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Exploring Acute Febrile Illness in Children: Clinical Characteristics and Diagnostic Challenges
Giridhar Darishetty1, Vasudev Kompally1, Vura U V Nagajyothi1
1Department of Pediatrics, Kakatiya Medical College, Hanamkonda, IND.
Insights
Serious bacterial infections (SBIs) affect over 9% of hospitalized children with febrile illnesses. Urinary tract infections (UTIs) are the most common SBI in young children, necessitating thorough evaluation for toxic symptoms.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Microbiology
Background:
- Pediatric febrile illnesses are a leading cause of hospitalization, presenting diagnostic challenges.
- These infections are associated with considerable morbidity and mortality in children.
- Effective diagnostic strategies are crucial for timely management.
Purpose of the Study:
- To investigate the clinical features of acute febrile illness in children.
- To evaluate the efficacy of diagnostic methods for identifying infections.
- To determine the prevalence of serious bacterial infections (SBIs) and their sources.
Main Methods:
- Prospective study conducted at Mahatma Gandhi Memorial Hospital, Warangal, India (Jan 2020-Oct 2022).
- Inclusion criteria: Children aged 1 month to 12 years with acute febrile illness.
- Data collection focused on clinical presentation, diagnostic tests, and identified pathogens.
Main Results:
- Out of 195 eligible children, 18 (9.23%) had SBIs.
- Urinary tract infections (UTIs) were the most frequent SBI in children aged 1-36 months.
- Bacteremia occurred in 2.5% of cases, with a higher prevalence of Gram-negative bacteria.
Conclusions:
- SBIs, particularly UTIs in young children, are significant in pediatric febrile illnesses.
- Children with toxic symptoms aged 1-36 months require comprehensive SBI evaluation.
- Diagnostic approaches should consider the higher incidence of Gram-negative bacteremia.
Abstract:
Background Pediatric febrile illnesses are a major cause of hospital admissions and are often associated with significant morbidity and mortality. These illnesses pose a diagnostic challenge to both clinicians and laboratories. This study aims to explore the clinical characteristics of acute febrile illness in children and examine the effectiveness of various diagnostic techniques. Methods This prospective study was carried out at the Mahatma Gandhi Memorial Hospital, Warangal, India, from January 2020 to October 2022. It included children aged one month to 12 years. Results Out of 245 identified cases, 195 met the inclusion criteria. This study found that 18 patients (9.23%) suffered from serious bacterial infections (SBIs). In 63 patients (32.20%), the source of infection remained unidentified. Among those with SBI, UTIs were the most frequent. Bacteremia was identified in 2.5% of the patients. Conclusion SBIs were identified in 18 hospitalized children (9.23%), with UTIs being the most common SBI in children aged one to 36 months. Children in this age group presenting with toxic symptoms should be thoroughly evaluated for SBIs. The study also observed a higher prevalence of Gram-negative bacteremia compared to Gram-positive cases.
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