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Acute infectious erythemas in children: a clinico-microbiological study
H M Goodyear1, P W Laidler, E H Price
1Department of Paediatrics, Queen Elizabeth Hospital for Children, London, U.K.
Abstract:
One-hundred children with an acute illness comprising fever and widespread erythematous rash were prospectively studied to determine whether clinical presentations are helpful in defining the causative agent and to identify the most appropriate microbiological specimens. An infectious agent was identified in 65 children; 72% were viruses, 20% were bacteria, 5% were Mycoplasma pneumoniae and in 3% both viruses and bacteria were detected. The most common infectious agents were picornaviruses, an atypical presentation of measles and Group A beta-haemolytic Streptococcus. Different patterns of rash occurred with each of these infections. The clinical presentation of a child with an acute febrile illness and rash was unhelpful in defining the causative agent. Routine management should include a throat swab for bacterial investigation and in selected cases a blood sample for IgM viral titres.
Insights
Identifying the cause of acute febrile illness and rash in children is challenging. Microbiological specimens like throat swabs are crucial for diagnosing viral and bacterial infections in pediatric patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Acute febrile illness with widespread rash is common in children.
- Clinical presentation alone is often insufficient to determine the causative agent.
Purpose of the Study:
- To evaluate the utility of clinical presentations in identifying infectious agents in children with acute febrile illness and rash.
- To determine the most appropriate microbiological specimens for diagnosis.
Main Methods:
- Prospective study of 100 children with acute febrile illness and rash.
- Identification of infectious agents through microbiological investigations.
Main Results:
- An infectious agent was identified in 65% of children.
- Viruses were the most common cause (72%), followed by bacteria (20%).
- Picornaviruses, atypical measles, and Group A beta-hemolytic Streptococcus were frequently identified.
Conclusions:
- Clinical presentation is not a reliable indicator for defining the causative agent in pediatric febrile rash illnesses.
- Routine throat swabs for bacterial investigation and selective blood tests for viral IgM are recommended.