Current challenges in the diagnosis and management of fever.

Abstract:

PURPOSE OF REVIEW: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. RECENT FINDINGS: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. SUMMARY: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.

journal_name

Curr Opin Pediatr

authors

Sherman JM,Sood SK

doi

10.1097/MOP.0b013e32835333e3

subject

Has Abstract

pub_date

2012-06-01 00:00:00

pages

400-6

issue

3

eissn

1040-8703

issn

1531-698X

journal_volume

24

pub_type

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