title: Pattern of febrile illnesses in children seen at a pediatric ambulatory care setting.
abstract: BACKGROUND
  Fever is the most common sign of childhood illnesses and febrile children constitute a substantial proportion of the practice of pediatrics and family medicine.
  
  
  OBJECTIVE
  To highlight the pattern of febrile illnesses in children attending pediatric ambulatory health-care settings.
  
  
  METHODS
  A one-year prospective study was conducted on febrile children who were consecutively seen and managed at two walk-in primary-care clinics in Sulaimania Children's Hospital, Riyadh. Data collection and analysis were structured around the principal study objectives.
  
  
  RESULTS
  Among the 16,173 children seen, 4086 (25.3%) were identified as having a fever and evaluated to determine the aetiology of their febrile illness. Boys outnumbered girls and a significant increase in the frequency of febrile illnesses was noted in children 4 to 24 months of age. Upper respiratory tract infections were the commonest cause of fever (75%) and most of these infections were viral rhinopharyngitis. Viral gastroenteritis and pneumonia were prominent diagnoses, each accounting for 5% of febrile illnesses. Notably of low frequency were serious bacterial infections, such as meningitis (0.5%), cellulitis and bone or joint infection (1.8%) and urinary tract infection (0.7%). Only 9% of the febrile children required hospitalization. The ambulatory management of the other febrile children included the prescription of oral antibiotics to 64% of them.
  
  
  CONCLUSIONS
  The proper clinical assessment of these febrile children and the prudent use of laboratory tests and antimicrobials remain the most important management strategies in primary health-care practice.
authors.affiliation: Department of Pediatrics, College of Medicine, King Saud University , Riyadh, Saudi Arabia.
authors.forename: Y A
authors.initials: YA
authors.lastname: Al-Eissa
authors.forename: S S
authors.initials: SS
authors.lastname: Ghazal
authors.forename: F A
authors.initials: FA
authors.lastname: Al-Zamil
authors.forename: A A
authors.initials: AA
authors.lastname: Al-Salloum
authors.forename: A O
authors.initials: AO
authors.lastname: Al-Omair
authors.forename: M N
authors.initials: MN
authors.lastname: Al-Nasser