Fever in Infants Under 2 Years

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Infants under 2 years of age often manifest a fever as the first sign of a viral or bacterial infection


Infants
under 2 years of age often manifest a fever as the first sign of a
viral or bacterial infection. Temperatures (rectal) over 100.4
Fahrenheit are considered by most physicians as indicative for the
presence of fever. Higher temperatures (103, or greater) have a greater
incidence of serious bacterial infection. The physician’s approach to
the febrile (feverish) infant focuses on determining the source of the
infection. A diagnosis will be possible only after a medical history,
physical examination, and diagnostic testing (if necessary) are
completed. The age and general appearance of the child are key factors
in the evaluation of the febrile infant. Fever in the infant under 1
year of age is potentially more serious than fever in an older child
(over the age of two years).

COMMON CAUSES OF FEVER IN INFANTS INCLUDE
 

1. UPPER RESPIRATORY INFECTION, “COLDS” (viral causes)

2. PNEUMONIA

3. TONSILLITIS

4. EAR INFECTION

5. URINARY TRACT INFECTION

6. Gastroenteritis

7. CROUP

8. EPIGLOTTITIS

9. BRONCHIOLITIS

10. MENINGITIS

11. SEPSIS (an important bacterial agent is Hemophilus influenza type B and currently
a recommeded vaccine (HIB) in the U.S.

The medical history and the findings upon physical examination will
help the physician arrive at the appropriate diagnosis. Laboratory
tests commonly performed on the febrile infant include:

1. CHEST X-RAY

2. URINALYSIS AND URINE CULTURE

3. BLOOD CULTURES

4. COMPLETE BLOOD COUNT

Younger infants (less than 3 months), or those with signs and
symptoms of meningitis (sicker infants with no obvious cause for high
fever) will require a spinal tap to rule out the presence of this
SERIOUS disease. Infants UNDER 3 months of age, who present with high
fever, are commonly admitted to the hospital for observation,
regardless of lab test results. Studies show this group has a much
higher rate of the serious bloodstream (bacterial) infection, known as
sepsis. Infants 3 months to 1 year may be admitted to the hospital for
more serious conditions such as pneumonia, urinary tract infection,
sepsis, or dehydration. Infants 1-2 years are commonly treated on an
outpatient basis for uncomplicated pneumonia, gastroenteritis, urinary
tract infection, or bronchiolitis. All cases of epiglottitis and
meningitis will be admitted to the hospital, regardless of the patients
age. Fever, in the infant UNDER 2 years, should always be evaluated by
a physician to exclude the presence of serious bacterial illness.
 
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