients that can help with everything from weight loss to cancer treatment.
It’s likely that you’ve tried lemongrass before if you’re a fan of dining out. It’s distinctive for its citrusy, lemony flavour, which is derived from the stalk of the plant. While the flavour won’t overpower your dishes, it gives a tangy kick that’s similar to that of the juice of a lemon or lime. But aside from its delicious flavour, there are so many reasons to incorporate lemongrass into your diet. Stay tuned to listen out for the top 13 health benefits of lemongrass.
No1 Boosts immune system and aids in weight loss
Lemongrass is a low-calorie herb, which makes it ideal for including in your diet if you’re watching your weight. If you opt for lemongrass tea, you’ll find it a satisfying beverage that fills you up, keeping you fuller for longer and making you less likely to reach for a sugary snack instead. Because it’s also a natural diuretic, over time, lemongrass will help you to lose some water weight.
Lemongrass contains polyphenols, a category of compounds found in lots of plant foods, that we know to increase energy expenditure and fat oxidation. Both of these contribute to weight loss. There’s even some evidence to suggest that lemongrass may be able to boost metabolism and directly assist in weight loss.
No2 Kills cancer cells
A recent study has found that lemongrass contains a number of important antioxidants, which may be able to fight off free radicals in the body. Free radicals attack cells, damaging them and causing them to divide unnaturally, which can eventually lead to cancer. It’s thought that lemongrass may be able to not only fight off the cancer-causing free radicals in your body – and therefore inhibiting the early stages of cancer, especially that of the liver – but it may also induce cell death in cancer patients who are undergoing treatment.
Even more interestingly, some studies have also shown how lemongrass extracts might be effective as a nontoxic alternative to cancer treatment. Research in this area is still lacking, but it’s promising to think that we may be able to naturally treat cancer with lemongrass one day.
No3 Improves digestion
Finding a natural remedy for stomach cramping and other digestive issues can be difficult. Luckily, lemongrass is a solution that actually works for the majority of people. It has a number of anti-inflammatory properties that make it ideal for settling the stomach and aiding in digestion. A component called citral, found in lemongrass, helps food to digest quickly and effectively, which is why lemongrass tea is favoured as an after-dinner drink.
No4 Cures stomach disorders
We’ve talked about lemongrass for digestion, and on a similar note, studies have also shown that lemongrass can help to cure stomach disorders and treat gastric ulcers. Impressively, research suggests that lemongrass can play a big part in fighting the infections caused by various harmful pathogens. It’s also effective in preventing gastrointestinal disorders and reducing inflammation, which may help relieve pain from gastric ulcers, colitis, diarrhea, nausea and stomach aches.
No5 Treats cough and cold symptoms
There are many natural remedies out there for coughs and colds, but none quite so effective as lemongrass. Because lemongrass is a natural immunity booster, it might help you to ward off coughs and colds in the first place. But if you do find yourself feeling under the weather,
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Learn how to make lemon grass tea or fever grass tea as it’s called in the Caribbean. Caribbean cookbook author and food personality Chris De La Rosa shares a simply recipe for making tea using lemongrass. Known as fever grass tea in the Caribbean, this is a hot drink his parents would make when anyone in the family had a fever. This lemon grass tea can be enjoyed both hot and cold.

For this lemon grass tea recipe you’ll need…

lemon grass (aka fever grass)
water
sweetener (honey or sugar)
slices of lemon (optional)

More Caribbean recipes can be found at http://www.caribbeanpot.com

Get my latest cookbook, The Vibrant Caribbean Pot – 100 Traditional And Fusion Recipes Vol 2 @ http://www.CaribbeanPot.com/book/ or Amazon @ http://www.amazon.ca/Vibrant-Caribbean-Traditional-Fusion-Recipes/dp/0992050502

Connect with Chris De La Rosa

Facebook: http://www.facebook.com/pages/Caribbean-Pot/160863714535
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Contact: http://caribbeanpot.com/contact/
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To learn more about Chris De La Rosa, you can visit http://www.ChrisDeLaRosa.com

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Music video by F performing Fever.
(C) 2011 Musicfront
Available in the iTunes Music Store: http://itunes.apple.com/nl/album/fever-single/id420422938

Credits:
Nik van den Berg: vocals and bass
Damion Grey: vocals
Richie Bleijenberg: drums

Words and music by Nik van den Berg, Richie Bleijenberg, Damion Grey, Martin Verheesen

Produced by Martin Verheesen
Recorded at Erasmus Studio Zoetermeer and Musicfront Studio Zoetermeer by Bram Bol and Martin Verheesen
Engineered, mixed and mastered by Bram Bol at Bram’s place
Additional vocals by Nyjolene Grey and Sacha de Bruin
Artwork and photography: Martin Verheesen
Released on February 17th, 2011

Video created by Martin Verheesen

A&R Management by Ivar Pijper

Thanks to: Simon Mol, Theater in Feite, all our buck naked friends in the video and most of all the mannequin.
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An 11Alive viewer reached out to the Verify team to find out at which temperature you should be concerned.

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Created by world-class clinical faculty, Learning in 10 (LIT) Reviews covers topics in the United States Medical Licensing Exam (USMLE) Step 2CK examination.

The collection of ten minutes lectures can be used by medical students to supplement their lecture materials. Each video undergoes a peer-review process to ensure accuracy of information.

To learn more about Learning in 10 (LIT), please visit http://www.learningin10.com

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“EBV causes typically an asymptomatic infection or can cause acute tonsillitis as a part of bigger infection called infectious mononucleosis also known as glandular fever. EBV typically occurs in adolescents and young adults and is transmitted orally via saliva. This is the reason EBV infections are also known as the kissing disease. Nearly everyone will become infected with EBV at some point, the good thing is for most of us it is asymptomatic. In this videos we will talk about a primary EBV infection which is asymptomatic and how the infection can evolve to be become infectious mononucleosis which is a symptomatic condition.

The pathophysiology of EBV infection begin with saliva transmission and the EBV virus targeting the tonsils which is a lymphoid tissue made up of T cells and B cells. In the tonsil the EBV target B cells and tonsillar epithelial cells. This is called the EBV primary infection and is usually asymptomatic. Once EBV infects the B cells the EBV has an Incubation period of about 2-6 weeks. During the incubation period a number of things happen:

EBV replicates in B-cell and the virus is shed intermittently into pharyngeal secretions, particularly saliva. Saliva is therefore how EBV is transmitted between people.

The cycle can continue and the person can be completely asymptomatic of course during this incubation and reactivation time the immune system will respond.

EBV Induces an immune response where by b cells capture an antigen of EBV and processes it, The b-cells can mount an immune response locally in the tonsils and the B cells enter circulation and mount an immune response in the lymph node, spleen and liver. Here the B cells stimulate CD8 T cell activity. CD8 t cells also known as cytotoxic t cells are important in the suppression of primary EBV infection. On a side note the CD8+ are thought to be the important players in preventing EBV reactivation and EBV associated lymphoproliferative disease. The B cells also activate CD4+ T cells through costimulation, which means the B cells also become activated. Activated B cells become plasma cells. The plasma cells are the antibody producing cells. The plasma cells will produce EBV specific antibodies which mean antibodies against components of the EBV – firstly the viral capsid antigen with IgM followed by the viral capsid antigen with igG. Plasma cells then eventually produce epstein Barr nuclear antigen igG once infection is resolved. The activation of other immune cells in the lymph nodes, spleen and liver is part of the immune response against EBV.

During the incubation period the EBV can also enter circulation. Here the immune cells in the blood will try to destroy them and also mount an immune response releasing cytokines. This interaction is one of the reasons why people in EBV infection become febrile and feel miserable.

During the incubation period the abnormal infiltrated B cells produce heterophile antibodies which is an important and quick marker for diagnosing EBV”

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Next time your little one strikes a fever it doesn’t mean you need to get overheated. There are a handful of things to remember to help you keep a cool head. First, it’s not considered a fever until the temperature tops 100.4.

“We like to know about fevers over the 100.4 mark. Anything above the 103.5 — 104 range can be associated with significant infections,” says Dr. Nancy Witham, pediatrician with Lee Memorial Health System.

Secondly, fever is a healthy response for the body.

“People always assume the fever itself may be part of the sickness, but a fever is oftentimes what your body is doing to help you fight off an infection,” says Dr. Witham.

Third on our list is to treat the symptoms, not the number. Instead of focusing on the thermometer’s fluctuations, pay attention to what’s making your child feel bad.

“You’re giving your fever reducer not so much to bring down the fever. It’ll do that hopefully, but it is also going to make them feel a little bit more comfortable. Maybe make them a little bit more likely to drink the juice you think they need,” says Dr. Witham.

Fourth up – in babies use a rectal temperature. A rectal thermometer gives true core temperature whereas forehead and ear thermometers aren’t nearly as accurate.

And finally, keep your doctor updated. And tell them about symptoms that might be a sign of something more serious.

“We would like to know where you’ve taken your temperature and what you’ve gotten, what you’re noticing as a parent. Your child is lying around even after the anti fever medicine and has that stiff neck. You might also want to notice any skin rashes; that can be very important,” says Dr. Witham.

Another important point, is to stay calm, most fevers subside in a matter of days.

View More Health Matters video segments at leememorial.org/healthmatters/

Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we’ve been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries.

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Dengue Fever & What You Need to Know, including Pathophysiology, Symptoms, Diagnosis & Treatment. Dengue fever is a viral infection with potentially fatal consequences. In this lesson, we discuss how people are infected with Dengue fever, pathophysiology of the condition, along with phases of infection, signs and symptoms, diagnosis, treatment, preventative methods (vaccines, mosquito repellent).

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**MEDICAL DISCLAIMER**: JJ Medicine does not provide medical advice, and the information available on this channel does not offer a diagnosis or advice regarding treatment. Information presented in these lessons is for educational purposes ONLY, and information presented here is not to be used as an alternative to a healthcare professional’s diagnosis and treatment of any person/animal.

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How do you know when a fever is too high? Alana Snyder, DO, emergency medicine physician with Medical City Healthcare shares tips that would turn a fever into a trip to the ER.
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Rehealthify offers reliable, up-to-date health information, anytime, anywhere, for free.

— video script below —

Viral hemorrhagic fevers (VHFs) are a group of illnesses caused by four families of viruses. These include the Ebola and Marburg, Lassa fever, and yellow fever viruses. VHFs have common features: they affect many organs, they damage the blood vessels, and they affect the body’s ability to regulate itself. Some VHFs cause mild disease, but some, like Ebola or Marburg, cause severe disease and death.

VHFs are found around the world. Specific diseases are usually limited to areas where the animals that carry them live. For example, Lassa fever is limited to rural areas of West Africa where rats and mice carry the virus.

The risk for travelers is low, but you should avoid visiting areas where there are disease outbreaks. Because there are no effective treatments for some of these viral infections, there is concern about their use in bioterrorism.

Centers for Disease Control and Prevention
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What is rheumatic fever? Rheumatic fever is thought to be an autoimmune reaction brought on as a result of a streptococcus infection.

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Fever is a high body temperature, usually defined as above 37.5 °C, but particularly when higher than 38 °C. It is normally caused by an infection. While it is not very serious in a previously healthy person, it is cause for transplant recipients, immunosuppressed patients and post-operative patients to visit emergency services.
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As a follow-up to The Urgency Room visit, board-certified emergency physicians discuss at-home care.
Visit us at http://www.urgencyroom.com
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Why children get fevers, and when to call the doctor. https://www.chop.edu/locations

In This Video:
0:26 What is a fever?
0:43 Why do you get a fever?
1:26 Why does a fever make you feel bad?
2:14 Is a fever dangerous?
2:36 What to do when a child has a fever
3:02 Is medicine necessary for a fever?
3:33 When should I call the doctor about a fever?

A fever is a temperature greater than or equal to 100.4ºF or 38ºC. Fever in children is very common. Fever is a normal body response that helps the body fight infections.

The information in this video is for otherwise healthy children older than 3 months. If your child is younger than 3 months, or has a health problem that makes infection more likely, always call you doctor for advice when your child has a fever.

Your child’s temperature is not the most important thing to monitor when your child has a fever. Most of the time you won’t even need to take your child’s temperature. Instead, pay attention to the symptoms your child is experiencing along with the fever.

These are normal symptoms: faster heart rate and breathing; shivering; cold hands and feet; head and body aches; tired and fussy; poor appetite. You don’t necessarily need to call the doctor if your child has these symptoms.

These are abnormal symptoms: extremely sleepy or irritable; trouble breathing; rashes; pain, redness or swelling in one area (like a sore throat or a red, swollen knee); drinking very little or not at all; severely decreased urination; fever lasting longer than 3 days; seizure. You should call the doctor if your child has any of these symptoms, or if your instincts are telling you something isn’t right.

Parents worry that a high fever will cause seizures or brain damage. A high temperature will not cause brain damage, and seizures due to fever are rare.
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