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Step by Step Algorithmic Approach to Pediatric Fever

Age < 21 days old (or 28 days for
Approach to Pediatric Fever ... in the urine Procalcitonin ... Algorithm #Infant #Fever
“Step by Step” – the new kid on the block – aims to risk stratify this
an infant with fever ... leukocytes in urine - Procalcitonin ... Stratification #Fever
Venn Diagram - Does this patient have pneumonia?
Diagnosis is generally based on three lines of evidence:
., fever/hypothermia ... leukocytosis, left-shift, procalcitonin
Community Acquired Pneumonia - Presenting Features
 • History in favor of CAP: Dyspnea, Cough, particularly if
if productive, Fever ... Tachycardia, Hypoxemia, Fever ... septic shock), ↑ Procalcitonin
COVID-19 Clinical Presentation and Labs
Common Symptoms
 • Fever in >75% at some point (~50% on admission)
Common Symptoms • Fever ... 50% • Triad of fever ... in 27-75% • Procalcitonin
Procalcitonin and its Interpretation

Satyendra Dhar, MD @DharSaty

#Procalcitonin #Interpretation #diagnosis
Procalcitonin and ... @DharSaty #Procalcitonin
Procalcitonin Guided Antibiotics in Sepsis

Efficacy and Safety of Procalcitonin Guidance in Patients With Suspected or Confirmed
Procalcitonin Guided ... and Safety of Procalcitonin ... @ZimickMD #Procalcitonin
Faget Sign - Pulse-Temperature Dissociation
Causes of Relative Bradycardia
 • Infectious Causes: Legionella, Psittacosis, Q fever, Typhoid
Psittacosis, Q fever ... , Typhoid fever, ... , Dengue fever, ... Mountain spotted fever ... , Drug fever
Fever Patterns - Differential Diagnosis Framework

Continuous Fever:
Temp > 38°C with only 1 degree fluctuation in 24
Fever Patterns - ... Continuous Fever ... (Step ladder: fever ... Intermittent Fever ... or no fever
Causes of Relative Bradycardia - Note the propensity for intracellular organisms.
Infectious: 
Legionella, Psittacosis, Q fever, Typhoid
Psittacosis, Q fever ... , Typhoid fever, ... , Dengue fever, ... Mountain spotted fever ... , Drug fever