"What We've Got Here Is Failure to Communicate": The Value of Reassurance.

A 2-year, 8-month-old boy was sent to the hospital by his pediatrician for an inpatient workup of fever of unknown origin. The child was born full term, had a normal newborn course, and was a healthy infant until he had a fever at 3 months of age due to influenza diagnosed by rapid in-office testing. This illness was managed as an outpatient, and the fever resolved after 2 days. However, the pediatrician did place emphasis on fever height and frequency as a sign for severe illness, such as meningitis, indicating a need for possible hospitalization and additional testing. He was again evaluated for fever in the emergency department (ED) at 8 months of age, and the ED staff confirmed a fever of 38.5°C. During that visit, he was diagnosed with an acute viral illness after laboratory testing resulted negative and discharged from the ED. Later that month, he was referred to gastroenterology for vomiting and fussiness, diagnosed with gastroesophageal reflux disease, and prescribed both lansoprazole and simethicone.