title: Duration of fever and course of symptoms in young febrile children presenting with uncomplicated illness.
abstract: OBJECTIVE
  It is important to advise parents when to consult a doctor when their child has fever. To provide evidence-based, safety-net advice for young febrile children, we studied the risk of complications, the occurrence of alarm symptoms, the duration of fever.
  
  
  METHODS
  In a 7-day prospective follow-up study, we included 463 consecutive children aged 3 months to 6 years who presented with fever at a general practitioner out-of-hours service. We excluded 43 children with complicated illnesses at presentation. In a structured assessment, the duration of fever before presentation was noted and a physical examination was performed. Parents reported alarming symptoms and rectal temperature in a diary for 1 week. The total duration of fever included its duration before presentation. Median duration of fever was estimated using the Kaplan-Meier test.
  
  
  RESULTS
  During follow-up, 3.2% of the children with uncomplicated illness at presentation developed a complicated illness. The presence of alarming symptoms dropped from 79.3% at day 2 of the fever episode to 36.7% at day 9. The estimated median duration of the total fever episode was 4.0 days (95% confidence interval, 3.6-4.4).
  
  
  CONCLUSIONS
  In children with uncomplicated illnesses, the daily occurrence of alarming symptoms reported by parents was high. The median duration of fever was 4 days. The predictive value of alarming symptoms reported by parents for complicated illness should be reconsidered.
authors.affiliation: Department of General Practice, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Marijke
authors.initials: M
authors.lastname: Kool
authors.forename: Gijs
authors.initials: G
authors.lastname: Elshout
authors.forename: Henriette A
authors.initials: HA
authors.lastname: Moll
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
authors.forename: Johannes C
authors.initials: JC
authors.lastname: van der Wouden
authors.forename: Marjolein Y
authors.initials: MY
authors.lastname: Berger
mesh_terms: D039602:After-Hours Care; D001831:Body Temperature; D002675:Child, Preschool; D005194:Family Practice; D005260:Female; D005334:Fever / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D006266:Health Education; D006801:Humans; D007223:Infant; D008297:Male; D008499:Medical Records; D009426:Netherlands; D010290:Parents; D011446:Prospective Studies; D014218:Triage
keywords: Body Temperature; Child; Family Practice; Fever; Infant; Preschool Child