What is the focus of an emergent physical exam for pediatric patients with fever?

Updated: Jul 23, 2019
  • Author: Hina Z Ghory, MD; Chief Editor: Russell W Steele, MD  more...
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The physical examination of the febrile child is directed at locating a source of or reason for the temperature elevation, with specific attention to potential serious bacterial illnesses. Alternatively, an elevated temperature is not the only vital-sign irregularity that may indicate a potential infectious problem. Hypothermia may be a presenting vital-sign abnormality in septic neonates.

Thermometer use varies between oral, rectal, or axillary. Ear-probe thermometers may not be as accurate as rectal thermometers in the neonate; some study results suggest that operator error is the main reason. Axillary and rectal temperature measurements may also vary widely in neonates. [26] A rectal-probe thermometer is probably most likely to result in an accurate assessment of a neonate's temperature. [27, 28, 29]

Temperature elevation may not be the only sign of sepsis in neonates and infants. Other potential signs and symptoms of sepsis unique to infancy should also be assessed.

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