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Prompt Assessment of Febrile Children Seen As Essential

Barriers may prevent physicians from recognizing serious illnesses such as meningococcal disease

FRIDAY, Aug. 31 (HealthDay News) -- Prompt clinical assessment is essential in recognizing serious illnesses such as meningococcal disease in feverish young children, according to an editorial comment published in the Sept. 1 issue of BMJ.

Anthony Harnden, M.D., of the University of Oxford in the United Kingdom, noted several difficulties facing general practitioners in the diagnosis and treatment of febrile children, including the rarity of serious pediatric bacterial infections, the similarity between early symptoms of meningococcal disease and self-limiting viral infections, and a lack of evidence supporting the utility in primary care of vital signs such as heart rate.

Harnden also assessed the recent National Institute for Health and Clinical Excellence (NICE) guidelines for the assessment and initial management of young children with feverish illness, calling the objectives laudable but faulting the recommendations for an over-reliance on consensus techniques and widespread consultation at the expense of a rigorous interpretation of the evidence.

"To improve the care of children with feverish illness in primary care we should be offering less telephone advice and more opportunities for a prompt clinical assessment," the author states. "We should recognize that we are seeing only a brief snapshot of a dynamic illness and should always empower and make it easy for the parent to consult again -- even a few hours later -- if symptoms deteriorate."


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