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>     How many people onthis list automatically perform a complete work =
up on
> the healthy, happy, babe that presents with a temp of 38?  ALso what =
about
> the babe who has a runny nose, watery eyes, hacky cough and family memb=
ers
> with similar symptoms. Are you getting blood urine and CSF on all of =
these??
> Till what age??
>
>We rarely do rectal temperatures so a temperature of 38 axillary or tymp=
anic may mean 38.5+. My response depends on the age of the "babe" under =
4 weeks certainly 4 weeks to 3 months I might do the cbc blood cultures =
and a clean catch and wait to see if they are diagnostic, however if the =
parents said that the child looked unwell in the previous 24 hours I woul=
d probably do the full workup. We have found a few bacteraemia in well =
looking children who had a history of looking sick but had been "cured" =
by paracetamol (apap) before the doctors saw him. As for the snotty babe =
in the snotty family I would do a NPA  for RSV and observe. We can get =
RSV immunofluoresence  back the same day if positive admit the little one=
s for risk of apnoea send others for home for follow up the next day. If =
negative reassess onthe basis of how the child has behaved while waiting =
for the results to come back.
 
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