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FEVER
= any rectal temperature ≥38.0°C, measured at home or in a…
FEVER
= any rectal temperature ≥38.0°C, measured at home or in a clinical setting
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age 30 - 90 days
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well appearing
Initial investigations: CBC, CRP, blood culture, urinalysis & urine culture, CXR
Risk stratify as per Aaronson rule:
Low risk if ≤1 point:
1)Age <21 days (+ 1 point)
2)Highest temperature measured in the ED: 38.0oC to 38.4oC (+ 2 points) OR ≥38.5oC (+ 4 points)
3) ANC ≥5185/μL (+ 2 points)
4)Urinalysis positive (leukocyte esterase, nitrite, or >5WBC/hpf) (+3 points)
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High risk - move forward with LP, treat empirically, admit until culture negative at 36 hours
age >90 days
unwell appearing
admit, full septic work up. begin broad spectrum abx
well appearing
fever > 39c :
If immunized: unrinalysis & urine C&S for females <24months, and uncircumsized males <12 months
If not immunized (or immunizations not up to date): CBC with differential, urinalysis & urine C&S
fever <39c:
no diagnostic tests neeeded. Acetaminophen, supportive care at home & clear return to care instructions
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