ACUTE FEVER WITHOUT AN APPARENT SOURCE IN YOUNG CHILDREN: EXPERIENCE OF THE PEDIATRIC MEDICAL EMERGENCY DEPARTMENT OF RABAT

Abstract

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.