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Tag Fever

Question: Fever

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 10-year-old girl with sudden onset fever and abdominal pain of one day’s duration. You note that in her chart she has… Continue Reading →

Urgent Care Diagnoses

Tripledemic is here, and many a chief complaint will be, “he just won’t stop coughing” or “she has a fever.” PEMsource has a new Urgent Care section with tips, differential diagnoses, symptomatic treatments, dosing of common medications, and parent education aids, for… Continue Reading →

Question: Fever

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a well-appearing 20 day old infant brought in for passing 4 stools instead of 6 today. The baby is full term, eating… Continue Reading →

Teething and Fever

(Click the link to comment and to vote – voting not working through email, sorry!) Note: controversies are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

Forehead Fever

(Click the link to comment and to vote – voting not working through email, sorry!)Note: controversies are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also regarding… Continue Reading →

Question: Fever + rash

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 3 year old girl who was discharged from the hospital a week ago. At that time, she presented with fever, intermittent… Continue Reading →

New Guidelines

You’ve probably heard… AAP Subcommittee on Febrile Infants came out with new guidelines. The algorithms have been posted on PEMsource algorithms page, and the fever table updated to reflect them. Also, the CDC came out with new guidelines regarding STI… Continue Reading →

LP for febrile 22-28 days?

(Click the link to comment and to vote – voting not working through email, sorry!) Note: controversies are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

Hypothermia as Harbinger

(Click the link to comment and to vote – voting not working through email, sorry!) Note: controversies are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

LP for febrile infants with UTI

(Click the link to comment and to vote – voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

Question: Kawasaki

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To cath or not

(Click the link to comment and to vote – voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

Question: ID

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 2.5 month old baby who underwent a fever work-up yesterday and has been called back due to a positive blood culture… Continue Reading →

Unvaccinated w/febrile seizure

(Click the link to comment and to vote – voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

Occult Bacteremia

(Click the link to comment and to vote – voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

Question: Heme

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UTI Risk Calculator

Staying with the topic of urine… investigators at University of Pittsburgh have derived and validated a UTI risk calculator for patients aged 2-23 months. The calculator (UTICalc) is linked from the On Shift page of PEMsource under the heading Neonatal… Continue Reading →

Ibuprofen in infants

(Click the link to comment and to vote – voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

Clean Catch Urine

Nothing slows down the ED flow like waiting for the urine flow of an infant or toddler. Whether or not to screen for UTI with a clean catch urine vs obtain a catheterized specimen will be left for another discussion,… Continue Reading →

10 wk w/ fever & GBS+ mom

(Click the link to comment and to vote – voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

Follow-up blood cultures positive

A 2 month old was seen in the ED 36 hours ago with a temperature of 39.2. The CBC had a WBC of 11.2 with 70% lymphocytes and no bandemia. Urinalysis was negative. The lab calls you to report that… Continue Reading →

Question: ID

A 12yo girl presents to the ED in December with fever for 4 days, malaise, and pain in the right thigh gradually leading to her having difficulty walking. There is no history of trauma, although she did play a lot… Continue Reading →

Complex febrile seizures

Do you do a CT and LP on all complex febrile seizure patients?

Bolus before infant LP

3 week old infant is brought in with fever of 38.5. The baby is well appearing and does not have any high risk factors in the birth history. You plan to get urine, blood, and CSF cultures and give empiric… Continue Reading →

Urinalysis in febrile young children

You are seeing a 15 month old female with 36 hours of fever, current temp in ED 38.9 rectal (last antipyretic 6 hours prior), no other symptoms, well-appearing, no past medical history. Which would you do?

Infant Fever Work-up

How much work-up do you do in the well-appearing, term, feeding, 29-60 day old infant with low-grade fever (38-38.5) without source? What about the 61-89 day old?

Infant UTI – do you LP?

You’re seeing a febrile well-appearing 29-60 day old with clear lab evidence of UTI and benign CBC. Do you do an LP? Do you admit and do you give parenteral antibiotics? What about for a 61-90 day old?

Combat fever phobia

Explain to parents – colds are called colds because viruses thrive in cold temperatures, so fevers are the body’s natural way to fight off the cold

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