Journal article
Management of Fever in Infants and Young Children
American family physician, v 101(11), pp 721-729
15 Jun 2020
PMID: 32538597
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Despite dramatic reductions in the rates of bacteremia and meningitis since the 1980s, febrile illness in children younger than 36 months continues to be a concern with potentially serious consequences. Factors that suggest serious infection include age younger than one month, poor arousability, petechial rash, delayed capillary refill, increased respiratory effort, and overall physician assessment. Urinary tract infections are the most common serious bacterial infection in children younger than three years, so evaluation for such infections should be performed in those with unexplained fever. Abnormal white blood cell counts have poor sensitivity for invasive bacterial infections; procalcitonin and C-reactive protein levels, when available, are more informative. Chest radiography is rarely recommended for children older than 28 days in the absence of localizing signs. Lumbar puncture is not recommended for children older than three months without localizing signs; it may also be considered for those from one to three months of age with abnormal laboratory test results. Protocols such as Step-by-Step, Laboratory Score, or the Rochester algorithms may be helpful in identifying low-risk patients. Rapid influenza testing and tests for coronavirus disease 2019 (COVID-19) may be of value when those diseases are circulating. When empiric treatment is appropriate, suggested antibiotics include ceftriaxone or cefotaxime for infants one to three months of age and ampicillin with gentamicin or with cefotaxime for neonates. For children three months to three years of age, azithromycin or amoxicillin is recommended if pneumonia is suspected; for urinary infections, suggested antibiotics are cefixime, amoxicillin/clavulanate, or trimethoprim/sulfamethoxazole. Choice of antibiotics should reflect local patterns of microbial resistance. Copyright (C) 2020 American Academy of Family Physicians.
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Details
- Title
- Management of Fever in Infants and Young Children
- Creators
- Jennifer L. Hamilton - Drexel UniversitySusanna G. Evans - Drexel UniversityMunish Bakshi - Drexel Univ, Coll Med, Dept Family Community & Prevent Med, Philadelphia, PA 19104 USA
- Publication Details
- American family physician, v 101(11), pp 721-729
- Publisher
- Amer Acad Family Physicians
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- MD (Doctor of Medicine) Program; Family (Community and Preventive) Medicine
- Web of Science ID
- WOS:000540338700004
- Scopus ID
- 2-s2.0-85086532204
- Other Identifier
- 991019167688304721
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- Web of Science research areas
- Primary Health Care