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Pattern of febrile illnesses in children seen at a pediatric ambulatory care setting
Y A Al-Eissa1, S S Ghazal, F A Al-Zamil
1Department of Pediatrics, College of Medicine, King Saud University , Riyadh, Saudi Arabia.
Insights
Fever is common in children, with most cases caused by viral infections like upper respiratory tract infections. Serious bacterial infections are rare, and most children with fever can be managed in outpatient settings.
Area of Science:
- Pediatric Infectious Diseases
- Ambulatory Care Medicine
- Epidemiology of Childhood Illnesses
Background:
- Fever is a primary indicator of pediatric illness, frequently encountered in general pediatrics and family medicine.
- Febrile children represent a significant patient demographic in primary care settings.
Purpose of the Study:
- To characterize the etiological patterns of febrile illnesses in children within pediatric ambulatory healthcare.
- To understand the common causes and management of fever in a primary care pediatric setting.
Main Methods:
- A one-year prospective study involving consecutive febrile children managed at two primary-care clinics.
- Data collection and analysis focused on identifying the causes and outcomes of febrile illnesses.
Main Results:
- 25.3% of 16,173 children presented with fever; boys and children aged 4-24 months were more frequently affected.
- Upper respiratory tract infections (75%), predominantly viral, were the leading cause; viral gastroenteritis and pneumonia each accounted for 5%.
- Serious bacterial infections were infrequent (meningitis 0.5%, UTI 0.7%); 9% required hospitalization, and 64% received oral antibiotics outpatient.
Conclusions:
- Effective clinical assessment and judicious use of diagnostics and antimicrobials are crucial for managing febrile children in primary care.
- The study underscores the predominantly viral etiology of childhood fever and the low incidence of serious bacterial infections in ambulatory settings.
Background:
Fever is the most common sign of childhood illnesses and febrile children constitute a substantial proportion of the practice of pediatrics and family medicine.
Objectives:
To highlight the pattern of febrile illnesses in children attending pediatric ambulatory health-care settings.
Methods:
A one-year prospective study was conducted on febrile children who were consecutively seen and managed at two walk-in primary-care clinics in Sulaimania Children's Hospital, Riyadh. Data collection and analysis were structured around the principal study objectives.
Results:
Among the 16,173 children seen, 4086 (25.3%) were identified as having a fever and evaluated to determine the aetiology of their febrile illness. Boys outnumbered girls and a significant increase in the frequency of febrile illnesses was noted in children 4 to 24 months of age. Upper respiratory tract infections were the commonest cause of fever (75%) and most of these infections were viral rhinopharyngitis. Viral gastroenteritis and pneumonia were prominent diagnoses, each accounting for 5% of febrile illnesses. Notably of low frequency were serious bacterial infections, such as meningitis (0.5%), cellulitis and bone or joint infection (1.8%) and urinary tract infection (0.7%). Only 9% of the febrile children required hospitalization. The ambulatory management of the other febrile children included the prescription of oral antibiotics to 64% of them.
Conclusion:
The proper clinical assessment of these febrile children and the prudent use of laboratory tests and antimicrobials remain the most important management strategies in primary health-care practice.
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01:26Patterns of Fever
01:25Types of Fever
Here are the different types of fever:
01:30Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
01:28Infectious Diseases and Their Occurrence
01:25Increased Body Temperature
01:22Methods of reducing fever
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