What signs and symptoms are associated with the fever

Most Infants have self-limited viral syndromes, primarily from respiratory viruses. GI symptoms or cutaneous manifestations (rash) are also frequently caused by viruses. Although these findings provide useful insight, their presence should not foreshorten an evaluation. Recent data suggest that presence of some viral diseases (eg, respiratory syncytial virus) reduces the risk of another more serious Infection In a febrile child; however, other studies have shown that viral diseases and an established focus of Infection do not protect Infants from a concurrent serious, deep Infection.

C. Are there any known sick contacts? Does a sibling or caregiver have a similar Illness? Does a contact have a serious Infectious or contagious illness (ie, meningococcemia) that demands immediate diagnostic consideration?

D. Are there any known or possible immune deficiencies that need to be considered? Fever may be the primary presentation of a child with severe combined Immunodeficiency syndrome or Indicate a first Instance of bacteremia from an encapsulated organism (eg, Pneumococcus) In a child with a sickling syndrome.

E. Does patient have bacterial meningitis? This Is the most Important question confronting the clinician when a child presents with fever. Meningitis must be considered and ruled out by history, physical exam, and, If necessary, diagnostic testing.

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