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Related Experiment Videos

The febrile infant.

M L McCutcheon

    The Journal of Family Practice
    |June 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Most febrile children (3-24 months) recover without intervention. However, physicians can identify serious bacterial infections using clinical assessment and specific laboratory markers, guiding further diagnostic tests and treatment decisions.

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    Area of Science:

    • Pediatrics
    • Infectious Disease

    Background:

    • Febrile illnesses are common in young children.
    • A significant percentage of febrile children recover spontaneously within 96 hours.
    • Serious bacterial infections (SBIs) occur in approximately 6% of febrile children, with higher incidence in younger children and higher fever.
    • Clinical assessment alone can identify many benign cases but requires laboratory support for definitive diagnosis.

    Purpose of the Study:

    • To outline a diagnostic approach for febrile children aged 3 to 24 months.
    • To differentiate between benign febrile illness and serious bacterial infections.
    • To guide the judicious use of diagnostic tests in febrile pediatric patients.

    Main Methods:

    • Clinical assessment of child's color, hydration, social response, consolability, and alertness.

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  • Laboratory evaluation including white blood cell count, neutrophil count, band cell count, and sedimentation rate.
  • Consideration of chest X-ray, blood culture, lumbar puncture, and urine culture based on clinical and laboratory findings.

    • Main Results:

    • Approximately 58% of febrile children recover within 96 hours without treatment.
    • About 6% of febrile children present with serious bacterial infections.
    • Clinical assessment identifies two-thirds of benign cases and one-tenth requiring inpatient evaluation.
    • Specific laboratory values (WBC > 15,000/microL, neutrophils > 10,000/microL, bands > 500/microL, ESR > 30 mm/h) suggest serious illness.

    Conclusions:

    • A combination of clinical observation and targeted laboratory testing aids in identifying febrile children who require further investigation for serious bacterial infections.
    • Physician judgment remains crucial in determining the need for further observation or outpatient management.
    • Prompt diagnosis and management of SBIs are essential to prevent complications in young children.