ACUTE FEVER WITHOUT AN APPARENT SOURCE IN YOUNG CHILDREN: EXPERIENCE OF THE PEDIATRIC MEDICAL EMERGENCY DEPARTMENT OF RABAT
DOI:
https://doi.org/10.53555/eijmhs.v1i2.93Keywords:
fever without source, children, infectionAbstract
Introduction Acute fever without source (FWS) in children is retained after a detailed history and a complete physical examination, in a febrile child and who was previously healthy. This is a common condition that may be the first sign of an invasive infection. The objective of this work is to study the epidemiological, clinical, biological and evolutionary profiles of the FWS and the evaluation of their management.
Materials and methods Prospective study carried out from 01 January to 31 April 2015 in the Pediatric Medical Emergency Department of the Rabat Children's Hospital and focused on 130 infants and children between 3 and 36 months who had consulted for FWS.
Results Children had an average age of 13.5 months. A female predominance was noted (sex ratio at 0.71). The fever was isolated in 57.7% of the cases, the associated signs were dominated by digestive signs (30%) and general signs (12.3%). FWS etiologies were dominated by: viral infections (59.2%), acute pyelonephritis (39.2%), and 2 cases of viral meningitis (1.5%). The evolution was favorable for all our patients.
Conclusion In our context, viral infections are the main etiology of FWS. Bacterial infections are dominated by acute pyelonephritis. A well-conducted initial clinical assessment, combined with a biological check-up, permits ambulatory care, and allows the detection of patients at high risk of severe infection requiring hospital inpatient care.
References
Elena Chiappini, Ph D, Nicola Princip, and al. Clinical. Management of Fever in Children: Summary of the Italian Pediatric Society Guidelines.Therapeutics 2009, 31
Richardson M, Lakhanpaul M; Guideline Development Group and the Technical Team. Assessment and initial management of feverish illness in children younger than 5 years: summary of NICE guidance. BMJ. 2007, 2: 1163-4
Davis T.Arch NICE guideline: feverish illness in children- assessement and initial management in children younger than 5 years. Dis Child Educ Pract 2013, 98(6):232-5.
Denise K. Sur, Md, and Elise L. Evaluating Fever of Unidentifiable Source in Young Children; University of California, Los Angeles, California. Am FAM Physician 2007, 15:1805-1811?
Larry J. Baraff, MD. Management of Infants and Young Children with Fever without Source. Pediatric Annals 2008,37: 10
Chiappini E, Principi N, Longui R et al. Clinical management of fever in children: summary of the Italian Pediatric Society Guidelines. Clin Ther. 2009, 31: 1826-43.
Richardson M, Lakhanpaul M. Guideline Development Group and the Technical Team. Assessment and initial management of feverish illness in children younger than 5 years: summary of NICE guidance. BMJ. 2007, 2: 1163-4.
Bourrillon A., Benoist G. Fièvre chez l’enfant. EMC (Elsevier Masson SAS, Paris), Traité de Médecine Akos, 8-0100, 2010.
SA Child Health Clinical Network Approved by SA Health Safety & Strategic Governance Committee Management of Fever without Focus in Children (excluding neonates): 1 July 2013. Department for Health and Ageing, Government of South Australia.
Paul Ishimine, MD. Fever without Source in Children 0 to 36 Months of Age. Pediatr Clin N Am. 2006
Craig JC, Williams GJ, Jones M, Codarini M, Mascaskill P, Hayen A et al. The accuracy of clinical symptoms and signs for the diagnosis of serious bacterial infection in young febrile children: prospective cohort study of 15 781 febrile illnesses. Br Med J.2010; 340: c1594.
Thompson MJ, Van den Bruel A. Diagnosing serious bacterial infection in young febrile children: Measuring vital signs and assessing a child’s overall state of illness are the priority. Br Med J. 2010; 340: c2062.
Kamrani H. Fièvre aigue sans orientation clinique (étude rétrospective). Thèse de médecine. Faculté de Médecine ET de Pharmacie Casablanca. Université Hassan II. 2005. N° 1784
Bousfiha. Causes des fièvres aigues aux urgences pédiatriques de Casablanca.urgence pratique. 2006 N°76 :37-39.
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