Prévalence hospitalière et profil étiologique de la fièvre chez la population pédiatrique à l’hôpital mixte de la wilaya de LAGHOUAT durant la période allant de 01/01/2021 au 31/12/2022

Abstract

Fever is a frequent reason for consultation in liberal medicine and in emergency services and its initial management is the prerogative of the parents. It is a symptom that can be indicative of an infectious syndrome whatever its bacterial or viral origin. Objective: To determine the hospital prevalence, the clinical, biological, etiological, therapeutic and evolutionary profile of fever in the pediatric department of the mixed hospital of LAGHOUAT over a period of 02 years from January 2021 to December 2022. Patients and methods: This is a retrospective study, based on files. The study population consists of all children hospitalized in the pediatric department at the mixed hospital of LAGHOUAT, during the period from 01/01/2021 to 31/12/2022. Result: In total, 208 patients (F 39.9% M 60.1%, mean age 35.06 months, extreme 30 days -14 years), were enrolled over a period of 02 years (2021-2022). The hospital prevalence of fever was estimated at 26.46%. More than half of these patients had no history, and when they were present, they were more frequently due to congenital malformations14.9%. The children in our study were not vaccinated or had an incomplete vaccination status in 46.6% of cases. It was most often revealed by respiratory signs (43.8% of cases). The child's fever was mostly acute to sub acute found in 92.8% of cases (n=193). Pulmonary diseases represented the most common etiology 43% with predominance of pneumonia or 26.4%. The etiologies of prolonged fever were most often neoplastic (leukemia, lymphoma, renal blastoma) and inflammatory (Kawasaki), found in 1.9% of cases each (n=4). The first-line assessment was performed in 100% of cases (n=208). Blood culture was never requested, which represents a significant shortcoming in our practice. Dehydration was the most common complication of fever in 13.4% (n=28) followed by febrile seizures in 9.6% of cases (n=20). Regarding treatment, antipyretics were the main symptomatic treatment (paracetamol at a dose of 60 mg/kg/d). It was an effective and well tolerated treatment with no adverse effects. The curative treatment depended exclusively on the etiological diagnosis. The evolution under well-conducted treatment is generally good in 64.4% of cases, it will depend on the age of the patients, the terrain, the etiology as well as the precocity of the treatment. Conclusion: Fever is a non-specific reaction and an important warning sign. It is most often revealed by respiratory signs within the limits of our sample. Pulmonary diseases represent the most common etiology of acute fever, and neoplasia of prolonged fever. Symptomatic treatment is effective and well tolerated without adverse effects. The curative treatment depends exclusively on the etiological diagnosis. The evolution under well-conducted treatment is generally good, it will depend on the age of the patients, the terrain, the etiology as well as the precocity of the treatment. Keywords: Fever; Infants; Thermometers; acute; prolonged, infections, inflammatory diseases; neoplasia; antipyretics.