Etiología del síndrome febril agudo sin foco en niños bajo 36 meses de edad que consultan a un servicio de urgencia

Abstract

Fever is a frequent symptom of consultation in Pediatric Emergency Department. to describe causes of acute fever of unknown origin (FUO) in infants under 36 months of age, the utility of requested tests and pediatrician decisions. 309 cards of children under 36 months who consulted at Emergency Department for acute FUO were reviewed. 64 % were classified with well clinical condition. Most frequent causes were: probable viral respiratory infections (72%), urinary tract infection (7.4%), pneumonia (2.9%), bacteremia (1.9%), and bacterial meningitis (1.3%). Streptococcus pneumoniae was the most frequent agent isolated from blood cultures. Tests of best utility were: urine analysis and urine culture. Leukocytes count < 15.000/mm(3) and PCR < 4.0 mg/dl had a negative predictive value of 96 %. Nine point seven percent of the patients were hospitalized, while 14.2% received antibiotic treatment at home. We suggest to perform urine analysis and culture as the initial study for children with acute FUO and well clinical condition.