What is the cause of hyperpyrexia (fever greater than 40 degrees Celsius) in a child for 2 days?

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Last updated: February 26, 2025View editorial policy

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Differential Diagnosis for Fever 40 deg C in a Child for 2 Days

Single Most Likely Diagnosis

  • Viral infection (e.g., influenza, respiratory syncytial virus): This is the most common cause of high fever in children, often accompanied by other symptoms such as cough, runny nose, and sore throat.

Other Likely Diagnoses

  • Bacterial infection (e.g., pneumonia, urinary tract infection): Bacterial infections can cause high fever and are more likely if the child has specific symptoms such as difficulty breathing, abdominal pain, or dysuria.
  • Meningitis: Although less common, meningitis is a significant concern in children with high fever, especially if accompanied by symptoms like headache, stiff neck, or altered mental status.
  • Otitis media: Ear infections are common in children and can cause high fever, especially if the child is pulling at their ears or has difficulty hearing.

Do Not Miss Diagnoses

  • Sepsis: A life-threatening condition that requires immediate attention, sepsis can present with high fever, tachycardia, and tachypnea, among other symptoms.
  • Meningococcemia: A severe bacterial infection that can cause high fever, rash, and shock, meningococcemia is a medical emergency.
  • Kawasaki disease: An acute febrile illness that can lead to coronary artery aneurysms if not treated promptly, Kawasaki disease is characterized by fever, rash, conjunctivitis, and cervical lymphadenopathy.

Rare Diagnoses

  • Leukemia or lymphoma: Although rare, these malignancies can present with persistent fever, among other symptoms like weight loss, fatigue, and bruising.
  • Autoimmune disorders (e.g., juvenile idiopathic arthritis, lupus): These conditions can cause recurring fevers and other systemic symptoms.
  • Factitious fever: A condition where the caregiver, often a parent, falsifies the child's temperature readings, which is a rare but important consideration in cases where the diagnosis is unclear.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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