title: Current challenges in the diagnosis and management of fever.
abstract: OBJECTIVE
  We review recommendations from recent publications on the management of fever with antipyretics, the classification and diagnosis of fevers of unknown origin (FUO), and the evaluation of fever in infants under 90 days of age.
  
  
  RESULTS
  Anxiety about fever persists in the population, while the toxicity of antipyretics is an increasing concern. The numerous opportunities for overdosing with antipyretics have been emphasized by the American Academy of Pediatrics (AAP). The practice of alternating acetaminophen and ibuprofen has limited value. Nonclassic FUO and pseudo-FUO are as important to consider as true FUO, and clinicians should become familiar with the variety of periodic fever syndromes. The clinical utility of low-risk criteria to identify febrile infants at low risk for serious bacterial infection (SBI) was demonstrated in a systematic review of studies.
  
  
  CONCLUSIONS
  Pediatricians should spend more time educating parents about fever and antipyretic use. Not all persistent fever is FUO, and testing should be targeted to the child's clinical condition. Existing low-risk criteria should be used to identify febrile infants who can be managed without extensive work-up and antibiotics. Adherence to evidence-based recommendations will lessen the morbidity and mortality associated with febrile illnesses in children.
authors.affiliation: Department of Pediatric Emergency Medicine, Cohen Children's Medical Center of New York, USA.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Sherman
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Sood
mesh_terms: D058633:Antipyretics / Q000009:adverse effects / Q000627:therapeutic use*; D001294:Attitude to Health; D010505:Familial Mediterranean Fever / Q000175:diagnosis; D005334:Fever / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D005335:Fever of Unknown Origin / Q000175:diagnosis; D006266:Health Education / Q000379:methods; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010290:Parents / Q000523:psychology; D010698:Phobic Disorders / Q000517:prevention & control
chemical_list: D058633:Antipyretics