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. 2003 Feb;8(2):76-82.
doi: 10.1093/pch/8.2.76.

Approach to the febrile child: A challenge bridging the gap between the literature and clinical practice

Jean-Bernard Girodias  1 , Benoit Bailey
Affiliations

Approach to the febrile child: A challenge bridging the gap between the literature and clinical practice

Jean-Bernard Girodias et al. Paediatr Child Health. 2003 Feb.

Abstract
in English, French

The approach to the febrile child is always concerning for any physician despite the fact that most fevers are viral in origin. However, in rare cases, a missed bacterial infection can have serious consequences. How can fevers of viral origin be differentiated from those of bacterial origin? Do all febrile children with no obvious infection site need a blood culture? Should antibiotics be administered before the results of the blood culture have been received? In the past 30 years, there has been an overabundance of recommendations, advice, opinions and suggested treatments on this subject. The purpose of this review is to present the evidence that is known at this time concerning the management of the febrile child and to present one approach used in a large urban paediatric emergency department.

La démarche face à l’enfant fiévreux est toujours préoccupante pour le médecin, même si la plupart des fièvres sont d’origine virale. Cependant, dans de rares cas, une infection bactérienne passée inaperçue peut avoir de graves conséquences. Comment peut-on distinguer les fièvres d’origine virale des fièvres d’origine bactérienne? Les enfants fiévreux sans foyer d’infection évident devraient-ils tous subir une hémoculture? Les antibiotiques devraient-ils être administrés avant la réception de l’hémoculture? Depuis 30 ans, une surabondance de recommandations, d’avis, d’opinions et de traitements suggérés ont été émis sur le sujet. La présente analyse vise à présenter les observations probantes connues à l’heure actuelle au sujet de la prise en charge de l’enfant fiévreux et à présenter une démarche utilisée dans un grand département d’urgence pédiatrique en milieu urbain.

Keywords: Children; Fever; Review.

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Figures

Figure 1)
Figure 1)
Management strategy in febrile children when there is no obvious site of infection. CBC Complete blood count; ± With or without. *Usually withheld unless symptom or sign (see text for discussion)
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