Hyperpyrexia (temperature greater than 40 C) in children.

A total of 516 charts of children who presented to the Oklahoma Children's Memorial Hospital Emergency Department or Walk-In Clinic with a temperature of 40 C(104 F) or more were reviewed. The findings were consistent with the concept that high fever in children is most often associated with common illnesses such as upper respiratory tract infections, otitis media, pneumonia, acute gastroenteritis, urinary tract infection, etc. There were only 22 (4%) admissions from the entire group and one death, actually due to delay in seeking medical help. The incidence and recurrence of febrile seizures (24 cases) was related to the use and compliance with anticonvulsant drugs rather than antipyretic measures. Appropriate laboratory work, x-rays and cultures should be done only when consistent with clinical findings. Follow-up can be done without hospitalization or antibiotics, as most children have a benign illness. The need for treatment of the underlying cause of the fever should, of course, remain the paramount goal. With proper parental guidance and education, the use of traditional methods of lowering fever can be discouraged.