Increased temperature in older children – especially fever

The risk of developing asymptomatic bacteremia decreases after the second year of life, however, older children may also suffer from severe bacterial infections or bacteremia with fever. According to Myers, out of 17 patients with latent pneumococcal bacteremia, 3 children were older than 6 years.

Burke studied 111 cases of pneumococcal bacteremia in children under 10 years of age. Six children (5.4%) were over 5 years old. In the above-mentioned work Marshall bacteremia caused by H. influenzae, in 42% of cases was detected in children older than 24 months. According to McGowen, out of 165 febrile children over the age of 4, 5 (3%) had bacteremia.

In the study of children with a body temperature of 41 ° C and above, McCarthy found that 19% of them were children over 4 years old. In 10% of children with hyperpyrexia over the age of 4 years, meningitis was diagnosed and in 4%, bacteremia without meningitis was detected.

The effect of age can be better represented by the example of fever in adults. Eisenberg studied 210 blood cultures taken in a group of 565 adults with fever who were admitted to the intensive care unit. Of the 96 hospitalized patients, bacteremia was detected in 9, and of the 124 people who were discharged home, only one was diagnosed.

Thus, the incidence of bacteremia was 1.8% of the number of all adults with fever, 4.8% of those who had blood cultures, and only 0.8% of the number of patients with a fairly good condition that allowed them to be discharged home . In adults with fever, bacteremia develops less frequently than in febrile children, and it is much easier and easier to diagnose it to select patients from the risk group.

Fever may be the first or even the only symptom of potentially dangerous diseases in children of any age. Although some studies state that the maximum frequency of latent pneumococcal bacteremia occurs in the age group of 6-12 or 6-24 months, in general, we can say that the smaller the child, the more attention it requires when a fever occurs.

Given the weakness of the body of the newborn to fight infection, as well as the great difficulties faced even by an experienced doctor in the early diagnosis of serious diseases and bacteremia in young children, it can be argued that all febrile children under the age of 60-90 days of life should be considered difficult sick until proven otherwise.

local_offerevent_note January 16, 2019

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