Pediatric Fever

It was confusing for me to remember what to do or what the work-up was for a pediatric patient for fever, so I made a breakdown by age from what I've learned from my clinical rotations. It is important to make sure all of these pediatric patients have follow-up within 24 hours of discharge especially if they are seen first in the emergency department.

Management by Age

Interesting fact: maternal immunity weans around 6 weeks.

0-30 (or 60 days) days: 

• full infectious work-up (blood, urine, CSF)
  
• all are admitted
  

30 - 60 d:

• if they meet low risk criteria (if all studies normal)
  
• +/- ceftriaxone
  

2-3 (or >3 months) months: 

• blood and urine
  
• if all normal d/c with no medication
  

>3 months to 6 months: 

• fever of more than 102.2 for more than 3 days
  
• CBC and urine +/- blood culture
  
• If cough +/- CXR (or CXR w/ WBC > 20)
  
• circumcised: 
• > 6 months = no urine
• not circumcised (up to a year) = urine
• female 1-2 yrs: 
• urine

Common sources of bacterial fever

• Acute Otitis Media
• Bacteremia
• Urinary tract infections
• pneumonias