Child with Fever at the Emergency Department and Observation Unit of the Children’s Clinical University Hospital: Clinical Characteristics and Treatment Tactics

Introduction: Management of a child with fever is one of the most frequent and most important health care problems in the world. Majority of increased body temperature in children are related to a self limiting virus caused acute infection and indeed rarely the cause of fever is related to a serious bacterial infection. Fear of increased body temperature in a child is the most frequent reason for parents to visit hospital emergency units.

Methods: Retrospective, descriptive study within the framework of European Union project’s HORIZON 2020 PERFORM study MOFICHE. Study included all patients who visited Children clinical university hospital (CCUH) in Riga Emergency Department (ED) with complaints of fever (38°C and over) at the time period from September 1 till December 31, 2016. Data was selected from the ED paper and electronic case files by using a specially created MOFICHE case record form.

Results: Preliminary data - ED was visited by 2720 patients with complaints of febrile body temperature during the study period. Most frequent cause of fever was upper respiratory tract infection (otitis, tonsillitis, pharyngitis, rhinitis) –25%. Based on complaints, objective findings, and laboratory results 5% of the fever patients had proven bacterial infection. Following the complaint of fever, the next more frequent were: rhinitis 20%, cough 25%, vomiting 15%, diarrhoea 10%. Antibacterial therapy was prescribed for 30% of all febrile children who visited ED during the study, in which bacterial infection was proven for 10% of these children.

Conclusions: the average CCUH ED patient within the mentioned time frame was a child of up to 4 years of age who most frequently had a viral upper respiratory tract infection with possible self limiting course of disease; treatment and health care most frequently corresponds with that of a primary care patient.