Etiología del síndrome febril agudo sin foco en niños bajo 36 meses de edad que consultan a un servicio de urgencia

Abstract

Fever is a frequent symptom of consultation in Pediatric Emergency Department. Objectives: to describe causes of acute fever of unknown origin (FUO) in infants under 36 months of age, the utility of requested tests and pediatrician decisions. Patients and Methods: 309 cards of children under 36 months who consulted at Emergency Department for acute FUO were reviewed. Results: 64 % were classified with well clinical condition. Most frequent causes were: probable viral respiratory infections (72%), urinary tract infection (7.4%), pneumonia (2.9%), bacteremia (1.9%), and bacterial meningitis (1.3%). Streptococcus pneumoniae was the most frequent agent isolated from blood cultures. Tests of best utility were: urine analysis and urine culture. Leukocytes count < 15.000/mm3 and PCR < 4.0 mg/dl had a negative predictive value of 96 %. Nine point seven percent of the patients were hospitalized, while 14.2% received antibiotic treatment at home. Conclusions: We suggest to perform urine analysis and culture as the initial study for children with acute FUO and well clinical condition. © 2007 Sociedad Chilena de Infectología.