scholarly journals The Significance of Clinical and Laboratory Findings in Predicting Serious Bacterial Infections in Children With Acute Fever Without a Focus

2020 ◽  
Vol 54 (4) ◽  
pp. 195-203
Author(s):  
Hasan Demir ◽  
Medine Ayşin Taşar
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Blood Count ◽  
Biochemical Indicators ◽  
Clinical Scales ◽  
Severe Bacterial Infection ◽  
Observation Scale ◽  
Erythrocyte Sedimentation ◽  
Serious Bacterial Infections ◽  
Yale Observation Scale

Objective: Fever is among most common causes of admission to hospital in childhood. In 20% of febrile infants and children, no focus can be identified by physical examination and this group is defined as “acute fever without a focus” (AFWF). Bacteremia (5%), and serious bacterial infection (15%) is determined in of children with AFWF. Clinical scales and laboratory tests are used to detect the risk of occult bacteremia and serious bacterial infection in children with AFWF This study aimed to determine relation between biochemical indicators and YALE Observation Scale, besides, rates of clinical scales and biochemical indicators predicting serious bacterial infections, in 3-36 months children with AFWF. Material and Methods: This study was performed prospectively, in 77 cases, between 3-36 months of AFWF. Low risk criteria was evaluated by performing YALE Observation Scale in children. Complete blood count, absolute neutrophil count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin 6, procalcitonin, urine analysis, chest x-ray, cerebrospinal fluid (CSF) examination; blood, urine and CSF cultures were obtained. Results: The mean age of the patients was 11.0 (4-36) months, 64.9% (n= 50) were boys. Most commonly AFWF recovered in patients (35.0%), and urinary tract infection was diagnosed (32.5%). Severe bacterial infection was determined in 44.2%. When patient groups with and without severe bacterial infection were compared, white blood count, ESH, CRP, and procalcitonin were significantly higher in severe bacterial infection (p< 0.05). Erythrocyte sedimentation rate had highest specificity (87.5%) in discriminating between groups with and without severe bacterial infection. Conclusion: In conclusion, AFWF mostly recovered in children at 3-36 months, and urinary tract infection was common cause. White cell count, ESR, CRP and procalcitonin were found valuable in predicting serious bacterial infection. Further studies are needed to predict interleukin-6 value relevant to serious bacterial infection.

scholarly journals Fever without a focus in children 0-36 months of age

2006 ◽  
Vol 59 (3-4) ◽  
pp. 187-191 ◽  
Author(s):  
Svetlana Kuzmanovic ◽  
Nevenka Roncevic ◽  
Aleksandra Stojadinovic
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Medical Care ◽  
Bacterial Infections ◽  
Clinical Presentation ◽  
Febrile Illness ◽  
Empirical Antibiotic Therapy ◽  
Focus Of Infection ◽  
Serious Bacterial Infections ◽  
Yale Observation Scale

Introduction. About 20% of fevers in childhood have no apparent cause. A small, but significant number of these children may have a seroius bacterial infection. Fever without a focus of infection is an acute febrile illness with rectal temperature of 38?C or higher in children younger than 36 months, without localizing signs or symptoms. Practice Guidelines for Medical Care. In this article, practical recommendations for medical care of febrile children 0-36 months of age are given, bearing in mind children's age, clinical presentation (toxic manifestations) and risk for serious bacterial infection (sepsis, meningitis, pneumonia, urinary tract infection...). Toxic appearance is a clinical presentation characterized by lethargy, poor perfusion, marked hypo/hyperventilation and cyanosis. All febrile children under 36 months of age, who are appearing toxic, require hospitalization, evaluation for sepsis and administration of empirical antibiotic therapy. All febrile neonates, however, must be hospitalized: cultures of blood, urine and spinal fluid should be taken and empirical antibiotic therapy administered immediately. Febrile infants, 28 to 90 days of age, need to be evaluated in order to determine whether they are in the low-risk group for serious bacterial infections (Rochester Criteria). Yale Observation Scale is recommended to assess febrile children aged 3-36 months, and the risk of occult bacteriemia. Febrile children, 3-36 months of age who appear well, with temperature of less than 39?C without focus, should be closely followed up without laboratory tests and antibiotics and 2-3 days later reexamined. In febrile children, 3-36 months old, with temperature of 39?C and above, without toxic manifestations, blood culture should be taken and ceftriaxone 50 mg/kg/in a single dose should be given, if leukocyte count is 15000/mm? or absolute neutrophil count is over 10.000/mm? .

The Accuracy of the Yale Observation Scale Score and Unstructured Clinician Suspicion to Identify Febrile Infants Aged <=60 Days with Serious Bacterial Infections:

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 296A-296A
Author(s):  
Lise E. Nigrovic ◽  
Prashant V. Mahajan ◽  
Leah Tzimenatos ◽  
Elizabeth R. Alpern ◽  
Alexander J. Rogers ◽  
...  
Keyword(s):  
Scale Score ◽  
Bacterial Infections ◽  
Observation Scale ◽  
Serious Bacterial Infections ◽  
Yale Observation Scale

scholarly journals The Yale Observation Scale Score and the Risk of Serious Bacterial Infections in Febrile Infants

PEDIATRICS ◽  
2017 ◽  
Vol 140 (1) ◽  
pp. e20170695 ◽  
Author(s):  
Lise E. Nigrovic ◽  
Prashant V. Mahajan ◽  
Stephen M. Blumberg ◽  
Lorin R. Browne ◽  
James G. Linakis ◽  
...  
Keyword(s):  
Scale Score ◽  
Bacterial Infections ◽  
Observation Scale ◽  
Serious Bacterial Infections ◽  
Yale Observation Scale

Bacterial Infection and Splenic Reticuloendothelial Function in Children with Hemoglobin SC Disease

PEDIATRICS ◽  
1983 ◽  
Vol 72 (1) ◽  
pp. 93-98
Author(s):  
George R. Buchanan ◽  
Susan J. Smith ◽  
Christine A. Holtkamp ◽  
John P. Fuseler
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Infection Risk ◽  
Bacterial Disease ◽  
Normal Children ◽  
Splenic Function ◽  
Focus Of Infection ◽  
Serious Bacterial Infections ◽  
Primary Focus ◽  
Hemoglobin Sc Disease

Although the epidemiology and pathophysiology of serious bacterial infection in homozygous sickle cell anemia (SS disease) have become increasingly well understood, information about infection risk and splenic reticuloendothelial function in hemoglobin SC disease is quite limited. Therefore, the type and frequency of invasive bacterial disease were examined in 51 children with SC disease followed for 370 person-years and splenic function was assessed in 31 patients by quantitation of pitted erythrocytes. Seven serious bacterial infections occurred in four of the patients, five due to Streptococcus pneumoniae and two to Haemophilus influenzae. A primary focus of infection was present in all episodes, none of which proved fatal. Although 30 episodes of pneumonia or chest syndrome occurred in 20 of the patients, a bacterial etiology was proven in only three instances. Splenic function was usually impaired, with a mean pit count of 7.1% ± 8.2% (range 0% to 22.9%). This is significantly greater than normal, but less than pit counts in patients with SS disease or asplenic subjects. Children with SC disease may have a greater risk of bacterial infection than normal children, but their infection rate is not nearly as high as that in patients with SS disease.

scholarly journals Fever and laboratory profiles as predictors of serious bacterial infection in children

2012 ◽  
Vol 52 (6) ◽  
pp. 313
Author(s):  
Ni Putu Veny Kartika Yantie ◽  
BNP Arhana ◽  
Purnomo Suryantoro
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Statistical Significance ◽  
Controlled Study ◽  
Control Group ◽  
Case Group ◽  
Bacterial Gastroenteritis ◽  
Leukocyte Counts ◽  
Serious Bacterial Infections ◽  
Tract Infections

Background There is a debate on the use of high fever \\lith othermorbidities to predict serious bacterial infection (SBI). Bacterialinfection occurs in 3􀁉15% of children with fever of 2: 39°C.Various laboratory parameters including increased C􀁉reactiveprotein (CRP) levels, leukocyte counts, and absolute neutrophilcounts (AN C) have been studied for their usefulness in predictingthe occurrence of SBI, but with varied results. The ability todiscriminate whether a patient has a SBI can lead to improvedpatient management.Objective To evaluate fever of 2: 39°C, leukocyte counts of2: 15,000/mm3, ANC of 2: 1O,000/mm3 and CRP of 2: 10 mgiL aspredictors of SBI in children aged 1 month􀁉 18 years.Methods A case􀁉controlled study was conducted by collectingdata from medical records at Sanglah Hospital, Denpasar. Subjectsin the case group were diagnosed \\lith SBls (bacterial meningitis,bacterial pneumonia, bacteremia or sepsis, urinary tract infections,or bacterial gastroenteritis), and subjects in the control group nonserious bacterial infections (non􀁉SBI). Data was analyzed usingbivariate and multivariate methods \\lith 95% confidence intervalsand a statistical significance value ofP <0.05.Results Sixty subjects were studied, \\lith 30 subjects in the casegroup and 30 in the control group. Baseline characteristics ofsubjects were similar between the two groups. Fever and CRP werepredictors ofSBI [OR8.71 (95% CI 1.61 t046.98), P 􀀁 0.009; andOR 6.20 (95% CI 1.58 to 24.24), P 􀀁 0.012, respectively].Conclusion Fever 2: 39°C and CRP 2: 10 mgiL were significantpredictors of serious bacterial infections in children. [Paediatrrndones, 2012;52:313-6].

scholarly journals Assessment of the utility of Yale observation scale as a predictor of bacteremia in children aged 3 months to 36 months

2019 ◽  
Vol 6 (2) ◽  
pp. 559
Author(s):  
P. Sudhakar ◽  
P. Ajitha
Keyword(s):  
Bacterial Infections ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Roc Curves ◽  
Operating Characteristics ◽  
Good Tool ◽  
Early Management ◽  
Observation Scale ◽  
Clinical Signs And Symptoms ◽  
Yale Observation Scale

Background: The Yale observation scale (YOS) is an illness severity helps to diagnose bacteremia based on simple noninvasive clinical signs and symptoms. The aim of the present study was to assess the utility of YOS as a predictor of bacterial infection in febrile children aged 3 to 36 months.Methods: This prospective observational study was conducted on 200 children aged 3 to 36 months presenting with fever, at the Institute of Child Health and Hospital for Children during the period from April 2016 to September 2016. Rectal temperature was taken for all children. Clinical examination was done as required based on the YOS and scores were given accordingly at the time of initial presentation of the child before invasive investigations. All the observation was assessed statistically and receiver operating characteristics (ROC) curve was performed to analyze the sensitivity of the YOS.Results: Highly significant correlation (p=0.0001) was found to exist between the age of the child, duration of the fever, higher body temperature >104, WBC count, ANC and improved condition of patient with higher YOS. ROC curves showed that the sensitivity and specificity of YOS at the best cut off value of 14.5 was found to be 97% and 79.6% respectively.Conclusions: YOS is very good tool for predicting bacteremia in young febrile children based on simple non-invasive clinical signs and symptoms. The findings ruled out by YOS aids in the immediate and early management of bacterial infections before the arrival of the results of the biochemical diagnostic tests.

A CONTROLLED TRIAL OF INTRAVENOUS IMMUNE GLOBULIN FOR THE PREVENTION OF SERIOUS BACTERIAL INFECTIONS IN CHILDREN RECEIVING ZIDOVUDINE FOR ADVANCED HUMAN IMMUNODEFICIENCY VIRUS INFECTION

PEDIATRICS ◽  
1995 ◽  
Vol 96 (2) ◽  
pp. 408-408
Author(s):  
David Fuentes ◽  
William T. Shearer
Keyword(s):  
Human Immunodeficiency Virus ◽  
Virus Infection ◽  
Human Immunodeficiency Virus Infection ◽  
Bacterial Infection ◽  
Immune Globulin ◽  
Bacterial Infections ◽  
Controlled Trial ◽  
Immunodeficiency Virus ◽  
Aids Related Complex ◽  
Serious Bacterial Infections

Children with AIDS or AIDS-related complex receiving zidovudine have a decreased risk of bacterial infection when given IVIG. In this study, the benefit is most apparent in those not receiving trimethoprim- sulfamethoxazole prophylaxis.

scholarly journals Efficacy of Yale observation scale to detect serious bacterial infection in febrile children aged one to 36 months

2015 ◽  
Vol 1 (2) ◽  
pp. 23-26
Author(s):  
Prerana Kansakar ◽  
Prakash Sundar Shrestha ◽  
Merina Shrestha
Keyword(s):  
Bacterial Infection ◽  
Febrile Illness ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Cross Sectional ◽  
Predictive Values ◽  
Serious Illness ◽  
Observation Scale ◽  
Yale Observation Scale ◽  
Sensitivity Specificity

Introductions: In most children aged 1-36 months, the cause of a febrile illness is a self limiting viral infection. It is very difficult to distinguish these from serious bacterial infection. Objective of this study is to assess the efficacy of the Yale Observation Scale (YOS) to detect serious bacterial infection in febrile children aged 1-36 months.Methods: YOS scores were assigned as a part of a cross- sectional study in 100 children presenting in Tribhuvan University teaching hospital with fever to divide the child into well- looking if YOS ≤10 or ill- looking if YOS >10. Then the history, examination and necessary investigation was performed to come to a diagnosis of non- serious illness and serious bacterial infection.Results: Serious bacterial infection was found in 33(33%) of the patients. The sensitivity, specificity, positive and negative predictive values for a YOS score greater than 10 to detect serious bacterial infection were 45.45%, 88.05%%, 65.21% and 76.62%, respectively.Conclusions: A YOS ≤10 predicts non-serious illness while a YOS>10 does not necessarily indicate serious bacterial infection and should undergo further evaluation to confirm serious bacterial infection.

Sign in / Sign up

Export Citation Format

Share Document