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In children under age three does procalcitonin help exclude serious bacterial infection in fever without focus?

Edited by Bob Phillips

Children’s Emergency Department Fellow, Starship Children’s Hospital, Auckland, New Zealand; david.herd@mac.com

The first 150 words of the full text of this article appear below.

A 4-month-old boy presents with a fever of 38.9°C and no focus on clinical examination. He does not appear septic and clean catch urine is normal. There are no respiratory symptoms and no clinical signs of meningitis. You think he has a low risk of a serious bacterial illness. You wonder if procalcitonin can help you exclude serious bacterial illness that may need antibiotics?

Structured clinical question
In children under three with a temperature >38.5°C and no clinical focus of infection [subject], is measurement of procalcitonin [intervention] a good screening test to exclude serious bacterial illness [outcome]?

Search strategy and outcome
Details of papers examined are given in table 1. Please see http://www.bestbets.org/cgi-bin/bets.pl?record=00597 for further information.