الفهرس | Only 14 pages are availabe for public view |
Abstract Fever without source is a common problem that represents a diagnostic and therapeutic challenge to physicians. Occult bacteremia or serious bacterial infection may occur in a variable sector of these patients especially infants and young children not receiving hemophilus or pneumococcal vaccines. We have planned this study in order to assess the rate of bacterial infections in children (2-36 m) with FWS, to determine causative microorganisms and to explore the ability of different clinical and laboratory parameters to predict SBIs. For these purpose one hundred children aged 2-36 months with FWS were enrolled in addition to 100 age and sex matched children having clinically definite or probable viral illnesses as controls. All subjects were exposed to history and clinical examination. Laboratory workup was done for all including complete blood count, CRP, urine analysis, urine and blood cultures and CSF analysis and culture when indicated. Positive cultures were encountered in 17 occasions in FWS patients (6 blood, 10 urine and 2 CSF) and the predominant pathogens were H.influenzae, S.pneumoniae, S.aureus (isolated from blood) and E.coli andEnterobacter (from urine). Positive cultures in controls included 4 blood and 5 urine cultures with more or less similar spectrum of pathogens.Comparison of culture positive and negative FWS patients revealed only significantly higher incidence of positive CRP in culture positive cases. Comparison of all culture positive and negative cases in both groups showed that culture positive cases have significantly higher incidence of low blood pressure and significantly higher incidence of positive CRP. Positive CRP and high temperature were the most significant predictors. |