Interesting discussion about febrile seizure. The data we have so far said
that the incidence of meningitis is less than 1%, so why should we treat a 4
month old febrile child with febrile sz different than the one with no sz. We
hardly ever do LP on a child with FS unless there is a very good reason i.e.
complex FS or the presence of meningeal signs. The guidelines from the AAP and
the ACEP are just guidelines and I hope to God they will stop publishing them.
What is irritating in our community is seeing all these kids coming from
community ER's after having every test under the sun including LP for a simple
FS and all they have is a simple infection somewhere. For those of you who
teach residents and medical students It is time we teach them how to be good
clinicians who can do a good H & P and formulate a logical plan not teaching
them some guidelines that said consider and recommended....etc. I hope no one
gets offended by my response I'm just tired of these so called guidelines
which may cause unnecessary risks to kids and is a financial burden for some parents.
Halim Hennes MD, MS
Associate Professor of Pediatrics & Emergency Medicine
Medical College of Wisconsin
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