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Incidence of Fever - 🧠ANSWER ✔✔One of most common reasons for
parents to seek medical care.
Preschoolers have an average 6-8 febrile illnesses a year.
Definition of fever - 🧠ANSWER ✔✔Rectal temperature ≥ 100.4°F
,Tympanic temperature - 🧠ANSWER ✔✔Not accurate in infants under 3
months
Fever Causes - 🧠ANSWER ✔✔Most common Benign viral illness, can also
caused by bacterial or fungal infections, drug reactions including
immunizations, malignancies, autoimmune or metabolic disorders, CNS
disorders, excessive environmental temperatures.
Factors that increase likelihood of serious bacterial illness - 🧠ANSWER
✔✔Age under 3 months, history of prematurity, chronic medical conditions
such as immunosupression or aspenia, previous hospitalizations, daycare.
Toxic appearance
Non-Toxic appearance - 🧠ANSWER ✔✔Strong cry
Consolable
Alert and easy to arouse
Pink skin tones
Good hydration; good turgor, tears, moist mucous membranes
Smiles, responsive to environment
Toxic appearance - 🧠ANSWER ✔✔Weak or high pitched cry
,Inconsolable
Difficult to arouse
Pale, ashen, cyanotic, or mottled skin tones
Poor hydration; poor turgor, dry mucous membranes, no tears
No smile, listless, dull, infant won't alert to environment
Signs of serious illness - 🧠ANSWER ✔✔Fever greater than 40 (105)
Nuchal rigidity
Petechial skin rash
Seizure activity
Stridor or increased WOB
Physical exam signs of serious infection: Skin - 🧠ANSWER ✔✔Petechiae,
rashes
Physical exam signs of serious infection: head/neck - 🧠ANSWER
✔✔Sunken or bulging fontanelles, nuchal rigidity
Physical exam signs of serious infection: ears - 🧠ANSWER ✔✔Bulging TM,
AOM, mastoiditis
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, Physical exam signs of serious infection: Chest - 🧠ANSWER
✔✔Tachypnea, wheezing, rales, rhonchi
Physical exam signs of serious infection: Heart - 🧠ANSWER ✔✔Murmurs
Physical exam signs of serious infection: Abdomen - 🧠ANSWER
✔✔Tenderness, distension
Physical exam signs of serious infection: Musculoskeletal - 🧠ANSWER
✔✔Refusal to bear weight or use an extremity, erythema/warmth over joint
Diagnostic tests for fever in infant and young child - 🧠ANSWER ✔✔CBC w/
Diff (WBC > 15,000 may indicate SBI. Child with overwhelming sepsis my
have WBC <5,000)
UA/ C&S: R/O UTI
CXR: R/O Pneumonia
Lumbar Puncture: R/O meningitis
Blood cultures: R/O Bacteremia
Stools for C&S: R/O Infectious diarrhea