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2017 ; 4
(9
): ä Nephropedia Template TP
gab.com Text
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English Wikipedia
Fever in Children: Pearls and Pitfalls
#MMPMID28862659
Barbi E
; Marzuillo P
; Neri E
; Naviglio S
; Krauss BS
Children (Basel)
2017[Sep]; 4
(9
): ä PMID28862659
show ga
Fever in children is a common concern for parents and one of the most frequent
presenting complaints in emergency department visits, often involving
non-pediatric emergency physicians. Although the incidence of serious infections
has decreased after the introduction of conjugate vaccines, fever remains a major
cause of laboratory investigation and hospital admissions. Furthermore,
antipyretics are the most common medications administered to children. We review
the epidemiology and measurement of fever, the meaning of fever and associated
clinical signs in children of different ages and under special conditions,
including fever in children with cognitive impairment, recurrent fevers, and
fever of unknown origin. While the majority of febrile children have mild,
self-resolving viral illness, a minority may be at risk of life-threatening
infections. Clinical assessment differs markedly from adult patients. Hands-off
evaluation is paramount for a correct evaluation of breathing, circulation and
level of interaction. Laboratory markers and clinical prediction rules provide
limited help in identifying children at risk for serious infections; however,
clinical examination, prudent utilization of laboratory tests, and post-discharge
guidance ("safety netting") remain the cornerstone of safe management of febrile
children.