Relative Bradycardia Is Not a Feature of Enteric Fever in Children

• Published in: Clinical infectious diseases 1999-03, Vol.28 (3), p.582-586
• Main Authors: Davis, Timothy M. E., Makepeace, Ashley E., Dallimore, Elizabeth A., Choo, Keng E.
• Format: Article
• Language: English
• Subjects: Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Bacterial Infections - physiopathology; Biological and medical sciences; Body Temperature; Bradycardia; Child; Child health services; Child, Preschool; Children; Clinical Articles; Cultural groups; Female; Fever; Heart rate; Human bacterial diseases; Humans; Infant; Infections; Infectious diseases; Linear regression; Male; Medical sciences; Pediatrics; Pulse; Retrospective Studies; Typhoid fever; Typhoid Fever - physiopathology; Virus Diseases - physiopathology
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/515143

We investigated pulse-temperature relationships in 66 children with enteric fever (group 1) and in 76 with other infections (group 2). Group 1 children were older than group 2 children (mean age ± SD, 91 ± 36 vs. 66 ± 32 months, respectively; P < .001) and had mean oral temperatures ± SD similar to those of group 2 children (38.3 ± 1.0 vs. 38.3 ± 0.9°C, respectively; P > .2); however, group 1 children had lower mean baseline pulse rates ± SD than did group 2 children (119 ± 25 vs. 127 ± 28 beats/min, respectively; P < .001). In a multiple linear regression model, pulse rate was independently associated with age (inversely; P < .001) and oral temperature (positively; P < .006) but not with diagnostic group or gender (P > .5). After adjustment of the mean initial pulse rate ± SD to age of 72 months, there was no difference between group 1 and group 2 children (126 ± 24 vs. 126 ± 20 beats/min, respectively; P > .5). From 4 to 72 hours after commencement of treatment, the mean oral temperature in group 1 patients was ∼0.3°C higher than that in group 2 patients, and the age-adjusted pulse rate was 5 beats/min higher in group 1 children than in group 2 children. These data suggest that relative bradycardia is not characteristic of enteric fever in children.