Revista chilena de infectologia : organo oficial de la Sociedad Chilena de Infectologia · 2007
[Etiology of acute fever without source in infants consulting at an emergency department].
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Brockmann V Pablo, Ibarra G Ximena, Silva W Ignacia, Hirsch B Tamara
Аннотация
UNLABELLED: Fever is a frequent symptom of consultation in Pediatric Emergency Department.
OBJECTIVES: to describe causes of acute fever of unknown origin (FUO) in infants under 36 months of age, the utility of requested tests and pediatrician decisions.
PATIENTS AND METHODS: 309 cards of children under 36 months who consulted at Emergency Department for acute FUO were reviewed.
RESULTS: 64 % were classified with well clinical condition. Most frequent causes were: probable viral respiratory infections (72%), urinary tract infection (7.4%), pneumonia (2.9%), bacteremia (1.9%), and bacterial meningitis (1.3%). Streptococcus pneumoniae was the most frequent agent isolated from blood cultures. Tests of best utility were: urine analysis and urine culture. Leukocytes count < 15.000/mm(3) and PCR < 4.0 mg/dl had a negative predictive value of 96 %. Nine point seven percent of the patients were hospitalized, while 14.2% received antibiotic treatment at home.
CONCLUSIONS: We suggest to perform urine analysis and culture as the initial study for children with acute FUO and well clinical condition.
OBJECTIVES: to describe causes of acute fever of unknown origin (FUO) in infants under 36 months of age, the utility of requested tests and pediatrician decisions.
PATIENTS AND METHODS: 309 cards of children under 36 months who consulted at Emergency Department for acute FUO were reviewed.
RESULTS: 64 % were classified with well clinical condition. Most frequent causes were: probable viral respiratory infections (72%), urinary tract infection (7.4%), pneumonia (2.9%), bacteremia (1.9%), and bacterial meningitis (1.3%). Streptococcus pneumoniae was the most frequent agent isolated from blood cultures. Tests of best utility were: urine analysis and urine culture. Leukocytes count < 15.000/mm(3) and PCR < 4.0 mg/dl had a negative predictive value of 96 %. Nine point seven percent of the patients were hospitalized, while 14.2% received antibiotic treatment at home.
CONCLUSIONS: We suggest to perform urine analysis and culture as the initial study for children with acute FUO and well clinical condition.