Occult bacteremia, the presence of pathogenic bacteria in the blood of a well-appearing febrile child without an identifiable focus of infection, is a subject of controversy in pediatrics and emergency medicine.

What is occult bacteremia?

Occult bacteremia, the presence of pathogenic bacteria in the blood of a well-appearing febrile child without an identifiable focus of infection, is a subject of controversy in pediatrics and emergency medicine.

What is a toxic appearance?

TOXIC APPEARANCE Toxic-appearing infants and children are pale or cyanotic, lethargic or inconsolably irritable. In addition, they may have tachypnea and tachycardia with poor capillary refill. A variety of conditions other than infection may result in a toxic appearance.

What is the most common cause of serious bacterial infection in children younger than 24 months old with fever without a focus?

Urinary tract infections (UTIs) are the most common source of serious bacterial infection in children younger than three months, commonly from Escherichia coli or Klebsiella species.

When should you follow up with a fever?

All children and infants with a febrile illness without a focus of bacterial infection require close follow-up care and instructions to return if the patient’s condition deteriorates. Follow-up visits should be arranged within 24-48 hours after the initial visit.

How is occult bacteremia diagnosed?

Most commonly, occult bacteremia is caused by Streptococcus pneumoniae bacteria. Typically, children have no symptoms other than fever. The diagnosis is based on blood tests.

Why is general appearance important?

The general appearance of a patient may provide diagnostic clues to the illness, severity of disease, and the patient’s values, social status, and personality. The astute physician will begin to gather this information immediately upon meeting the patient.

How do you report a general appearance of a patient?

Appearance

  1. Age: Does the patient appear to be his stated age, or does he look older or younger?
  2. Physical condition: Does he look healthy?
  3. Dress: Is he dressed appropriately for the season?
  4. Personal hygiene: Is he clean and well groomed, or unshaven and unkempt, with dirty skin, hair or nails?

How does bacteremia occur?

Bacteremia is the presence of bacteria in the bloodstream. It can occur spontaneously, during certain tissue infections, with use of indwelling genitourinary or IV catheters, or after dental, gastrointestinal, genitourinary, wound-care, or other procedures.

What WBC indicates viral infection?

On the other hand, if you have low levels of neutrophils (30%) and high levels of lymphocytes (60%), this is a sign that you have a viral infection. You should ask your doctor about your white blood cell differential, as it may tell you whether you have a bacterial infection or a viral infection.

When is an adults temperature too high?

Adults. Call your doctor if your temperature is 103 F (39.4 C) or higher. Seek immediate medical attention if any of these signs or symptoms accompanies a fever: Severe headache.

What is occult (hidden) bacteremia?

Occult (hidden) bacteremia is the presence of bacteria in the bloodstream of a child who has a fever but who looks well and has no obvious source of infection. Most commonly, occult bacteremia is caused by Streptococcus pneumoniae bacteria. Typically, children have no symptoms other than fever.

What is the treatment for occult bacteremia in children?

Treatment is with antibiotics, either in the hospital or as outpatients; select children are treated pending blood culture results. The causes, evaluation, and management of possible occult bacteremia vary by children’s age and immunization status.

What are the symptoms of occult bacteremia in children?

Occult Bacteremia 1 Symptoms. Children who have other symptoms, such as cough, shortness of breath,… 2 Diagnosis. Because doctors cannot tell with certainty which children who have a fever have occult bacteremia,… 3 Treatment. Sometimes, before results of the culture are known, doctors give an antibiotic to children who have…