Evaluation of the precision of emergency department diagnoses in young children with fever.

Abstract

OBJECTIVE. To characterize causes of fever in children presenting to a pediatric emergency department (ED). METHODS. One-year retrospective review of ED records. Inclusion criteria were 2 to 36 months of age with a documented temperature ≥ 39°C. Exclusion criteria were elopement, repeat visit, and underlying diagnosis with a predisposition to infection. Medical records were reviewed using a predefined, study-specific, data abstraction tool. Based on diagnosis and pathogen detection, visits were assigned to 3 groups, laboratory confirmed pathogen and focal or nonfocal diagnosis without confirmed pathogen. RESULTS. A total of 1091 visits met inclusion criteria. Fourteen percent had a pathogen detected, 56% had a focal diagnosis without a confirmed pathogen, and 30% had a nonfocal diagnosis without confirmed pathogen. CONCLUSIONS. In a cohort of febrile children 2 to 36 months of age, only 14% had a confirmed pathogen. New rapid viral diagnostic techniques may provide an opportunity to improve diagnostic certainty in young children presenting with fever.

DOI: 10.1177/0009922811417295

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@article{Colvin2012EvaluationOT, title={Evaluation of the precision of emergency department diagnoses in young children with fever.}, author={Joshua M Colvin and David M. Jaffe and Jared T. Muenzer}, journal={Clinical pediatrics}, year={2012}, volume={51 1}, pages={51-7} }