The febrile child

Question 1

How to identify a fever?

Answer 1

Ask parents
Under a month use electronic thermometer in the axilla
Over this use electronic/chemical dot thermometer in axilla or infra red tympanic

Question 2

What need to be aware of if child uner 3 months?

Answer 2

Immune system not properyl developed - need sepsis screen, broad specturm ABs

Question 3

Risk factors for febrile child

Answer 3

Illness in the family
Illness in the wider community
Unimmunised
Recent travel abroad
Contact with animals
Immunodeficiancy

Question 4

Red flags in febrile children

Answer 4

Fever over 38 degrees under 3 months old
>39 if over 3 months
If hypothermic under 3 months
Colour - pale, mottled, blue
Reduced LOC, neck stiff, bulging fontanelle, focal neurological signs, seizures
Significatn respiratory distress
Bile stained vommitting
Severe dehydration/shock
Rash

Question 5

Septic screen in a febrile child

Answer 5

Blood culture
FBC
CRP
Urine sample
Consider: CXR
LP - unless contraindicated
Rapid antigen screen on blood/csf/urine
Meningococcal/pneumococcal on PCR blood/CSF
PCR for viruses in CSF

Question 6

What drug if encephalitis suspected?

Answer 6

Aciclovir

Question 7

What antibiotics give to child under 3 months?

Answer 7

Cefotaxime and ampicillin

Question 8

What give to child over 3 months?

Answer 8

Cephalosporun eg cefotaxime/ceftriaxone

Question 9

When give antipyretics?

Answer 9

Child appears distressed and unwell

Question 10

Should undress child with a fever?

Answer 10

No