Term
|
Definition
| rectal temperature of 100.4° F or 38° C or higher |
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Term
| Fever that requires further eval |
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Definition
previously healthy, well-appearing children 3 to 36 months of age, temperature of 102.2° F or 39° C requires further evaluation
Mostly H. influenzae and s. pneumoniae |
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Term
|
Definition
RULE OUT unsuspected bacteremia
- visible source of infxn |
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Term
| Fever w/o focus: high risk (5) |
|
Definition
- Febrile infant less than 1 month – (higher than 100.4) none of us are good enough to decipher OM etc.
- Any toxic appearing (lethargy, irritability, sick appearing, non-responsive) child of any age
- Infant under 3 months with AOM – HAVE TO BE VERY CAREFUL
- 1-3 months Fever =>102.2
- 1-3 months Chronic illness (heart disease) |
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Term
| Fever w/o focus: low risk (5) |
|
Definition
- Healthy appearing
- Or mildly ill appearing from 3-36 months over 102.2 |
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Term
| Serious Bacterial Infection (SBI) |
|
Definition
- bacteremia
- UTI
- meningitis
- bacterial AGE - acute gastroenteritis
- occult pneumonia |
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Term
|
Definition
ANTERIOR FONTANEL!!!
and feeding? |
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Term
| What is not a good sign, esp. btwn 3-6 months?? |
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Definition
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Term
|
Definition
- 0-28 days old if greater than 100.4
- 1-3 months if greater than 102.2
- over 104 (any age)
- toxic looking |
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Term
|
Definition
- 0-28 days
- 1-3 months
- 3-36 months |
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Term
|
Definition
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Term
|
Definition
CBC with Diff
UA with Cx
Blood Cx
CSF studies
IV antibiotics
Observe for 48 hours
Or until source found
- If LP is abnormal, give cefotaxime and ampicillin
If normal, give ampicillin and gentamicin |
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|
Term
| Febrile Infants 1-3 months - non toxic but higher than 102.2 |
|
Definition
CBC with diff
UA with Culture
Blood Cultures
Stool studies (if indicated- diarrhea)
CXR (if indicated – respiratory distress)
CSF studies if antibiotics given |
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Term
| 3 mos to 3 y/o: Non-toxic, temp greater than or equal to 102.2F or 39 C (2) |
|
Definition
1. Observe only
Evaluate in 24-48 hours
2. CBC with diff
UA with Cx
F/U in 24 hrs |
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Term
| 3 mos to 3 y/o: Non-toxic, temp less than 102.2 (2 options) |
|
Definition
1. Observe only
Close F/U can have them come back in 24 hrs
2. catheterized urine for UA and culture
- obtain CBC on those who have not had at least 3 doses of PCV13
- If CBC shows abnormal SBC or ANC, consider rocephin (after obtaining urine and blood Cx)
- CXR if reps. sx or if WBC>20,000 |
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Term
|
Definition
- all pts <28 days w/ temp over 100.4
- any high risk |
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Term
|
Definition
WBC <15,000
ANC < 10,000/mm3
UA WNL |
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|
Term
| Lab result followup (WBC) |
|
Definition
Normal - reevaluate in 24 hrs, followup w/ cultures
consider ceftriaxone 50 mg/kg IM
Abnormal - consider admission for observation
Obtain blood cultures
Consider CSF exam
treat identifiable source |
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Term
|
Definition
| Prolonged fever>101 rectally for 2-3 weeks |
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Term
|
Definition
- CBC
- ESR, CRP
- aerobic blood cx
- UA and urine cs
- chest x ray
- PPD
- Serum electrolytes, BUN, creatinine, and hepatic enzymes
- consider HIV |
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Term
|
Definition
High fever of more than 5 days, w/ 4 of the 5:
- bilateral bulbar conjunctival injection, peeling of hands, Lip or oral conjstrawberry tongue, lymphadenopathy, and rash
- erythema of palms
- polymorphous rash
- cervical lymphadenopathy (at least one lymph node >1.5 cm in diameter) |
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|
Term
| Infectious Disease Consult - when? |
|
Definition
- unexplained fever > 5-7 days
- partially treated meningitis
- management of infants when LP was unsuccessful, traumatic, or parents refuse
- management and interpretation of unusual organisms
- management of deep seated infections - like abscess appendicitis
- toxic appearing patients w/o an obvious source |
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|
Term
| Febrile needing evaluation |
|
Definition
- Infants who are less than three months of age
- Children > 3 months with fever more than 3 days or fussiness or refusal to take fluids – ask them if they’re drinking well
- Children who are three to 36 months who have a temperature of 102ºF (38.9ºC) or greater
- Children of any age whose temperature is 104ºF (40ºC) or greater
- Children of any age who have a febrile seizure
- Children of any age who have recurrent fevers, even if the fevers only last a few hours
- Children of any age who have a fever and have a chronic medical problems
- Children with fever and a new rash |
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Term
|
Definition
| - anyone toxic appearing w/ over 104 |
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