title: Impact of the availability of an influenza virus rapid antigen test on diagnostic decision making in a pediatric emergency department.
abstract: OBJECTIVE
  Fever is one of the most commonly seen symptoms in the pediatric emergency department. The objective of this study was to observe how the rapid testing for influenza virus impacts on the management of children with fever.
  
  
  METHODS
  We performed a review of our pediatric emergency department records during the 2008/2009 annual influenza season. The BinaxNow Influenza A+B test was performed on patients with the following criteria: age 1.0 to 16.0 years, fever greater than 38.5 °C, fever of less than 96 hours' duration after the onset of clinical illness, clinical signs compatible with acute influenza, and nontoxic appearance. Additional laboratory tests were performed at the treating physician's discretion.
  
  
  RESULTS
  The influenza rapid antigen test was performed in 192 children. One hundred nine (57%) were influenza positive, with the largest fraction (101 patients) positive for influenza A. The age distribution did not differ between children with negative and positive test results (mean, 5.3 vs. 5.1 years, not statistically significant). A larger number of diagnostic tests were performed in the group of influenza-negative patients. Twice as many complete blood counts, C-reactive protein determinations, lumbar punctures, and urinalyses were ordered in the latter group.
  
  
  CONCLUSIONS
  Rapid diagnosis of influenza in the pediatric emergency department affects the management of febrile children as the confirmation of influenza virus infection decreases additional diagnostic tests ordered.
authors.affiliation: Department of Pediatrics, University of Bern, Inselspital, CH-3010 Bern, Switzerland. katayun88@hotmail.com
authors.forename: Katayun
authors.initials: K
authors.lastname: Hojat
authors.forename: Andrea
authors.initials: A
authors.lastname: Duppenthaler
authors.forename: Christoph
authors.initials: C
authors.lastname: Aebi
mesh_terms: D000293:Adolescent; D000956:Antigens, Viral / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D042241:Early Diagnosis; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005334:Fever / Q000209:etiology; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D009980:Influenza A virus / Q000276:immunology*; D009981:Influenza B virus / Q000276:immunology*; D007251:Influenza, Human / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D009305:Nasopharynx / Q000821:virology; D012189:Retrospective Studies; D012621:Seasons; D013557:Switzerland / Q000453:epidemiology
chemical_list: D000956:Antigens, Viral