Pediatric fever of uncertain source: Difference between revisions
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==See Also== | ==See Also== | ||
[[UTI (Peds)]] | [[UTI (Peds)]] | ||
[[Sepsis (Peds)]] | |||
[[Meningitis (Peds)]] | |||
==Source== | ==Source== |
Revision as of 01:29, 14 June 2011
Management of patients who are Well-Appearing, vaccinated, and no clinical source of fever
Age Group | Evaluation | Treatment |
0-28d, ≥38C SBI incidence of ill appearing: 13%–21% if not ill appearing: <5% |
CBC, blood Cx UA, Ucx CSF cell count, GS, Cx CXR (only if resp sx) Stool testing (if diarrhea present) |
Admit Ampicillin 50mg/kg + (cefotaxime 50mg/kg or gentamicin 2.5mg/kg) |
29-56d, ≥ 38.2 (100.8) (Philadelphia Protocol)
if not ill appearing: <5%
|
Same as for neonates |
Discharge if: 1. WBC <15K but >5K and <20% bands 2. UA negative Admit if above are not met and treat with CTX 50mg/kg if CSF normal, 100mg/kg if signs of meningitis |
57d-6mo, ≥38
UTI is 3%–8%
|
UA and Ucx alone OR treat 57-90d using Philadelphia Protocol |
Discharge if negative Treat UTI w/ cefixime 8mg/kg/d or cefpodoxime 10mg/kg/d divided into BID or cefdinir 14mg/kg/d x 7-10days as outpatient Admit and tx with CTX if fail criteria for d/c |
57d-6mo, ≥39 (102.2)
|
UA and Ucx alone OR UA and Ucx + CBC + blood cx |
|
6–36 mo
|
UA and Ucx in: girls 6-24mo boys 6-12mo uncirc 12-24mo |
Discharge if negative Treat for UTI as above as outpatient |
>36mo | No further w/u is routinely necessary |
See Also
UTI (Peds) Sepsis (Peds) Meningitis (Peds)
Source
Tintinalli