Unexplained fever in infants and young children: when is it serious?

Unexplained fever in infants and young children: when is it serious?

Bower J R; Powell K R

Consultant (00107069)

2001

2001-04-15

When an infant or child younger than 36 months presents with fever that has no obvious source, the major concern is overlooking a serious bacterial infection. Ask about underlying medical problems, previous hospitalizations, recent infectious contacts, current or recent antibiotic therapy, previous infectious illnesses, and immunization status. Determine whether an infant younger than 60 days was premature, received perinatal antibiotics, or had unexplained hyperbilirubinemia. The cutoff temperature varies by age for fever that signals the need for further evaluation: 38 degrees C (100.4 degrees F) or greater for infants younger than 60 days, and 39 degrees C (102.2 degrees F) or greater for children 60 days to 36 months of age. A white blood cell (WBC) count between 5000/microL and 15,000/microL in infants younger than 60 days indicates a very low risk of serious bacterial infection. In older infants and children who have high fever, a WBC count greater than 15,000/microL raises the relative risk of bacteremia 5-fold.

Infant; Body Temperature; Age Factors; Physical Examination; Clinical Assessment Tools; Diagnosis; Newborn; Laboratory; Patient History Taking; Bacterial Infections – Diagnosis – In Infancy and Childhood; Blood – Analysis – In Infancy and Childhood; Fever – Etiology – In Infancy and Childhood; Urinalysis – In Infancy and Childhood

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