[Etiology of acute fever without source in infants consulting at an emergency department].
Fever is a frequent symptom of consultation in Pediatric Emergency Department.


OBJECTIVE
to describe causes of acute fever of unknown origin (FUO) in infants under 36 months of age, the utility of requested tests and pediatrician decisions.


METHODS
309 cards of children under 36 months who consulted at Emergency Department for acute FUO were reviewed.


RESULTS
64 % were classified with well clinical condition. Most frequent causes were: probable viral respiratory infections (72%), urinary tract infection (7.4%), pneumonia (2.9%), bacteremia (1.9%), and bacterial meningitis (1.3%). Streptococcus pneumoniae was the most frequent agent isolated from blood cultures. Tests of best utility were: urine analysis and urine culture. Leukocytes count < 15.000/mm(3) and PCR < 4.0 mg/dl had a negative predictive value of 96 %. Nine point seven percent of the patients were hospitalized, while 14.2% received antibiotic treatment at home.


CONCLUSIONS
We suggest to perform urine analysis and culture as the initial study for children with acute FUO and well clinical condition.
Brockmann V
Pablo
P
Departamento de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. pbrockmann@gmail.com
Ibarra G
Ximena
X
Silva W
Ignacia
I
Hirsch B
Tamara
T
D000208:Acute Disease; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications* / Q000188:drug therapy; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005335:Fever of Unknown Origin / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007958:Leukocyte Count; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D000900:Anti-Bacterial Agents