Management of the young febrile child: a continuing controversy

A criticism of practice guidelines for treating feverish children may be as extreme as the guidelines themselves. The guidelines recommend aggressively testing and treating all feverish children who have an elevated white blood cell count. They are based on a 1975 study which found that elevated temperature and white blood cell count predicted which children had serious bacterial infections. Critics of the guidelines say such aggressive testing and treatment is unnecessary and expensive. The best treatment for these children may lie somewhere between these two extremes.
In 1975, Teele and colleagues[1] identified the risk factors for and occurrence of bacteremia in young febrile children presenting to a pediatric walk-in clinic. They found that 3.2% of children [...]