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Fever is a very common reason for consultation among children attending the emergency department. Most of these children have a self-limiting viral infection. Nevertheless, despite advances in vaccinations and antibiotics, serious infections remain significant causes of death of children. Early identification of children with serious bacterial infections is essential to initiate immediate antibiotic therapy. But, identification of these patients may be difficult, mainly in an overcrowded emergency department, in which most of the incoming patients appear well. In fact, a large number of children with an invasive bacterial infection are not identified at first contact.1
Different efforts have been made in order to identify children at low risk and high risk for serious bacterial infection. In this way, the appearance of the child, the vital signs and certain laboratory data are useful to identify these children.
In selected populations, complementary tests are helpful to identify children at high risk or low risk of serious bacterial infection. Classically, leucocyte count has been used to identify children with serious bacterial infection. During the last decades, new blood tests such as C reactive protein (CRP) and, mainly, procalcitonin (PCT) have shown a better performance. Thus, leucocyte indicators are less valuable than inflammatory markers for …
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.
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