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A couple of thoughts after reading the thread...
   
  I recently had a very similar patient, same age and chief complaint...Perhaps for all of the wrong reasons, I ordered an xray and was amazed to see a button battery in the child's esophagus on the film...The child wound up with an extended stay in the ICU...
   
  During an epidemic, i.e, respiratory season, at what point do you discount the "community symptoms", i.e, cough, fever and a runny nose and look for the zebras...pneumonia, foreign body, etc. I
   
  In addition, I would be willing to bet that if this child does follow up the next day with a PCP, there is a very good chance that they will be referred right back to the ED for an xray. Right or wrong, that is a very real scenario in my community...
   
  Tom Langston, MD
  Austin, TX
   
   
   
  

[log in to unmask] wrote:
  What is the current practice and EBM when presented with a non toxic looking infant male (4 months old) with temp 100.7 (no prior anti pyretic given) and a cough of two days?without any other finding to explain the fever.
Do you get a U/A and or urine culture ? or you call it a URI and kiss the baby goodbye.
Will you change the practice if you see the baby in a non flu season ?
thanks
Giora Winnik MD
Maimonides
Brooklyn


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