Office pediatrics: Fever without apparent source on clinical examination, infectious diseases, and lower respiratory infections in children

Current Opinion in Pediatrics

Volumn 10, Issue 1, 1998, Pages 101-116

  McCarthy, Paul L ^a   Kahn, Jeffrey S ^b   Shapiro, Eugene ^b   Klig, Jean ^b  

^a YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

ANTIBIOTIC AGENT; ANTIVIRUS AGENT; POLIOMYELITIS VACCINE;

CHILD; CLINICAL EXAMINATION; FEVER; HERPES; HUMAN; IDIOPATHIC DISEASE; IMMUNIZATION; INFANT; LOWER RESPIRATORY TRACT INFECTION; POLIOMYELITIS; PRIORITY JOURNAL; REVIEW; STREPTOCOCCUS AGALACTIAE; COMMUNICABLE DISEASE; HERPES SIMPLEX; MYCOPLASMA PNEUMONIA; NEWBORN; PATHOPHYSIOLOGY; POLYMERASE CHAIN REACTION; PRACTICE GUIDELINE; PRESCHOOL CHILD; PYREXIA IDIOPATHICA; RESPIRATORY TRACT DISEASE; STREPTOCOCCUS INFECTION;

CHILD, PRESCHOOL; COMMUNICABLE DISEASES; FEVER OF UNKNOWN ORIGIN; HERPES SIMPLEX; HUMANS; INFANT; INFANT, NEWBORN; PNEUMONIA, MYCOPLASMA; POLIOMYELITIS; POLIOVIRUS VACCINE, INACTIVATED; POLYMERASE CHAIN REACTION; PRACTICE GUIDELINES; RESPIRATORY TRACT DISEASES; STREPTOCOCCAL INFECTIONS; STREPTOCOCCUS AGALACTIAE;

EID: 0031943353     PISSN: 10408703     EISSN: None     Source Type: Journal    
DOI: 10.1097/00008480-199802000-00021     Document Type: Review

References (94)

1. 2 formation in cerebral microvessels and brain parenchemya: implications for the pathogenesis of fever. Cytokine 1996, 8:371-376.
2. Sofer S, Yerushalmi B, Shahak E, Berenstein T, Schulman H: Possible etiology of haemorrhagic shock and encephalopathy syndrome in the Negev area of Israel. Arch Dis Child 1996, 75:332-334.
3. Beckstrand RL, Moran S, Wilshaw R, Schaalje GB: Supralingual temperatures compared to tympanic and rectal temperatures. Pediatric Nursing 1996, 22:436-438.
4. Zengeya ST, Blumenthal L: Modern electronic and chemical thermometers used in the axilla are inaccurate. Eur J Pediatr 1996, 155:1005-1008.
5. Timmermans DRM, Sprij AJ, DeBel CE: The discrepancy between daily practice and the policy of a decision-analytic model: The management of fever of unknown origin. Med Decis Making 1996, 16:357-366.
6. Downs SM, McNutt RA, Margolis PA: Management of infants at risk for occult bacteremia: A decision analysis. J Pediatr 1991, 118:11-20.
7. Lieu TA, Schwarte JS, Jaffe DM, Fleisher GR: Strategies for diagnosis and treatment of children at risk for occult bacteremia: clinical effectiveness and cost-effectiveness. J Pediatr 1991, 118:21-29.
8. Schriger DL: Clinical guidelines in the setting of incomplete evidence. Pediatrics 1997, 100:136. Relates the controversy about the diagnosis and management of occult bacteremia to a difference in perspective between physicians based in office practice and those in hospital facilities, such as an Emergency Department. The analysis is very persuasive.
9. Edwards A, Pill R: Patterns of help-seeking behavior for toddlers from two contrasting socio-economic groups: new evidence on a neglected topic. Fam Prac 1996, 13:377-381.
10. Kai J: What worries parents when their preschool children are acutely ill and why: A qualitative study. BMJ 1996, 313:983-966. This study is based on interviews with 95 parents of preschool children. It identifies key parental concerns when children become acutely ill and potential interventions which address the specific concerns raised by parents.
11. McCarthy PL, Klig JE, Kahn JS, Shapiro ED, Baron MA: Fever without apparent source on clinical examination, Lower respiratory infections in children, Other infectious diseases and acute gastroenteritis and diarrhea of infancy and early childhood. Curr Opin Pediat 1997, 9:105-126.
12. Gottesman G, Vanunu D, Maayan MC, Lang R, Uziel Y, Sagi H, Wolach B: Childhood brucellosis in Israel. Pediatr Infect Dis J 1996, 15:610-615. Although brucellosis is not seen frequently, this article outlines the cardinal features of this interesting and diagnostically challenging entity. Joint involvement is an important part of the clinical picture.
13. Majeed HA, Rawashdeh M: The clinical patterns of arthritis in children with familial Mediterranean fever. Q J Med 1997, 90:37-43. This article also focuses on an entity which is diagnostically challenging, familial mediterranean fever. Forty percent of children developed joint complaints -arthralgia or arthritis primarily of the knee or ankle which often appeared acutely and which resolved most often in a week or less. This entity should be considered in children with fever and acute joint complaints.
14. Chiu C-H, Lin T-Y, Bullard MJ: Identification of febrile neonates unlikely to have bacterial infections. Pediatr Infect Dis J 1997, 16:59-63.
15. Elzoobi K, Hoff C, O'Connor T: Letter to the Editor. Pediatr Emerg Care 1997, 13:85-86.
16. Durongpisitkul K, Gururaj VJ, Martin CF: The appropriateness of early discharge of hospitalized children with suspected sepsis. Jour Family Practice 1997, 44:91-96.
17. Baraff LJ, Bass JW, Fleisher GR, Klein JO, McCracken GH Jr., Powell KR, Schriger DL: Practice guideline for the management of infants and children 0 to 36 months of age with fever without source. Pediatrics 1993, 92:1-12.
18. Kramer MS, Shapiro ED: Management of the young febrile child: A commentary on recent practice guidelines. Pediatrics 1997, 100:128-134. This article focuses on guidelines for the diagnosis and management of febrile children 3 to 36 months of age. It appeared in an issue of Pediatrics in July, 1997. The authors provide a counter-point to published guidelines on the management of young febrile children. They do so by analyzing thoroughly the issue of occult bacteremia and the limitation of meta-analytic techniques which have been used as a basis for formulating guidelines.
19. Fleisher GR, Rosenberg N, Vince R, Steinberg J, Powell K, Christy C, Boenning DA, Overturf G, Jaffe D, Platt R: Intramuscular versus oral antibiotic therapy for the prevention of meningitis and other bacterial sequellae in young febrile children at risk for occult bacteremia. J Pediatr 1994, 124:504-512.
20. Baraff LJ, Bass JW, Fleisher GR, Klein JO, McCracken, GH Jr., Powell KR. Commentary on practice guidelines. Pediatrics 1997, 100:134-135.
21. Bauchner H, Pelton SI: Management of the young febrile child: A continuing controversy. Pediatrics 1997, 100:137-138.
22. Reed RP, Friedland IR, Wegerhoff FO, Khoosal M: Campylobacter bacteremia in children. Pediatr Infect Dis J 1996,15:345-348.
23. Nathoo KJ, Chigonde S, Nhembe M, Ali MH, Mason PR: Community-acquired bacteremia in human immunodeficiency virus-infected children in Harare, Zimbabwe. Pediatr Infect Dis J 1996, 15:1092-1097.
24. Orlicek SL, Herrod HG, Leggiadro RJ, Luedtke G, English BK: Repeated invasive pneumococcal infections in young children without apparent underlying immunodeficiency. J Pediatr 1997, 130:284-288. The authors report that children, especially those in the first 2 to 3 years of life, may have a recurrent episode of invasive pneumococcal disease and yet may have normal immunologic function tests and do well on follow-up. This article reports on 10 such children of a total of 394 evaluated for invasive pneumococcal disease over a 30 month period at a Children's Hospital (Memphis, TN).
25. Roberts GJ, Holzel HS, Sury MRJ, Simmons NA, Gardner P, Longhurst P: Dental bacteremia in children. Pediatr Cardiol 1997, 18:24-27. This study is carefully done and, in reporting on a large group of children, demonstrates that bacteremia after common dental procedures is frequent. Study results emphasize the need for antibiotic prophylaxis before dental procedures in children with increased risk of focal complications from bacteremia.
26. El-Baba M, Tolia V, Lin C-H, Dajani A: Absence of bacteremia after gastrointestinal procedures in children. Gastrointest Endosc 1996, 44:378-381.
27. Mermin J, Hoar B, Angulo FJ. Iguanas and Salmonella marina infection in children: a reflection of the increasing incidence of reptile-associated salmonellosis in the United States. Pediatrics 1997, 99:399-402.
28. Begovac J, Kuzmanovic N, Bejuk D: Comparison of clinical characteristics of Group A streptococcal bacteremia in children and adults. Clin Infect Dis 1996, 23:97-100.
29. Aebi C, Ahmed A, Ramilo O: Bacterial complications of primary varicella in children. Clin Infect Dis 1996, 23:698-705.
30. Peterson CL, Vugia DJ, Meyers HB, Chao SM, Vogt J, Lanson J, Brunell PA, Kim KS, Mascola L: Risk factors for invasive group A streptococcal infections in children with varicella: A case-control study. Pediatr Infect Dis J 1996, 15:151-156.
31. Doctor A, Harper MB, Fleisher GR: Group A B hemolytic streptococcal bacteremia.: historical overview, changing incidence and recent association with varicella. Pediatrics 1995, 96:428-433.
32. Vichinsky EP, Styles LA, Colangelo LH, Wright EC, Castro O, Nickerson B, and the Cooperative Study of Sickle Cell Disease: Acute chest syndrome in Sickle Cell Disease: Clinical presentation and course. Blood 1997, 89:1787-1792. This study is based on an experience with 3751 patients throughout the United States. It found that, as compared with adults, children with ACS more often are febrile, have upper lobe infiltrates and have bacteremia, that is, ACS in children is more likely due to infection than in adults. Careful consideration of infection is warranted in children with sickle cell disease and acute chest complaints.
33. Wright J, Thomas P, Serjeant GR: Septicemia caused by salmonella infection: An overlooked complication of sickle cell disease. J Pediatr 1997, 130:394-399. This series is based on experience over a 22 year period in a referral center in the West Indies. By the time children with sickle cell disease were 15 years of age, 8.6% had either bacteremia or osteomyelitis with Salmonella. The authors argue, appropriately, that antibiotic coverage in undiagnosed septic conditions in patients with sickle cell disease should include coverage for Salmonella.
34. Newcombe J, Cartwright K, Palmer WH, McFadden J: PCR of peripheral blood for diagnosis of meningococcal disease. Journal of Clinical Microbiology 1996, 34:1637-1640. The PCR in which DNA is amplified holds promise for diagnosing infectious agents in children with fever without apparent source. This article demonstrates that subtle variations in the test methods-such as using blood buffy coat versus serum-affect test results. This study adds to a growing data base about the utility of PCR in febrile children.
35. Schwartz GR, Wright SW: Changing bacteriology of periorbital cellulitis. Annals of Emergency Medicine 1996, 28:617-620.
36. Cohen HA, Wolach B, Linder N, Vardi A, Barzilai A: Urine samples from disposable diapers: an accurate method for urine cultures. The Journal of Family Practice 1997, 44:290-292.
37. Hoberman A, Wald ER, Reynolds EA, Penchansky L, Charron M: Is urine culture necessary to rule out urinary tract infection in young febrile children. Pediatr Infect Dis J 1996, 15:304-309. This article, reports on an extensive experience of diagnosing and managing urinary tract infection in children presenting with fever. One may disagree with the authors conclusions but the information discussed in both articles should be part of the data base of physicians who care for children presenting with fever.
38. Hoberman A, Wald ER: Urinary tract infections in young febrile children. Pediatr Infect Dis J 1997, 16:11-17.
39. Brown ZA, Selke S, Zeh J, Kopelman J, Maslow A, Ashley RL, Watts DH, Berry S, Herd M, Corey L: The acquisition of herpes simplex virus during pregnancy. N Engl J Med 1997, 337:509-515. Acquisition of HSV during pregnancy is studied over a 4 year period. All cases of neonatal HSV occurred in women infected near the time of delivery. No adverse outcomes were noted in women who seroconverted before the onset of labor.
40. Whitley R, Arvin A, Prober C, Corey L, Burchett S, Plotkin S, Starr S, Jacobs R, Powell D, Nahmias A, et al.: Predictors of morbidity and mortality in neonates with herpes simplex virus infections. The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. N Engl J Med 1991, 324:450-454.
41. Brown ZA, Benedetti J, Selke S, Ashley R, Watts DH, Corey L: Asymptomatic maternal shedding of herpes simplex virus at the onset of labor: relationship to preterm labor. Obstet Gynecol 1996, 87:483-488. Asymptomatic shedding of genital HSV in infected women is found to be associated with preterm delivery (though this was not observed in the Brown et al. [N Engl J Med 1997, 337:509-515] study).
42. Brown ZA, Vontver LA, Benedetti J, Critchlow CW, Solls CJ, Berry S, Corey L: Effects on infants of a first episode of genital herpes during pregnancy. N Engl J Med 1987, 317:1246-1251.
43. Poliomyelitis prevention: recommendations for use of inactivated poliovirus vaccine and live oral poliovirus vaccine. American Academy of Pediatrics Committee on Infectious Diseases. Pediatrics 1997, 99:300-305. Rationale for change in polio immunization regimens is clearly described. Excellent overview.
44. Poliomyelitis prevention in the United States: introduction of a sequential vaccination schedule of inactivated poliovirus vaccine followed by oral poliovirus vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 1997, 46(RR-3):1-125. Comprehensive review of polio immunization strategies.
45. Strebel PM, Sutter RW, Cochi SL, Biellik RJ, Brink EW, Kew OM, Pallansch MA, Orenstein WA, Hinman AR: Epidemiology of poliomyelitis in the United States one decade after the last reported case of Indigenous wild virus-associated disease. Clin Infect Dis 1992, 14:568-579.
46. Expanded programme on immunization. Statement on poliomyelitis eradication. Wkly Epidemiol Rec 1995, 70:345-346.
47. Peter G, Halsey NA: Red Book committee considers increased IPV use. In AAP News 1995, 13.
48. Institute of Medicine: An Evaluation of Poliomyelitis Vaccine Policy Options. National Academy of Sciences 1988.
49. Modlin JF, Halsey NA, Thorns ML, Meschievitz CK, Patriarca PA: Humoral and mucosal immunity in infants Induced by three sequential inactivated poliovirus vaccine-live attenuated oral poliovirus vaccine immunization schedules. Baltimore Area Polio Vaccine Study Group. J Infect Dis 1997, 175(Suppl 1):S228-234. Sequential administration of IPV and TOPV is shown to be more effective in inducing neutralizing antibodies than IPV alone in a group of infants and children in the Baltimore area.
50. Onorato IM, Modlin JF, McBean AM, Thorns ML, Losonsky GA, Bernier RH: Mucosal immunity induced by enhance-potency inactivated and oral polio vaccines. J Infect Dis 1991, 163:1-6.
51. Plotkin SA: Inactivated polio vaccine for the United States: a missed vaccination opportunity. Pediatr Infect Dis J 1995, 14:835-839.
52. McBean AM, Thorns ML, Albrecht P, Cuthie JC, Bernier R: Serologic response to oral polio vaccine and enhanced-potency inactivated polio vaccines. Am J Epidemiol 1988, 128:615-628.
53. Faden H, Duffy L, Sun M, Shuff C: Long-term immunity to poliovirus in children immunized with live attenuated and enhanced-potency inactivated trivalent poliovirus vaccines. J Infect Dis 1993, 168:452-454.
54. Prevention of perinatal group B streptococcus disease: a public health perspective. Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep 1996, 45(RR-7):1-24. Comprehensive review and rationales for the screening and treatment of GBS disease in mothers and exposed newborns.
55. Boyer KM, Gotoff SP: Strategies for chemoprophylaxis of GBS early-onset infections. Antibiot Chemother 1985, 35:267-280.
56. Zangwill KM, Schuchat A, Wenger JD: Group B streptococcal disease in the United States, 1990: report from a multistate active surveillance system. MMWR CDC Surveill Summ 1992, 41:25-32.
57. Weisman LE, Stoll BJ, Cruess DF, Hall RT, Merenstein GB, Hemming VG, Fischer GW: Early-onset group B streptococcal sepsis: a current assessment. J Pediatr 1992, 121:428-433.
58. Boyer KM, Gotoff SP: Prevention of early-onset neonatal group B streptococcal disease with selective intrapartum chemoprophylaxis. N Engl J Med 1986, 314:1665-1669.
59. Allen UD, Navas L, King SM: Effectiveness of intrapartum penicillin prophylaxis in preventing early-onset group B streptococcal infection: results of a meta-analysis. Can Med Assoc J 1993, 149:1659-1665.
60. Boyer KM, Gotoff SP: Antimicrobial prophylaxis of neonatal group B streptococcal sepsis. Clin Perinatal 1988, 15:831-850.
61. American Academy of Pediatrics Committee on Infectious Diseases and Committee on Fetus and Newborn: Guidelines for prevention of group B streptococcal (GBS) infection by chemoprophylaxis. Pediatrics 1992, 90:775-778.
62. Murray CJL, Lopez AD: Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 1997, 349:1436-1442.
63. Anonymous: Antibiotic resistance among nasopharyngeal isolates of Streptococcus pneumoniae and haemophilus influenzae-Bangui, Central African Republic, 1995. MMWR Morbid Mortal Wkly Rep 1997, 46:62-64.
64. Qazi SA, Rehman GN, Khan MA: Standard management of acute respiratory infections in a children's hospital in Pakistan: impact on antibiotic use and case fatality. Bull World Health Organ 1996, 74:501-507.
65. Correa AG: Diagnostic Approach to Pneumonia in Children. Semin Respir Infect 1996, 11:131-138. Useful review of available options for diagnosing pneumonia.
66. Patwari AK, Bisht S, Srinivasan A, Deb M, Chattopadhya D: Aetiology of pneumonia in hospitalized children. J Trop Pediatr 1996, 42:15-20.
67. Gendrel D, Raymond J, Moulin F, Iniguez JL, Ravilly S, Habib F, Lebon P, Kalifa G: Etiology and response to antibiotic therapy of community-acquired pneumonia in French children. Eur J Clin Microbiol Infect Dis 1997, 16:388-391.
68. Gupta D, Mishra S, Chaturvedi P: Fast Breathing in the Diagnosis of Pneumonia - A Reassessment. J Trop Pediatr 1996, 42:196-199.
69. Cherian T, Steinhoff MC, Simoes E, John TJ: Clinical signs of acute lower respiratory tract infections in malnourished infants and children. Pediatr Infect Dis J 1997, 16:490-494.
70. Taylor J, DelBeccaro M, Done S, Winters W: Establishing clinically relevant standards of tachypnea in febrile children younger than 2 years. Arch Pediatr Adolesc Med 1995, 149:283-287.
71. Weber MW, Usen S, Palmar A, Jaffar S, Mulholland EK: Predictors of hypoxaemia in hospital admissions with acute lower respiratory tract infection in developing country. Arch Dis Child 1997, 76:310-314.
72. Davies HD, Wang EEL, Manson D, Babyn P, Shuckett B: Reliability of the chest radiograph in the diagnosis of lower respiratory infections in young children. Pediatr Infect Dis J 1996, 15:600-603. Interesting study of variations within and between radiologists in the interpretation of lower respiratory infections on chest radiographs.
73. Jadavji T, Law B, Lebel MH, Kennedy WA, Gold R, Wang EE: A practical guide for the diagnosis and treatment of pediatric pneumonia. Can Med Assoc J 1997, 156:8703-8711. Outstanding critical review of LRI diagnosis and treatment that is highly recommended.
74. Korppi M, Heiskanen-Kosma T, Leinonen M: White blood cells, C-reactive protein and erythrocyte sedimentation rate in pneumococcal pneumonia in children. Eur Respir J 1997, 10:1125-1129.
75. Hams JS: Antimicrobial Therapy of Pneumonia in Infants and Children. Semin Respir Infect 1996, 11:139-147. Useful review though it recommends use of ceftriaxone that is controversial.
76. Pichichero ME: Empiric antibiotic selection criteria for respiratory infections in pediatric practice. Pediatr Infect Dis J 1997, 16(Suppl 3):S60-S64. Useful review of current issues regarding pertussis.
77. Pasternack MS: Pertussis in the 1990's: diagnosis, treatment, and prevention. Curr Top Infect Dis 1997, 17:24-36.
78. Lindgren C, Milerad J, Lagercrantz H: Sudden infant death and prevalence of whooping cough in the Swedish and Norwegian communities. Eur J Pediatr 1997, 156:405-409.
79. Aoyama T, Kato T, Takeuchi Y, Kato K, Morokuma K, Hirai T: Simple, speedy, sensitive and specific serodiagnosis of pertussis by using a particle agglutination test. J Clin Microbiol 1997, 35:1859-1861.
80. Halperin SA, Bortolussi R, Langley JM, Miller B, Eastwood BJ: Seven days of erythromycin estolate is as effective as fourteen days for the treatment of Bordetella pertussis infections. Pediatrics 1997, 100:65-71.
81. Jacobson SJ, Griffiths K, Diamond S, Winders P, Sgro M, Fledman W, Macarthur C: A Randomized Controlled Trial of Penicillin vs Clindamycin for the Treatment of Aspiration Pneumonia in Children. Arch Pediatr Adolesc Med 1997, 151:701-704.
82. Leong MA, Nachajon R, Ruchelli E, Allen JL: Bronchitis Obliterans Due to Mycoplasma Pneumonia. Pediatr Pulmonol 1997, 23:375-381.
83. Tay YK, Huff JC, Weston WL: Mycoplasma pneumoniae infection is associated with Stevens-Johnson syndrome, not erythema multiforme (von Hebra). J Am Acad Dermatol 1996, 35:757-760.
84. Falck G, Gnarpe J, Gnarpe H: Prevalence of Chlamydia pneumoniae in healthy children and in children with respiratory tract infections. Pediatr Infect Dis J 1997, 16:549-554.
85. Khan MA, Potter CW: The nPCR of detection of Chlamydia pneumoniae and Chlamydia trachomatitis in children hospitalized for bronchiolitis. J Infect 1996, 33:173-175.
86. Woo PCY, Chiu SS, Seto WH, Peiris M: Cost-Effectiveness of Rapid Diagnosis of Viral Respiratory Tract Infections in Pediatric Patients. J Clin Microbiol 1997, 35:1579-1581.
87. Klassen TP: Recent Advances in the Treatment of Bronchiolitis and Laryngitis. Pediatr Clin North Am 1997, 44:249-261. Outstanding critical review of the treatment of bronchiolitis and croup.
88. Flores G, Horwitz R: Efficacy of beta2-agonists in bronchiolitis: a reappraisal and meta-analysis. Pediatrics 1997, 100:233-239. Interesting examination of the available data to support current widespread use of beta-agonists for treatment of bronchiolitis.
89. van Woensel JBM, Wolfs FW, van Aalderen WMC, Kimpen JLL: Randomized double blind placebo controlled trial of prednisolone in children admitted to hospital with respiratory syncytial virus bronchiolitis. Thorax 1997, 52:634-637.
90. Wandstrat TL: Respiratory syncytial virus immune globulin intravenous. Ann Pharmacother 1997, 31:83-88. Detailed review of RSV-immune globulin therapy.
91. Dezateux C, Fletcher M, Dundas I, Stocks J: Infant respiratory function after RSV-proven bronchiolitis. Am J Respir Crit Care Med 1997, 155:1349-1355.
92. Merth IT, de Winter JP, Zonderland HM, Brand R, Quanjer PH: Pulmonary function during the first year of life following acute viral bronchiolitis. Am J Respir Crit Care Med 1996, 154:689-694.
93. Krilov LR, Mandel FS, Barone SR, Fagin JC, The Bronchiolitis Study Group: Follow-up of children with respiratory syncytial virus bronchiolitis in 1986 and 1987: potential effect of ribavirin on long term pulmonary function. Pediatr Infect Dis J 1997, 16:273-276.
94. Kolnaar BGM, Folgering H, van den Hoogen HJM, van Weel C: Asymptomatic bronchial hyperresponsiveness in adolescents and young adults. Eur Respir J 1997, 10:44-50.