Consensus guidelines on evaluation and management of the febrile child presenting to the emergency department in India

Mahajan, Prashant; Batra, Prerna; Thakur, Neha; Patel, Reena; Rai, Narendra; Trivedi, Nitin; Fassl, Bernhard; Shah, Binita R.; Lozon, Marie M.; Oteng, Rockerfeller A.; Saha, Abhijeet; Shah, Dheeraj; Galwankar, Sagar

doi:10.1007/s13312-017-1129-8

Cited by 14 publications

(7 citation statements)

References 22 publications

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“…The World Health Organization and the society of critical care medicine and the infectious disease society of America (IDSA) and paediatric emergency medicine (PEM) section of academic college of emergency experts in India (ACEE-INDIA) in Delhi (October 2015) defined fever as an equivalent rectal temperature of ≥38 0 C (100.4 0 F) or an axillary temperature of ≥37.5 0 C (99.5 0 F). 1 Axillary temperature is 0.3-0.6 0 C lower than the rectal temperature. Various other invasive methods of tempera-ture assessment like pulmonary artery catheter, oesophageal thermometry is identified but are not widely practised in our country.…”

Section: Introductionmentioning

confidence: 87%

Mortality and morbidity of children admitted with febrile thrombocytopenia in a tertiary care hospital

Mythili

Nazeer

Thangavel

et al. 2021

Int J Contemp Pediatr

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Background: This study is conducted at Mahatma Gandhi memorial hospital, Trichy gains significance as there hasn‘t been any of its kind prior to this among children and in this geographical area. Aim and objectives of the study were to study the clinical profile of children presenting with febrile thrombocytopenia and possible etiology. The study correlates clinical features with the laboratory parameters and assessing the complications associated with fever and thrombocytopenia.Methods: Prospective, descriptive study consist of 200 children aged 1 months to 12 years admitted with fever and thrombocytopenia as inpatients in the paediatric wards at Mahatma Gandhi memorial government hospital, Trichy during July 2017 to June 2018. Inclusion criteria included children aged 1 month to 12 years admitted in paediatric wards of MGM GH, Trichy, exclusion criteria excluded neonates <1 month and children >12 years, patients presenting with thrombocytopenia without fever, ITP, platelet dysfunction disorders, malignancy, patients on chemotherapy and immunosuppressive agents and on drugs causing thrombocytopenia. Results: Dengue was the most common cause of febrile thrombocytopenia in our region accounting for 56% of cases, this is followed by enteric fever in 17%, undifferentiated fever in 16.5%, sepsis in 6.5%, scrub typhus in 3.5% and malaria in 0.5%. 5% of children with febrile thrombocytopenia were given platelet transfusion. 95% (n=190) of the children with febrile thrombocytopenia improved and were discharged. 1% (n=2) left against medical advice. The mortality rate in the study is 4% (n=8).Conclusions: The risk of bleeding increases as the platelet count decreases. The mortality is not related to the severity of thrombocytopenia.

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Section: Introductionmentioning

confidence: 87%

Mortality and morbidity of children admitted with febrile thrombocytopenia in a tertiary care hospital

Mythili

Nazeer

Thangavel

et al. 2021

Int J Contemp Pediatr

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“…All the data were recorded in a structured pre-tested form. Rectal temperature was taken at presentation for all enrolled children, The various diagnoses were made and management carried out according to the departmental protocols guided by standard management guidelines [9,10]. Mean (SD) or median (IQR) were calculated for the baseline characteristics.…”

Section: Comparison Of Domiciliary and Hospital-measured Temperature mentioning

confidence: 99%

Research Letters

Bansal

Ghate²,

Bhattacharya

et al. 2020

Indian Pediatr

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“…ACEE-INDIA recently gave guidelines on the evaluation of fever in the pediatric ED. 7 We studied febrile infants, aged 3 months 2 years presenting to ED and managed with ACEE-INDIA guidelines.…”

Section: Introductionmentioning

confidence: 99%

Febrile infants in the emergency department of a public hospital in India: respiratory infections lead the pack

Pradhan

Mishra

Juneja

et al. 2021

Int J Contemp Pediatr

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Background: The objective of study was to find the etiology, signs and symptoms of fever of 4-7 days in the age group of 91 days 2 years and their outcome following treatment in a tertiary care hospital.Methods: This was a prospective study conducted at the Emergency Department (ED) of a public hospital in New Delhi between April, 2018 and January, 2019. 150 children aged 3 months to 2 years with 4-7 days of fever were included. Demographic, clinical and diagnostic data were collected, and children were managed using ACEE-INDIA guidelines, telephonic follow-up was done for those discharged from ED.Results: Out of 150 children, respiratory tract infections were most common etiological group (64%), followed by gastrointestinal infections (16.7%) and CNS infections (9.3%). Fever with cough (with respiratory distress-27.3%) was the most common symptom in these children. Overall, 61% were admitted; majority (58%) being with respiratory problems. Median (IQR) duration of stay in admitted children was 2 (0, 3) days. Mortality was observed in 12 (8%) children. Mortality was 4 times higher in children with CNS infections as compared to other conditions [RR=4.14 (1.4 to 12.4); P=0.01].Conclusions: Fever in the ED among Indian infants at a public hospital was mainly due to respiratory infection, which could be managed on outpatient-basis in the majority using the ACEE-INDIA (Academic College of Emergency Experts in India) guidelines. However, among those admitted, neurological conditions were the most common cause of death.

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Consensus guidelines on evaluation and management of the febrile child presenting to the emergency department in India

Cited by 14 publications

References 22 publications

Mortality and morbidity of children admitted with febrile thrombocytopenia in a tertiary care hospital

Mortality and morbidity of children admitted with febrile thrombocytopenia in a tertiary care hospital

Research Letters

Febrile infants in the emergency department of a public hospital in India: respiratory infections lead the pack

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