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Pediatric emergencies associated with fever

Ilene Claudius1, Larry J Baraff

  • 1Department of Emergency Medicine, University of Southern California and Children's Hospital, 1200 State Street 1011, Los Angeles, CA 90033, USA.

Emergency Medicine Clinics of North America
|December 1, 2009
PubMed

Insights

Fever in infants requires prompt evaluation, especially in neonates and those with risk factors like sickle cell disease. Early identification and management of serious infections, including MRSA and HSV, are crucial for preventing severe outcomes.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Emergency Medicine

Background:

  • Fever is a common pediatric symptom, defined as a rectal temperature >38.0°C (100.4°F).
  • Home-documented fevers require similar management as those in the Emergency Department (ED).
  • Certain populations, including neonates and children with sickle cell disease, are at higher risk for serious febrile illness.

Purpose of the Study:

  • To outline the evaluation and management of pediatric fever.
  • To identify high-risk populations and specific pathogens requiring urgent attention.
  • To emphasize the importance of considering less common but serious causes of fever.

Main Methods:

  • Review of current guidelines and literature on pediatric fever management.
  • Discussion of diagnostic criteria for sepsis workup in infants.
  • Highlighting clinical and laboratory indicators for risk stratification.

Main Results:

  • Febrile infants <28 days old require a full sepsis workup and parenteral antibiotics.
  • Low-risk infants aged 1-4 months can be identified using clinical/laboratory criteria.
  • Consideration of Methicillin-resistant Staphylococcus aureus (MRSA) and Herpes Simplex Virus (HSV) infections is essential.

Conclusions:

  • Prompt and appropriate management of pediatric fever is critical.
  • Risk stratification aids in determining the intensity of workup and treatment.
  • Awareness of specific pathogens like MRSA and HSV improves patient outcomes.

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