Evaluation of fever in children

References

Key articles

National Institute for Health and Care Excellence. Fever in under 5s: assessment and initial management. Nov 2021 [internet publication].Full text

Pantell RH, Roberts KB, Adams WG, et al. Evaluation and management of well-appearing febrile infants 8 to 60 days old. Pediatrics. 2021 Aug;148(2):e2021052228.Full text  Abstract

American College of Radiology. ACR appropriateness criteria: fever without source or unknown origin-child. 2015 [internet publication].Full text

American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Pediatric Fever, Mace SE, Gemme SR, et al. Clinical policy for well-appearing infants and children younger than 2 years of age presenting to the emergency department with fever. Ann Emerg Med. 2016 May;67(5):625-39.e13.Full text  Abstract

Reference articles

1. Petersdorf RG, Beeson PB. Fever of unexplained origin: report on 100 cases. Medicine (Baltimore). 1961 Feb;40:1-30. Abstract

2. Chusid MJ. Fever of unknown origin in childhood. Pediatr Clin North Am. 2017 Feb;64(1):205-30. Abstract

3. Crocetti M, Moghbeli N, Serwint J. Fever phobia revisited: have parental misconceptions about fever changed in 20 years? Pediatrics. 2001 Jun;107(6):1241-6. Abstract

4. Section on Clinical Pharmacology and Therapeutics, Committee on Drugs, Sullivan JE, et al. Fever and antipyretic use in children. Pediatrics. 2011 Mar;127(3):580-7.Full text  Abstract

5. Chow A, Robinson JL. Fever of unknown origin in children: a systematic review. World J Pediatr. 2011 Feb;7(1):5-10. Abstract

6. Greenes DS, Harper MB. Low risk of bacteremia in febrile children with recognizable viral syndromes. Pediatr Infect Dis J. 1999 Mar;18(3):258-61. Abstract

7. Freedman SB, Haladyn JK, Floh A, et al. Pediatric myocarditis: emergency department clinical findings and diagnostic evaluation. Pediatrics. 2007 Dec;120(6):1278-85. Abstract

8. Durani Y, Egan M, Baffa J, et al. Pediatric myocarditis: presenting clinical characteristics. Am J Emerg Med. 2009 Oct;27(8):942-7. Abstract

9. Forgie SE, Robinson JL. Pediatric malignancies presenting as a possible infectious disease. BMC Infect Dis. 2007 May 22;7:44.Full text  Abstract

10. Advanced Life Support Group. Advanced paediatric life support: a practical approach to emergencies (APLS). 6th ed. Oxford, Wiley-Blackwell; 2016.

11. National Institute for Health and Care Excellence. Fever in under 5s: assessment and initial management. Nov 2021 [internet publication].Full text

12. Royal College of Paediatrics and Child Health. A safe system framework for recognising and responding to children at risk of deterioration. July 2016 [internet publication].Full text

13. Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10.Full text  Abstract

14. National Institute for Health and Care Excellence. Sepsis: recognition, diagnosis and early management. Mar 2024 [internet publication].Full text

15. Weiss SL, Peters MJ, Alhazzani W, et al. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Intensive Care Med. 2020 Feb;46(suppl 1):10-67.Full text  Abstract

16. Daugaard JJ, Jensen JJ, Jacobsen CJ. [The importance of an empty pleural cavity in the treatment of pleural effusion]. [in dan]. Ugeskr Laeger. 1987 Jan 19;149(4):221-2.

17. Royal College of Physicians. National Early Warning Score (NEWS) 2. Dec 2017 [internet publication].Full text

18. American College of Emergency Physicians (ACEP) Expert Panel on Sepsis. DART: an evidence-driven tool to guide the early recognition and treatment of sepsis and septic shock. [internet publication].Full text

19. Academy of Medical Royal Colleges. Statement on the initial antimicrobial treatment of sepsis. May 2022 [internet publication].Full text

20. ​UK Health Security Agency. Scarlet fever: managing outbreaks in schools and nurseries. Apr 2023 [internet publication].Full text

21. Centers for Disease Control and Prevention. Clinical guidance for group A streptococcal pharyngitis. Mar 2024 [internet publication].Full text

22. UK Health Security Agency (UKHSA). Group A streptococcal infections: activity during the 2022 to 2023 season. Jun 2023 [internet publication].Full text

23. Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012 Nov 15;55(10):e86-102.Full text  Abstract

24. Gerber MA, Baltimore RS, Eaton CB, et al. Prevention of rheumatic fever and diagnosis and treatment of acute Streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation. 2009 Mar 24;119(11):1541-51.Full text  Abstract

25. UK Health Security Agency. UKHSA update on scarlet fever and invasive group A strep. May 2023 [internet publication].Full text

26. World Health Organization. Increased incidence of scarlet fever and invasive Group A Streptococcus infection - multi-country. Dec 2022 [internet publication].Full text

27. Liu W, Zhang Q, Chen J, et al. Detection of COVID-19 in children in early January 2020 in Wuhan, China. N Engl J Med. 2020 Apr 2;382(14):1370-1.Full text  Abstract

28. Xia W, Shao J, Guo Y, et al. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 2020 May;55(5):1169-74.Full text  Abstract

29. Graneto JW, Soglin DF. Maternal screening of childhood fever by palpation. Pediatr Emerg Care. 1996 Jun;12(3):183-4. Abstract

30. Hooker EA, Smith SW, Miles T, et al. Subjective assessment of fever by parents: comparison with measurement by noncontact tympanic thermometer and calibrated rectal glass mercury thermometer. Ann Emerg Med. 1996 Sep;28(3):313-7. Abstract

31. Stanley R, Pagon Z, Bachur R. Hyperpyrexia among infants younger than 3 months. Pediatr Emerg Care. 2005 May;21(5):291-4. Abstract

32. Trautner BW, Caviness AC, Gerlacher GR, et al. Prospective evaluation of the risk of serious bacterial infection in children who present to the emergency department with hyperpyrexia (temperature of 106 degrees F or higher). Pediatrics. 2006 Jul;118(1):34-40.Full text  Abstract

33. Baker MD, Fosarelli PD, Carpenter RO. Childhood fever: correlation of diagnosis with temperature response to acetaminophen. Pediatrics. 1987 Sep;80(3):315-8. Abstract

34. Mandl KD, Stack AM, Fleisher GR. Incidence of bacteremia in infants and children with fever and petechiae. J Pediatr. 1997 Sep;131(3):398-404. Abstract

35. National Institute for Health and Care Excellence. Lyme disease. October 2018 [internet publication].Full text

36. Herz AM, Greenhow TL, Alcantara J, et al. Changing epidemiology of outpatient bacteremia in 3- to 36-month-old children after the introduction of the heptavalent-conjugated pneumococcal vaccine. Pediatr Infect Dis J. 2006 Apr;25(4):293-300. Abstract

37. Bhargava A, Ralph R, Chatterjee B, et al. Assessment and initial management of acute undifferentiated fever in tropical and subtropical regions. BMJ. 2018 Nov 29;363:k4766. Abstract

38. McCarthy PL, Sharpe MR, Spiesel SZ, et al. Observation scales to identify serious illness in febrile children. Pediatrics. 1982 Nov;70(5):802-9. Abstract

39. Long SS, Pool TE, Vodzak J, et al. Herpes simplex virus infection in young infants during 2 decades of empiric acyclovir therapy. Pediatr Infect Dis J. 2011 Jul;30(7):556-61. Abstract

40. Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Clinical practice guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 guidelines for the prevention, diagnosis and treatment of Lyme disease. Clin Infect Dis. 2021 Jan 23;72(1):1-8.Full text  Abstract

41. Centers for Disease Control and Prevention. Group A Streptococcal (GAS) disease. Jun 2022 [internet publication].Full text

42. Van den Bruel A, Thompson MJ, Haj-Hassan T, et al. Diagnostic value of laboratory tests in identifying serious infections in febrile children: systematic review. BMJ. 2011 Jun 8;342:d3082.Full text  Abstract

43. Baker MD, Bell LM. Unpredictability of serious bacterial illness in febrile infants from birth to 1 month of age. Arch Pediatr Adolesc Med. 1999 May;153(5):508-11.Full text  Abstract

44. Baker MD, Avner JR, Bell LM. Failure of infant observation scales in detecting serious illness in febrile, 4- to 8-week-old infants. Pediatrics. 1990 Jun;85(6):1040-3. Abstract

45. Schlapbach LJ, Watson RS, Sorce LR, et al. International consensus criteria for pediatric sepsis and septic shock. JAMA. 2024 Feb 27;331(8):665-4.Full text  Abstract

46. Baker MD, Bell LM, Avner JR. Outpatient management without antibiotics of fever in selected infants. N Engl J Med. 1993 Nov 11;329(20):1437-41.Full text  Abstract

47. Baker MD, Bell LM, Avner JR. The efficacy of routine outpatient management without antibiotics of fever in selected infants. Pediatrics. 1999 Mar;103(3):627-31. Abstract

48. Pantell RH, Roberts KB, Adams WG, et al. Evaluation and management of well-appearing febrile infants 8 to 60 days old. Pediatrics. 2021 Aug;148(2):e2021052228.Full text  Abstract

49. Bonsu BK, Harper MB. Identifying febrile young infants with bacteremia: is the peripheral white blood cell count an accurate screen? Ann Emerg Med. 2003 Aug;42(2):216-25. Abstract

50. Bonsu BK, Harper MB. Utility of the peripheral blood white blood cell count for identifying sick young infants who need lumbar puncture. Ann Emerg Med. 2003 Feb;41(2):206-14. Abstract

51. Mahajan P, Grzybowski M, Chen X, et al. Procalcitonin as a marker of serious bacterial infections in febrile children younger than 3 years old. Acad Emerg Med. 2014 Feb;21(2):171-9.Full text  Abstract

52. Milcent K, Faesch S, Gras-Le Guen C, et al. Use of procalcitonin assays to predict serious bacterial infection in young febrile infants. JAMA Pediatr. 2016 Jan;170(1):62-9. Abstract

53. American College of Radiology. ACR appropriateness criteria: fever without source or unknown origin-child. 2015 [internet publication].Full text

54. American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Pediatric Fever, Mace SE, Gemme SR, et al. Clinical policy for well-appearing infants and children younger than 2 years of age presenting to the emergency department with fever. Ann Emerg Med. 2016 May;67(5):625-39.e13.Full text  Abstract

55. Shaikh N, Morone NE, Lopez J, et al. Does this child have a urinary tract infection? JAMA. 2007 Dec 26;298(24):2895-904. Abstract

56. Bachur R, Perry H, Harper MB. Occult pneumonias: empiric chest radiographs in febrile children with leukocytosis. Ann Emerg Med. 1999 Feb;33(2):166-73. Abstract

57. Murphy CG, van de Pol AC, Harper MB, et al. Clinical predictors of occult pneumonia in the febrile child. Acad Emerg Med. 2007 Mar;14(3):243-9. Abstract

58. Bradley JS, Byington CL, Shah SS, et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011 Oct;53(7):e25-76.Full text  Abstract

59. Sanders S, Barnett A, Correa-Velez I, et al. Systematic review of the diagnostic accuracy of C-reactive protein to detect bacterial infection in nonhospitalized infants and children with fever. J Pediatr. 2008 Oct;153(4):570-4. Abstract

60. McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017 Apr 25;135(17):e927-9.Full text  Abstract

61. Gewitz MH, Baltimore RS, Tani LY, et al. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American Heart Association. Circulation. 2015 May 19;131(20):1806-18.Full text  Abstract

62. Centers for Disease Control and Prevention. Case definitions for infectious conditions under public health surveillance. MMWR Recomm Rep. 1997 May 2;46(10):1-55.Full text  Abstract

63. Gorelick MH, Shaw KN. Screening tests for urinary tract infection in children: a meta-analysis. Pediatrics. 1999 Nov;104(5):e54. Abstract

64. Miller JM, Binnicker MJ, Campbell S, et al. A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 update by the Infectious Diseases Society of America and the American Society for Microbiology. Clin Infect Dis. 2018 Aug 31;67(6):e1-e94.Full text  Abstract

65. Cohen JF, Bertille N, Cohen R, et al. Rapid antigen detection test for group A streptococcus in children with pharyngitis. Cochrane Database Syst Rev. 2016 Jul 4;7(7):CD010502.Full text  Abstract

66. Cohen JF, Pauchard JY, Hjelm N, et al. Efficacy and safety of rapid tests to guide antibiotic prescriptions for sore throat. Cochrane Database Syst Rev. 2020 Jun 4;6(6):CD012431.Full text  Abstract

67. Slavin RG, Spector SL, Bernstein IL, et al. The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol. 2005 Dec;116(6 Suppl):S13-47. Abstract

68. Nigrovic LE, Kuppermann N, Macias CG, et al. Clinical prediction rule for identifying children with cerebrospinal fluid pleocytosis at very low risk of bacterial meningitis. JAMA. 2007 Jan 3;297(1):52-60.Full text  Abstract

69. Tyler KL. Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret's. Herpes. 2004 Jun;11 Suppl 2:57A-64A. Abstract

70. Kuppermann N, Fleisher GR, Jaffe DM. Predictors of occult pneumococcal bacteremia in young febrile children. Ann Emerg Med. 1998 Jun;31(6):679-87. Abstract

71. Stoll ML, Rubin LG. Incidence of occult bacteremia among highly febrile young children in the era of the pneumococcal conjugate vaccine: a study from a children's hospital emergency department and urgent care center. Arch Pediatr Adolesc Med. 2004 Jul;158(7):671-5.Full text  Abstract

72. Unkila-Kallio L, Kallio MJ, Eskola J, et al. Serum C-reactive protein, erythrocyte sedimentation rate, and white blood cell count in acute hematogenous osteomyelitis of children. Pediatrics. 1994 Jan;93(1):59-62. Abstract

73. Woods CR, Bradley JS, Chatterjee A, et al. Clinical practice guideline by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America: 2021 guideline on diagnosis and management of acute hematogenous osteomyelitis in pediatrics. J Pediatric Infect Dis Soc. 2021 Sep 23;10(8):801-44.Full text  Abstract

74. Bhutta ZA. Current concepts in the diagnosis and treatment of typhoid fever. BMJ. 2006 Jul 8;333(7558):78-82. Abstract

75. Rahimian J, Wilson T, Oram V, et al. Pyogenic liver abscess: recent trends in etiology and mortality. Clin Infect Dis. 2004 Dec 1;39(11):1654-9.Full text  Abstract

76. Nystad TW, Myrmel H. Prevalence of primary versus reactivated Epstein-Barr virus infection in patients with VCA IgG-, VCA IgM- and EBNA-1-antibodies and suspected infectious mononucleosis. J Clin Virol. 2007 Apr;38(4):292-7. Abstract

77. Christie LJ, Honarmand S, Talkington DF, et al. Pediatric encephalitis: what is the role of Mycoplasma pneumoniae? Pediatrics. 2007 Aug;120(2):305-13. Abstract

78. Silvia MT, Licht DJ. Pediatric central nervous system infections and inflammatory white matter disease. Pediatr Clin North Am. 2005 Aug;52(4):1107-26, ix. Abstract

79. Leake JA, Albani S, Kao AS, et al. Acute disseminated encephalomyelitis in childhood: epidemiologic, clinical and laboratory features. Pediatr Infect Dis J. 2004 Aug;23(8):756-64. Abstract

80. Tenembaum S, Chitnis T, Ness J, et al. Acute disseminated encephalomyelitis. Neurology. 2007 Apr 17;68(16 Suppl 2):S23-36. Abstract

81. World Health Organization. WHO guidelines for malaria. Mar 2023 [internet publication].Full text

82. Centers for Disease Control and Prevention (CDC). Recommendations for test performance and interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease. MMWR Morb Mortal Wkly Rep. 1995 Aug 11;44(31):590-1.Full text  Abstract

83. Mead P, Petersen J, Hinckley A. Updated CDC Recommendation for serologic diagnosis of lyme disease. MMWR Morb Mortal Wkly Rep. 2019 Aug 16;68(32):703.Full text  Abstract

84. Lewinsohn DM, Leonard MK, LoBue PA, et al. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical practice guidelines: diagnosis of tuberculosis in adults and children. Clin Infect Dis. 2017 Jan 15;64(2):e1-e33.Full text  Abstract

85. Geldmacher H, Taube C, Kroeger C, et al. Assessment of lymph node tuberculosis in northern Germany: a clinical review. Chest. 2002 Apr;121(4):1177-82. Abstract

86. Weir MR, Thornton GF. Extrapulmonary tuberculosis. Experience of a community hospital and review of the literature. Am J Med. 1985 Oct;79(4):467-78. Abstract

87. Baydur A. The spectrum of extrapulmonary tuberculosis. West J Med. 1977 Apr;126(4):253-62.Full text  Abstract

88. Nataraj G, Kurup S, Pandit A, et al. Correlation of fine needle aspiration cytology, smear and culture in tuberculous lymphadenitis: a prospective study. J Postgrad Med. 2002 Apr-Jun;48(2):113-6.Full text  Abstract

89. Centers for Disease Control and Prevention (CDC). Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of tuberculosis. MMWR Morb Mortal Wkly Rep. 2009 Jan 16;58(1):7-10.Full text  Abstract

90. World Health Organization. Module 5: Management of tuberculosis in children and adolescents. WHO consolidated guidelines on tuberculosis. Geneva: World Health Organization; 2022.Full text  Abstract

91. World Health Organization. WHO consolidated guidelines on tuberculosis: module 3: diagnosis: rapid diagnostics for tuberculosis detection. Mar 2024 [internet publication].Full text

92. Bjerrum S, Schiller I, Dendukuri N, et al. Lateral flow urine lipoarabinomannan assay for detecting active tuberculosis in people living with HIV. Cochrane Database Syst Rev. 2019 Oct 21;10(10):CD011420.Full text  Abstract

93. Windfuhr JP, Toepfner N, Steffen G, et al. Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management. Eur Arch Otorhinolaryngol. 2016 Apr;273(4):973-87.Full text  Abstract

94. Lean WL, Arnup S, Danchin M, et al. Rapid diagnostic tests for group A streptococcal pharyngitis: a meta-analysis. Pediatrics. 2014 Oct;134(4):771-81. Abstract

95. Barakat AJ, Evans C, Gill M, et al. Rapid strep testing in children with recently treated streptococcal pharyngitis. Pediatr Investig. 2019 Mar;3(1):27-30.Full text  Abstract

96. Kimberlin DW, Banerjee R, Barnett ED, et al. Red book: 2024-2027 report of the Committee on Infectious Diseases. 33rd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2024.

97. World Health Organization, Special Programme for Research and Training in Tropical Diseases (TDR). Dengue: guidelines for diagnosis, treatment, prevention and control. New edition. 2009 [internet publication].Full text

98. Teixeira MG, Barreto ML. Diagnosis and management of dengue. BMJ. 2009 Nov 18;339:b4338. Abstract

99. Centers for Disease Control and Prevention. CDC DENV-1-4 real-time RT-PCR assay for detection and serotype identification of dengue virus. July 2013 [internet publication].Full text

100. Lima Mda R, Nogueira RM, Schatzmayr HG, et al. Comparison of three commercially available dengue NS1 antigen capture assays for acute diagnosis of dengue in Brazil. PLoS Negl Trop Dis. 2010 Jul 6;4(7):e738.Full text  Abstract

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