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Under 28 days i would do a full work up. After that, I generally do NOT
get any diagnostic tests (other than establish a good FU) iFF as you
said, they are previously healthy, without antecedent risk factors,
normal exam (other than URI with a positive epidemiology) and a
temperature of 100.4F(38C).
 
Unlike Dr.Richard Lennon in Sydney, we rely on rectal temperatures for
all infants with a fever. Data by Hooker et al (Southern Medical
Journal, June 1996) from Louisville amongst an adult population revealed
a sensitivity of only 68-70 % for the tympanic reading as compared to
rectal readings. My personal experience suggests that reliability in
infancy of the tympanic reading still leaves a lot to be desired.
 
On that note, is any one aware of any data on accuracy of tympanic
versus axillary versus rectal in pediatrics?
 
Warm regards
 
Jay
 
> -----Original Message-----
> From: MARTIN I HERMAN [SMTP:[log in to unmask]]
> Sent: Tuesday, March 31, 1998 1:50 PM
> To:   Multiple recipients of list PED-EM-L
> Subject:      Febrile infants
>
>     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
> members
> with similar symptoms. Are you getting blood urine and CSF on all of
> these??
> Till what age??
>
> Thanks,,
>
>
 
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