This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Pantell, R. H. Articles by Dias, J. K. Search for Related Content PubMed PubMed Citation Articles by Pantell, R. H. Articles by Dias, J. K. Social Bookmarking                         What's this?

Fever in the First Six Months of Life

Risks of Underlying Serious Infection

Departments of Family Practice and Pediatrics, Medical University of South Carolina, 171 Ashley Avenue, Charleston, South Carolina 29403

Michael Naber

Departments of Family Practice and Pediatrics, Medical University of South Carolina, 171 Ashley Avenue, Charleston, South Carolina 29403

Rebecca Lamar

Departments of Family Practice and Pediatrics, Medical University of South Carolina, 171 Ashley Avenue, Charleston, South Carolina 29403

James K. Dias

Departments of Family Practice and Pediatrics, Medical University of South Carolina, 171 Ashley Avenue, Charleston, South Carolina 29403

The age-specific rate of elevated temperature over 37.8 C was evaluated in all infants less than 6 months of age (n = 1341) seen from July 1, 1974 to June 30, 1978 in a family practice clinic. Mild elevations (37.8 C-38.3 C) were common even in the first few months of life, and accounted for 20.7 per cent of infant visits. Temperatures greater than 38.3 C are uncommon in the first months of life but are seen more frequently with each succeeding month. Temperature elevation over 38.3 C was associated with a significantly higher rate of meningi tis (p < .01), otitis media (p < .001) and lower respiratory infection (p < .05). Significantly higher laboratory usage was documented in infants less than 3 months and for infants with temperature more than 38.3 C. The high rate of mild temperature elevations in young infants suggests that a selective diag nostic strategy directed at high-risk infants is important. Infants less than three months of age with a fever exceeding 38.3 C are calculated to have 21.5 times the risk of a serious underlying infection as infants older than three months with a similar temperature elevation. Clinical evaluation must remain an important tool in determining which febrile infants should be evaluated by further laboratory and diagnostic tests.

Clinical Pediatrics, Vol. 19, No. 2, 77-82 (1980)
DOI: 10.1177/000992288001900201


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				E. D. Cox, M. A. Smith, and J. M. Bartell Managing Febrile Infants: Impact of Literature Recommendations Published During a Physician's Residency Eval Health Prof, September 1, 2005; 28(3): 328 - 348. [Abstract] [PDF]

				D. L. McGillivray, R. Roberts-Brauer, and M. S. Kramer Diagnostic Test Ordering in the Evaluation of Febrile Children: Physician and Environmental Factors Arch Pediatr Adolesc Med, August 1, 1993; 147(8): 870 - 874. [Abstract] [PDF]

				L. W. Herzog and L. J. Coyne What Is Fever?: Normal Temperature in Infants Less than 3 Months Old Clinical Pediatrics, March 1, 1993; 32(3): 142 - 146. [Abstract] [PDF]

				W. J. Wenner JR and R. Lambert Delayed Diagnosis of Infantile Meningitis Medical and Legal Outcomes American Journal of Medical Quality, September 1, 1991; 6(3): 82 - 84. [Abstract] [PDF]

				T. E. Terndrup and A. Wong Influence of Otitis Media on the Correlation Between Rectal and Auditory Canal Temperatures Arch Pediatr Adolesc Med, January 1, 1991; 145(1): 75 - 78. [Abstract] [PDF]

				C. W. Broner, S. A. Polk, and J. M. Sherman Febrile Infants Less than Eight Weeks Old: Predictors of Infection Clinical Pediatrics, August 1, 1990; 29(8): 438 - 443. [Abstract] [PDF]

				A. Putto, O. Ruuskanen, and O. Meurman Fever in Respiratory Virus Infections Arch Pediatr Adolesc Med, November 1, 1986; 140(11): 1159 - 1163. [Abstract] [PDF]

				M. S. Krober, J. W. Bass, J. M. Powell, F. R. Smith, and D. S. Y. Seto Bacterial and Viral Pathogens Causing Fever in Infants Less Than 3 Months Old Arch Pediatr Adolesc Med, September 1, 1985; 139(9): 889 - 892. [Abstract] [PDF]

				K. B. ROBERTS Management of Young, Febrile Infants: Primum non Nocere Revisited Arch Pediatr Adolesc Med, December 1, 1983; 137(12): 1143 - 1144. [Abstract] [PDF]

				J. W. Greene, C. Hara, S. O'Connor, and W. A. Aftemeier Management of Febrile Outpatient Neonates Clinical Pediatrics, June 1, 1981; 20(6): 375 - 380. [Abstract] [PDF]