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In a non-psychiatric clinic a combined psychiatric and somato-autonomic investigation was performed in 75 prepuberty and puberty children with functional hyperthermia . Syndromal and nosological characterization was performed on a spectrum of psychic disorders in these patients. Some correlations were found between syndromal and nosological distributions and grouping based on somato-autonomic++ picture.

Based on clinical observations and investigations carried out in 150 patients the authors suggest the classification of hyperthermic reactions, in which metabolic, regulatory, malignant, bacterial, nocious, infusion and artificial forms are distinguished. Pathogenetic mechanisms of the development, typical of all these forms, their clinical symptomocomplex, characteristic features of laboratory and functional diagnostics, the main principles of therapy are reported. In patients with energetic disbalance an aimed differential therapy is found to be highly effective.

Most medications can cause fever, with or without concomitant clinical manifestations. The fever may arise from the drug's pharmacologic action, its effects on thermoregulation, a local complication following parenteral administration, or an idiosyncratic response. The most common mechanism is probably an immunologic reaction mediated by drug-induced antibodies. Drug fever may have any pattern; it typically occurs after seven to ten days of treatment and usually resolves within 48 hours of discontinuing the administration. Failure to diagnose drug fever may lead to inappropriate and potentially harmful diagnostic and therapeutic interventions. In suspected cases, it is necessary to discontinue administration of all potentially causative medicines, together or sequentially. Rechallenge with the offending agent will usually cause recurrence of fever within a few hours, confirming the diagnosis.

Fever in infants (age less than 24 months) is a medical urgency because of the possibility that a severe bacterial infection may be present. A clinical approach to this recurring dilemma is provided to help the practitioner avoid the twin dangers of either missing a serious infection or embarking on an over-exuberant diagnostic work-up.

While 46 percent of febrile children, aged 3 months to 24 months, will be well without treatment within 24 to 48 hours, and another 12 percent well within 72 to 96 hours, approximately 6 percent will have serious bacterial infections. The incidence of such infections tends to increase with decreasing age and increasing degree of fever. Physicians, who make specific observations of the child's color, hydration, social response, consolability, and degree of alertness after the child has been made comfortable, can identify about two thirds of those with benign illness and the one tenth who require inpatient evaluation. Of the remaining patients, those with serious illness can be further identified if their white blood count is greater than 15,000/microL, neutrophils are greater than 10,000/microL, band cells are greater than 500/microL, or sedimentation rate is more than 30 mm/h. Children with these laboratory findings should then have a chest film and blood culture and, if the former is negative, should be considered for a lumbar puncture and urine culture. Whether further observation or treatment at this point can be done as an outpatient depends on physician judgment.