Infectious Disease Book

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Fever Evaluation in Children

Aka: Fever Evaluation in Children, Triage of the Child with Fever
  1. See Also
    1. Fever
    2. Fever Without Focus
    3. Fever of Unknown Origin
    4. Toxic Findings Suggestive of Occult Bacteremia
    5. Fever Without Focus Labs
    6. Fever Without Focus Management Birth to 3 Months
    7. Fever Without Focus Management 3 to 36 months
    8. Pediatric Sepsis
    9. Neonatal Sepsis
    10. Rochester Criteria for Febrile Infant 0 to 60 days
    11. Philadelphia Criteria for Febrile Infant 29-60 days
    12. Boston Criteria for Febrile Infant 28-89 days
    13. Yale Scale for Febrile Child 3 to 36 months
  2. Causes: Serious fever causes with cryptic presentations
    1. HSV Encephalitis (or Neonatal HSV)
    2. Meningococcemia
    3. Kawasaki Disease
    4. Fever of Unknown Origin
  3. Indications: Immediate Evaluation
    1. Age under 2 months
      1. Assess for Neonatal Sepsis
    2. Inconsolable or constant whimper
      1. Assess for serious illness
    3. Rectal Temperature >104 degrees Fahrenheit
    4. Signs of Meningitis or Meningococcemia
      1. Stiff neck
      2. Purpura
      3. Difficult to arouse or Delirium
    5. Dyspnea (beyond simple congestion)
    6. Dysuria
  4. Indications: Routine clinical evaluation
    1. Age 2 to 6 months
      1. Assess for serious infection
    2. Fever persists longer than 48 to 72 hours
      1. Assess for Bacterial Infection
    3. Fever cleared for more than 24 hours, then recurred
      1. Assess for Bacterial superinfection
    4. No site of infection for more than 24 hours
      1. Assess for Fever Without Focus (Occult Bacteremia)
      2. Exercise higher level of suspicion in age <18 months

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