One of the most common reasons for seeking medical help in pediatrics is an increase in body temperature in children.

Fever in infants is considered a condition in which the rectal temperature exceeds 38 ° C. In older children, fever is considered a condition in which, during rectal changes, the temperature is above 38.4 ° C and when measured in the oral cavity, greater than 37.8 ° C.

Most children with fever in the absence of an infection center do not need medication because fever is a viral infection. Another no less common cause of fever is a urinary tract infection, in which the focus of infection is also not determined. However, in some children, a febrile state is the result of latent bacteremia, which can lead to serious infectious complications. It is particularly important to note that if there is a fever of unclear origin in children under 3 years of age, there is a low but clinically significant risk of sepsis and meningitis.

A team of researchers from the Department of Pediatrics at the Georgetown University School of Medicine (Washington, USA) analyzed the available data on this problem. The information was searched in the Medline medical database and in the medical records held by the researchers themselves. The purpose of the analysis was to determine a strategy to identify children with fever of unknown origin and to choose their treatment tactics.

The results of the analysis showed that the following microorganisms are the most common causative agents of bacterial infectious diseases in children under the age of 1 month:

The researchers noted the important role of viruses (Herpes simplex and enteroviruses) in the development of a febrile state in children of this age.

It has been found that in the age group of children over 3 months of age, the most common causative agents of the infectious process are S. pneumoniae (in unvaccinated children), N. meningitides, Salmonella spp.

All febrile children under the age of 3 months whose initial manifestations of fever have been accompanied by a toxic reaction should be hospitalized in a hospital where they will undergo a comprehensive examination to exclude sepsis or meningitis, and these patients should be treated antimicrobial.

The risk of bacterial infection is very low in children over 24 months with fever, if they feel satisfied. In this case, it is recommended to monitor the child without any laboratory test and without prescribing antibiotic therapy.

At the age of 3 to 24 months, antibiotic therapy is prescribed if an outbreak (or outbreaks) of infection is detected; if there is no focus of infection and the child is feeling well, usually no laboratory test or antibiotic is required.

Most febrile children under the age of one month and all children under the age of 7 days should be hospitalized in a hospital and antibiotic therapy is recommended; however, it is possible to adhere to the expected tactics without prescribing antibiotics (in the hospital or on an outpatient basis, if the patient is at low risk).

The greatest risk of developing bacterial infections is seen in the first months of the baby's life, and is especially high in premature babies.

Many studies have identified low risk factors for serious infections.

All febrile children under the age of 3, in whom the initial manifestations of fever have been accompanied by a toxic reaction, should be hospitalized in a hospital where they will undergo a complete examination to exclude sepsis or meningitis

A toxic reaction can be defined as the clinical manifestation of septic syndrome, including lethargy, hypoventilation or hyperventilation, cyanosis. A comprehensive exam to rule out sepsis includes:

Although fever with an unclear etiology in children under 3 years of age presents a low risk of developing sepsis and meningitis, always should be aware of these serious infectious diseases.

Researchers note that in countries where vaccination against S.pneumonia and H. influenzae is practiced, the risk of developing severe bacterial infections in young children is greatly reduced , however, it is necessary to show maximum vigilance in each case of a similar condition.