Fever Flashcards
What Questions should always be asked in a child presenting with Fever?
- Character of Fever: Timings+ pattern of occurrence
- Other symptoms: Lethargy, Headache, D&V, Rigors (non-specific), more specific for diagnosis
- Pain?
- Animal Contacts and Foreign Travel
What investigations need to be done in a neonate with Fever?
Full septic screen including
1. FBC, CRP, Procalcitonin, Cultures
2. Urine MCS
3. LP
Consider
- Throat Swap
- Stool cultures
- CXR
Often localised symptoms are not present
Why is Aspirin Generally avoided as antipyrexial in children?
Due to association with Reye’s Syndrome
Rare, but acute encepalopathy in children <10 years, who have been treated with ASS for a viral infection
Also associated with Hepatic impairment
What are important History Questions in a Child presenting with Fever and Rash?
- Is the Child ill (e.g. very ill in measles and meningococcaemia, rubella fifth disease e.g. child usually quite well)
- Ithcy? Yes –> Chickenpox or allergic response
- PMH: Immunisations up to date? (Atypical rash can occur 10 days post immunisation)
- Contacts with ill people, Animals, Travel
What Rashes with Fever do usually Start on the Face and extend down?
Measles and Rubella
What Rashes with Fever usually start on the Trunk
Roseola and Chickenpox
What Rashes with Fever usually start on the Hands?
What is an enanthem?
“Rash on Mucous Membranes”
e.g. Kopik spots on Measles
What is the typical Rash for Measles?
Maculopapular Rash
Starting on Face and spreads downwards
What are associated Symptoms with a Measles Rash?
Koplic Spots
Conjunctivits
Cryozal Symptoms
General malaise and illness
What is the typical Rubella Rash?
Macular /Maculopapular (Very small pink spots)
Starting on Face (being ears) and spreads to trunk and words downwards
Excluding the Rash, what additional symptoms are associated with Rubella infection?
Generally Child is well
Mild fever, malaise, Coryzal symptoms
Lymphadepnopathy (particularly sub occipital and post auricular/cervical)
