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Fever without apparent source on clinical examination

Bernadette Antonyrajah1, Deepa Mukundan

  • 1Department of Pediatrics, University of Toledo College of Medicine, Toledo, Ohio 43608, USA.

Current Opinion in Pediatrics
|January 17, 2008
PubMed

Insights

The heptavalent pneumococcal conjugate (PCV7) vaccine has significantly reduced bacteremia in young children, shifting the focus of fever causes to urinary tract infections and necessitating updated management guidelines.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Immunology

Background:

  • Fever in children under 3 years old is a common clinical presentation.
  • Previous management guidelines were based on higher rates of bacteremia.

Purpose of the Study:

  • To review the impact of PCV7 vaccine and viral detection methods on fever management in young children.
  • To highlight changes in the epidemiology of serious infections.

Main Methods:

  • Review of literature published since 2002.
  • Analysis of changes in bacteremia rates post-PCV7 introduction.
  • Discussion of diagnostic advancements like PCR for viral identification.

Main Results:

  • PCV7 vaccine introduction led to a decrease in bacteremia to 1%.
  • Urinary tract infections are now the most common cause of fever in this age group.
  • PCR testing aids in early viral diagnosis and reduces antibiotic overuse.

Conclusions:

  • Current fever management guidelines for children under 3 require revision due to decreased bacteremia.
  • Development of better markers for predicting serious bacterial infections is needed.
  • Further research on host immune responses is crucial.
Abstract

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