Fragkandrea et al reported a number of physical findings that may be red flags identifying a pediatric patient with an underlying malignancy. These can help to identify a patient who may benefit from a more in-depth evaluation. The authors are from The Royal Marsden Hospital, Epsom and St. Helier NHS University Hospital, and Panagiotis and Aglaia Kyriakou Children’s Hospital in Athens.


Patient selection: pediatric patient


Clinical findings that may be red flags for an underlying malignancy:

(1) fever lasting > 2 weeks and unexplained

(2) fever associated with weight loss

(3) fever associated with bone or joint pain

(4) fever with lymphadenopathy and/or hepatosplenomegaly

(5) fever with a palpable mass

(6) fever with night sweats

(7) fever with pallor and/or petechiae

(8) recurrent or treatment-resistant infection


Some of these findings may also be red flags for an immunodeficiency, mycobacterial or deep fungal infection.


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