Definition of Fever without Source and Serious Bacterial Infections

Febrile infants and children frequently present to pediatricians and emergency room physicians. The majority of these children are less than 3 years of age. Fever is defi ned as a rectal temperature 38.0o C. An infant or child with a recent history of a documented fever who is afebrile in the offi ce or emergency department should be considered a febrile child. Temperatures in infants and young children should be measured rectally. Axillary and tympanic membrane temperatures are unreliable and have a sensitivity of approximately 50% to 65%.1,2 Although some infants with serious bacterial infections may be afebrile, most of these will appear seriously ill. 1. Review the current evidence upon which rational decision making for the management of infants and children with fever without source should be based.