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Comparison of Temple Temperatures with Rectal Temperatures in Children Under Two Years of Age

Division of Infectious Diseases, Department of Pediatrics, School of Medicine; Pediatric Infectious Diseases, Park 256, The Johns Hopkins Hospital, 600 N Wolfe Street, Baltimore, MD 21287

Marie Diener-West, PhD

Department of Biostatistics, School of Hygiene & Public Health

Elizabeth Schappell, RN

Division of Disease Control, Department of International Health, Bloomberg School of Public Health; The Johns Hopkins University, Baltimore, MD

Ruth A. Karron, MD

Division of Infectious Diseases, Department of Pediatrics, School of Medicine; Division of Disease Control, Department of International Health, Bloomberg School of Public Health; The Johns Hopkins University, Baltimore, MD

We assessed the agreement between rectal and noninvasive temporal artery temperature measurements in infants and children. We also evaluated the temple thermometer as a screening tool for rectal fever in this age group. Finally, we compared the performance of parents with that of nurses in using the temple thermometer. The 95% limits of agreement between the difference in rectal and average temple temperature were -1.03 and +1.52⁰C. Mean temple temperatures obtained by parents and by nurses were similar (95% limits of agreement, -0.6⁰C to +0.70C). A maximum temple temperature cutoff of 37.2°C (99.0°F) distinguished children with rectal fever of 238.0°C with 91% sensitivity and 53% specificity. A cutoff of 37.8⁰C (100.0⁰F) distinguished moderate rectal fevers (238.5°C) with 97% sensitivity and 84% specificity. A cutoff of 38.3°C (101.0°F) distinguished a high rectal fever (?39.0°C) with a sensitivity of 95% and specificity of 95%. In conclusion, temple temperatures do not reliably predict rectal temperatures, but the temple thermometer can be used as an effective screen for clinically important rectal fever in children 3-24 months old. The findings do not support use of temple temperatures to screen young infants for rectal fever 238.0°C. Temperatures obtained by parents were comparable to those obtained by nurses.

Clinical Pediatrics, Vol. 41, No. 6, 405-414 (2002)
DOI: 10.1177/000992280204100605


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