Emergency medicine clinics of North America
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Environmental exposure to high temperatures can result in abnormalities ranging from mild heat exhaustion to heat stroke with multiorgan system failure. An understanding of the mechanisms of thermoregulation and how those mechanisms fail with extreme heat stress is critical for management of the patient with elevated body temperature in the emergency department.
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Fever is the most common reason that children and infants are brought to emergency departments. Emergency physicians face the challenge of quickly distinguishing benign from life-threatening conditions. ⋯ In this article, the evaluation and treatment of children with fevers of known and unknown origin are described. Causes of common and dangerous conditions that include fever in their manifestation are also discussed.
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This article provides an overview of the pathogenesis and signs and symptoms of dangerous endocrine causes of hyperthermia. Treatment strategies based on specific causes are discussed.
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Postprocedure fevers vary in the timing of their occurrence, duration, and severity. Such fevers do not all have an infectious cause, but they all require thorough investigation to rule out life-threatening conditions. This article summarizes the principles of diagnosis and management of postprocedure fevers for the emergency care provider.
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Neurologic conditions are categorized as either those that cause a change in mental status or those that create a focal finding on physical examination. Neurologic abnormality associated with fever can be caused by a primary neurologic condition or one that does not originate in the central nervous system. Optimal management of such conditions requires high clinical suspicion and a broad differential diagnosis, which facilitates rapid recognition and effective treatment. A thorough history and physical examination are key determinants in accurately diagnosing neurologic conditions associated with fever, often requiring acquisition of collateral information from persons other than the patient.