Patient selection: sick pediatric patient (age < 18 years) in the Emergency Department
Hyperpyrexia was defined as a rectal temperature >= 106°F.
Potential outcome of prolonged hyperpyrexia: heat stress
Risk factors for hyperpyrexia:
(1) serious bacterial infection (SBI)
(2) viral infection
(3) mixed bacterial and viral infection
(4) intoxication
(5) heat stroke
(6) neuroleptic malignant syndrome
Findings suggestive of bacterial infection:
(1) history of chronic underlying disease
(2) diarrhea
Findings suggestive of viral infection:
(1) rhinorrhea
Rapid diagnostic methods using molecular techniques can help to specifically identify significant pathogens and to help guide management.
The authors recommended antibiotic therapy for pediatric patients with hyperpyrexia:
(1) without confirmed viral infection
(2) with confirmed viral infection if sick enough to require hospitalization
