Recognising serious illness in feverish young children in primary care

doi:10.1136/bmj.39295.383843.AD

BMJ 2007;335:409-410 (1 September), doi:10.1136/bmj.39295.383843.AD

Editorials

Recognising serious illness in feverish young children in primary care

Increasing the opportunity for prompt clinical assessment isthe priority

The first 150 words of the full text of this article appear below.

The diagnosis and management of children with fever is an importantpart of primary care. Parents and children put their trust ingeneral practitioners, who rightly worry about making a correctjudgment. Although general practitioners have substantial clinicalexperience of assessing febrile children, half of children withmeningococcal disease are sent home at first primary care consultation.¹How can this be and what can we do to improve our assessmentof febrile children?

Several diagnostic difficulties face us. Firstly, serious bacterialinfection in children is now rare. The successful introductionof Haemophilus influenzae type B and meningococcal C vaccinesinto the UK childhood immunisation schedule has led to a dramaticreduction in the prevalence of invasive infections caused bythese organisms.² ³ Early reports suggest that the recentlyintroduced conjugate pneumococcal vaccine will do the same.⁴Studies have reported a large variation in estimated incidencesof invasive bacterial disease in preschool . . . [Full text of this article]

Anthony Harnden, university lecturer in general practice

Department of Primary Health Care, University of Oxford, Oxford OX3 7LF

anthony.harnden@dphpc.ox.ac.uk

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Thompson, M, Coad, N, Harnden, A, Mayon-White, R, Perera, R, Mant, D (2009). How well do vital signs identify children with serious infections in paediatric emergency care?. Arch. Dis. Child. 94: 888-893 [Abstract] [Full text]
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