10- fever Flashcards
when would you get fever after vaccine
killed- few days
live- 6-14 days after
Fever of unknown origin
temperature greater than 38.3 C (101 F) for at least 8 days duration with no apparent diagnosis after initial workup in the inpatient or outpatient setting.
fever without source
complete history has been obtained and a detailed physical examination performed, and there is no identified source of the child’s fever.
signs of meningitis
Fever Hypothermia Bulging fontanelles Lethargy Irritability Restlessness Paroxysmal crying (crying when picked up) Poor feeding Vomiting and/or Diarrhea nuchal rigid
Kernig’s sign
resistance to extension of the knee.
Brudzinski’s sign
flexion of the hip and knee in response to flexion of the neck by the examiner.
differential for infant with fever
UTI Pneumonia sepsis occult bacteremia- positive blood culture in a well-appearing child meningitis- bacterial and viral roseola HSV otitis media viral URI
tests to do for fever differential
CBC
LP
blood culture
UA/urine culture
Obtaining a Urine Specimen in a Child
Clean catch
Catheterization
Suprapubic aspiration
bagging urine- contaminated
go-to to treat UTIs in kids
ceftriaxone
what imaging should you do to follow up on improved pyelonephritis
renal and bladder US
pyuria defintion
with > 5 WBCs per high-power field (hpf) in a centrifuged urine considered positive.
If a counting chamber is used, then > 10 WBCs per microliter in uncentrifuged urine is considered positive.
nitrite test for UTI
when gram-negative bacteria, which can reduce urinary nitrate into nitrite, are present in the urine (esp. E. coli, Klebsiella, and Proteus spp) for an adequate amount of time (3-4 hours).
highly specific, low sensitivity (many false neg)
Leukocyte Esterase Test
detects esterases released from broken-down leukocytes = presence of WBCs
occult bacteremia
positive blood culture in a well-appearing child.
