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Fever without source in infants and young children: dilemma in diagnosis and management

Ahmed Farag Elhassanien1, Abdel-Aziz Alghaiaty Hesham, Fawaz Alrefaee

  • 1Pediatric Department, Elmansoura University, Elmansoura, Egypt.

Risk Management and Healthcare Policy
|June 15, 2013
PubMed

Insights

A standardized guideline effectively managed young children with fever without source (FWS), identifying serious bacterial infections (SBI) like urinary tract infections. This approach aids in appropriate pediatric fever management.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Emergency Medicine

Background:

  • Management of fever without source (FWS) in young children remains controversial.
  • Existing strategies aim to guide the care of pediatric patients presenting with FWS.

Purpose of the Study:

  • To evaluate the clinical applicability of a standardized guideline for managing children up to 36 months old with FWS.
  • To assess the guideline's effectiveness in identifying serious bacterial infections (SBI) in this age group.

Main Methods:

  • Prospective, cross-sectional study conducted in a pediatric emergency unit.
  • Involved children aged up to 36 months with FWS.
  • Utilized a guideline stratifying SBI risk based on age, toxemia, clinical signs, and lab tests.

Main Results:

  • 26 cases (6.8%) of SBI were identified among 385 completed cases.
  • Urinary tract infection was the most common SBI, diagnosed in 40.4% of newborns.
  • A significant proportion of infants and toddlers without toxemia were classified at high risk for SBI, with many receiving antibiotic treatment.

Conclusions:

  • The standardized guideline proved appropriate for managing children with FWS, utilizing basic laboratory investigations.
  • Urinary tract infection was identified as the predominant SBI in the studied pediatric population.
  • The guideline facilitated risk stratification and appropriate management of FWS in young children.
Abstract

Keywords:
fever without sourceinfantssepsisserious bacterial infectionyoung children

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