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CC BY 4.0 · AJP Rep 2025; 15(03): e113-e115
DOI: 10.1055/a-2642-7488
Case Report

Assessing the Significance of Hyperthermia in Newborns Undergoing Phototherapy for Hyperbilirubinemia

Krishna Trivedi
1   Department of Pediatrics Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
Janet D.-Williams
2   Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Rohan Rao
2   Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Allison Rometo
2   Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Benjamin Miller
2   Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Abstract

Objective

About 2% of full-term neonates are evaluated for fever, with serious bacterial infections (SBIs) identified in roughly 10% of cases. The 2021 American Academy of Pediatrics guideline standardizes febrile neonate evaluation, but factors like phototherapy for hyperbilirubinemia can complicate decisions. Phototherapy-associated hyperthermia raises concern about distinguishing environmental causes from true infection. This study assessed the prevalence of hyperthermia in neonates receiving phototherapy and its association with SBI.

Study Design

We performed a retrospective chart review of neonates admitted for phototherapy at a quaternary pediatric hospital (2019–2022). Using International Classification of Diseases codes, we identified patients with hyperthermia (≥38°C) and reviewed whether they underwent SBI evaluation and follow-up within 2 weeks.

Results

Among 639 neonates, 9 (1.4%) developed hyperthermia. Two (22%) were diagnosed with an SBI; one had a negative SBI workup, and six were not further evaluated. None of the seven without SBI returned for care. The 1.4% hyperthermia rate is not higher than the general neonatal fever prevalence (2%).

Conclusion

Hyperthermia during phototherapy is uncommon, but the 22% SBI rate in febrile neonates is noteworthy. Elevated temperatures in this context should not be presumed to be environmental. Clinicians should maintain vigilance and consider full SBI evaluations.

Key Points

  • Consider SBIs in febrile neonates on phototherapy; do not attribute fever to environmental factors.

  • Phototherapy rarely causes fever; while it warms infants, it does not raise fever risk.

  • Standardized approaches reduce variability in fever care.

Keywords

neonate - fever - phototherapy - hyperbilirubinemia - serious bacterial infection - hyperthermia evaluation


Publication History

Received: 27 February 2025

Accepted: 19 June 2025

Article published online:
11 July 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Greenhow TL, Hung YY, Pantell RH. Management and outcomes of previously healthy, full-term, febrile infants ages 7 to 90 days. Pediatrics 2016; 138 (06) e20160270
    PubMedSearch in Google Scholar
  • 2 Burstein B, Anderson G, Yannopoulos A. Prevalence of serious bacterial infections among febrile infants 90 days or younger in a Canadian urban pediatric emergency department during the COVID-19 pandemic. JAMA Netw Open 2021; 4 (07) e2116919
    PubMedSearch in Google Scholar