Paediatric Fever Without Focus Flashcards
A 3 week old male presents with an acute fever. The source of the fever is indiscernible on history and PE. What is your management plan?
- Admit
- Full septic W/U (CBC and differential, blood culture, U/A and culture, LP) as well as inflammatory markers (ESR/CRP), LFTs, CXR if resp. symptoms.
- Empiric IV antibiotics (Ampicillin and cefotaxime or gentamycin). Consider adding acyclovir for HSV coverage.
What is the recommended broad spectrum antibiotic indicated for a 0-1 month old child with a fever without focus?
Ampicillin + cefotaxime or gentamycin +/- acyclovir (for HSV coverage).
What are the most common bugs implicated in a child 3-36 months with a fever without focus?
Strep. pneumo. (~85%) and H. Flu. B
A 22 month old girl presents with fever without focus. Immunizations are up to date. If you can only select one investigation, what investigation do you choose?
U/A and urine culture to rule out UTI. This is also indicated in the same presentation of boys less than 12 months and uncircumcised. If immunizations are incomplete the child requires a CBC with differential, blood cultures if WBC >/= 15 000, U/A and culture, +/- ceftriaxone.
In infants under 4 weeks of age, what regimen would you choose and for what indication?
A. Ampicillin and ceftriaxone and ampicillin would be to cover anaerobes
B. Ampicillin and ceftriaxone and ampicillin would be to empirically cover for enterococcus
C. Ampicillin and gentamicin and gentamicin is to cover for anaerobes
D. Ampicillin and gentamicin and ampicillin would be Listeria moncytogenes
D. Ampicillin and gentamicin and ampicillin would be Listeria moncytogenes
Which routine immunizations are accredited with changing the epidemiology of serious bacterial infections in children 3-36 months in fever without source?
A. S. pneumoniae and Diphtheria-Tetanus vaccines
B. S. pneumoniae and GAS vaccines
C. S. pneumoniae and HiB vaccines
D. S. pneumoniae and Neisseria meningitides vaccines
C. S. pneumoniae and HiB vaccines
