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Evaluation of child with fever without source: review of literature and update

Rajan Arora1, Prashant Mahajan

  • 1Division of Emergency Medicine, Carman and Ann Adam Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Boulevard, Detroit, MI 48201, USA.

Pediatric Clinics of North America
|October 8, 2013
PubMed

Insights

Identifying serious bacterial infections (SBI) in febrile infants is critical to prevent severe outcomes. Early and accurate diagnosis in young children remains a key challenge for clinicians.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Clinical Risk Stratification

Background:

  • Fever is a common pediatric symptom prompting medical evaluation.
  • Serious bacterial infections (SBI) in febrile infants can lead to life-threatening conditions like meningitis and sepsis.
  • Accurate risk-stratification is essential for timely SBI diagnosis in young children.

Purpose of the Study:

  • To review current strategies for identifying serious bacterial infections in febrile children.
  • To highlight the critical need for early and accurate diagnosis of SBI in infants.
  • To discuss the evolving epidemiology of SBI in the context of widespread vaccination.

Main Methods:

  • Review of traditional risk-stratification strategies for febrile children.
  • Analysis of the epidemiology of serious bacterial infections.
  • Consideration of the impact of conjugate vaccines on SBI patterns.

Main Results:

  • Infants under 90 days old face the highest risk of SBI.
  • The landscape of SBI is changing due to conjugate vaccines.
  • Effective risk assessment is crucial for preventing severe sequelae.

Conclusions:

  • Early and precise identification of SBI in febrile infants is paramount.
  • Risk-stratification tools are vital for managing febrile infants.
  • Understanding evolving SBI epidemiology aids in optimizing clinical practice.

Keywords:
FeverFever without sourceSerious bacterial infectionTissue culture

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