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Genetics and the Evaluation of the Febrile Child

Genetics and the Evaluation of the Febrile Child Opinion EDITORIAL Howard Bauchner, MD Clinicians who care for children have encountered the same fants presenting to an emergency department have a higher questions for decades: does the child have an infection, is it risk of SBI than those in practice, and follow-up may be more likely bacterial or viral, and is an antibiotic indicated? These difficult, necessitating a different clinical approach. questions were further com- Two articles in this issue of JAMA contribute to the plicated by the “discovery” of 5-decades-long discussion of the evaluation of febrile in- Related articles pages 835 and bacteremia. In 1973-1974, fants and children and represent an important advance—the Teele et al obtained blood potential of genetics to help in the evaluation of febrile 12,13 cultures from 600 consecutive febrile children younger than children. Specifically, can RNA expression profiling be 2 years with temperatures of 38.3°C or higher and found that successful when clinical scores and other laboratory tests 19 (3.2%) had pathogens in their blood. Streptococcus pneu- (aside from blood culture results) have largely failed to differ- moniae was the most common pathogen (n = 15), followed by entiate children with bacterial disease from those with viral Haemophilus influenzae type b (n http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Genetics and the Evaluation of the Febrile Child

JAMA , Volume 316 (8) – Aug 23, 2016

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Publisher
American Medical Association
Copyright
Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2016.11137
pmid
27552615
Publisher site
See Article on Publisher Site

Abstract

Opinion EDITORIAL Howard Bauchner, MD Clinicians who care for children have encountered the same fants presenting to an emergency department have a higher questions for decades: does the child have an infection, is it risk of SBI than those in practice, and follow-up may be more likely bacterial or viral, and is an antibiotic indicated? These difficult, necessitating a different clinical approach. questions were further com- Two articles in this issue of JAMA contribute to the plicated by the “discovery” of 5-decades-long discussion of the evaluation of febrile in- Related articles pages 835 and bacteremia. In 1973-1974, fants and children and represent an important advance—the Teele et al obtained blood potential of genetics to help in the evaluation of febrile 12,13 cultures from 600 consecutive febrile children younger than children. Specifically, can RNA expression profiling be 2 years with temperatures of 38.3°C or higher and found that successful when clinical scores and other laboratory tests 19 (3.2%) had pathogens in their blood. Streptococcus pneu- (aside from blood culture results) have largely failed to differ- moniae was the most common pathogen (n = 15), followed by entiate children with bacterial disease from those with viral Haemophilus influenzae type b (n

Journal

JAMAAmerican Medical Association

Published: Aug 23, 2016

References