TY - CHAP M1 - Book, Section TI - Chapter 66. Fever and Serious Bacterial Illness in Children A1 - Nadkarni, Milan D. A2 - Cline, David M. A2 - Ma, O. John A2 - Cydulka, Rita K. A2 - Meckler, Garth D. A2 - Handel, Daniel A. A2 - Thomas, Stephen H. PY - 2012 T2 - Tintinalli's Emergency Medicine Manual, 7e AB - Fever is the most common chief complaint presenting to an emergency department and accounts for 30% of outpatient visits each year. Early studies suggested that infants younger than 3 months were at high risk of a serious bacterial illness (SBI), which included sepsis, pyelonephritis, pneumonia, and meningitis. Current practice guidelines vary in their cut-offs for evaluation and treatment strategies. Neonates are clearly at the highest risk, while infants in their second and third months of life gradually transition to the lower risk profile of older infants and children. The incidence of bacteremia falls from around 10% among febrile neonates to approximately 0.2% in immunized infants and children older than 4 months; meningitis risk decreases from about 1% in the first month of life to < 0.1% later in infancy; the risk for pyelonephritis remains relatively constant among young girls with fever, and gradually decreases among boys over the first year of life. The individual practitioner must weigh these risks against the invasiveness of their ED evaluation and make shared decisions with the family on the best approach. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=56273837 ER -