Febrile Child. Ping-Wei Chen PGY-1 Emergency Medicine Dr. Lorraine Mabon. Objectives. Definition of Fever Measuring Fever Approach to Managing Febrile Patient <30 days old 1-3 months old >3 months old. What is a fever?. Pathophysiology Increased hypothalamic set point Pyrogens
PGY-1 Emergency Medicine
Dr. Lorraine Mabon
What else do you want to know on history?
What do you want to do with this patient?
Infants between 1 and 28 days old with a fever should be presumed to have a serious bacterial infection. (Level A Recommendation)
-Vitals: 38.7C, 133bpm, RR24, 100% Room Air
-otherwise examines well (no focus of infection)
-Urine <10 WBC/Hpf
-Stool <5 WBC/Hpf (if diarrhea)
-NOTE: No LP criteria!
• NPV = 98.9%
• P/E: Vitals 38.7C, 125bpm, RR24, 99% Room Air
-examines and appears well (no focus of infection)
2 of 5:
-Less than 12 months old
-Temperature of 39.0°C or higher
-Fever for 2 days or more
-Absence of another source of fever on examination
Level B Recommendation:
A chest radiograph should be obtained in febrile children aged younger than 3 months with evidence of acute respiratory illness.
Level C Recommendation:
Consider a chest radiograph in children older than 3 months with a temperature >39.0C and a WBC count greater than 20.