Pediatric Fever *

Objectives (EM)

1. For a neonate, infant, or child who presents with fever, stratify the risk of sepsis based on age and other factors, and use the risk stratification to determine the appropriate septic work-up.
2. For a neonate, infant, or child who presents with fever, look for and recognize subtle or non-specific signs and symptoms of sepsis (i.e., lethargy, poor feeding, and abnormal vital signs).
3. In a child with suspected sepsis, provide early broad-spectrum antibiotic coverage.
4. In a child with fever and rash, distinguish significant rashes (e.g., measles, meningococcemia) from non-specific viral exanthems.
5. In a child with a prolonged or persistent fever without an evident focus of infection, look for less common causes (e.g., malaria, Kawasaki, inflammatory disorders, malignancy).
6. In a child with acute fever and no obvious focus of infection, consider non-infectious exogenous causes (e.g., toxic exposure, heat-related illness).
7. In a child with fever with a focus of infection that is likely non-bacterial (e.g., otitis media, viral URTI), do not prescribe antibiotics.
8. When providing antipyretics to a child with fever, use dosing based on weight, not on age.