RT Book, Section
A1 Chang, Todd P.
A2 Cydulka, Rita K.
A2 Fitch, Michael T.
A2 Joing, Scott A.
A2 Wang, Vincent J.
A2 Cline, David M.
A2 Ma, O. John
SR Print(0)
ID 1143141377
T1 Fever and Serious Bacterial Illness in Children
T2 Tintinalli's Emergency Medicine Manual, 8e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071837026
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1143141377
RD 2024/04/19
AB Fever  is  the  most  common  pediatric  chief  complaint  presenting  to  an  emergency  department  (ED)  and  accounts  for  30%  of  outpatient  visits.  Infants  and  children  are  at  relatively  high  risk  for  serious  bacterial  illness  (SBI),  which  includes  urinary  tract  infection  (UTI),  pneumonia,  bacteremia  or  sepsis,  and  meningitis—in  decreasing  prevalence.  Neonates  are  at  the  highest  risk  due  to  their  immature  immune  response,  while  infants  from  1  to  3  months  of  age  gradually  transition  to  the  lower  risk  profile  of  older  infants  and  children.  The  incidence  of  UTI  is  5%  overall  in  children  2  months  to  2  years,  with  a  prevalence  of  3%  to  8%  in  all  febrile  children  visiting  an  ED.  Widespread  vaccination  has  dropped  the  incidence  of  occult  bacteremia  for  children  3  to  36  months  of  age  to  0.5%  to  0.7%,  with  further  decreases  expected  with  the  13-valent  pneumococcal  conjugate  vaccine.  Meningitis  risk  decreases  from  about  1%  in  the  first  month  of  life  to  <0.1%  later  in  infancy  and  childhood.