Richtlijn voor kinderen met koorts in de tweede lijn

Relevanties voor huisarts en kinderarts
Richtlijnen
14-03-2014
Ruud G. Nijman, Nicole Oteman en Rianne Oostenbrink

Guideline for febrile children in the hospital setting; relevance for general practitioners and paediatricians

  • Febrile children pose the diagnostic dilemma of distinguishing those with serious infections from the vast majority with self-limiting diseases at an early stage.

  • Alarm symptoms can aid in assessing the probability of serious infections in febrile children.

  • The combined absence of alarm symptoms is useful in ruling out serious infections.

  • CRP and PCT values are important diagnostic markers in febrile children in hospital settings.

  • Children without any alarm symptoms and low inflammatory markers can be treated conservatively, provided there are good instructions on reassessment.

  • Children with amber alarm symptoms or mildly elevated inflammatory markers in whom a serious infection cannot be ruled out require clinical observation or ambulant follow-up; empirical parenteral antibiotic treatment should also be considered and easily accessible.

  • Children with red alarm symptoms or highly elevated inflammatory markers deserve clinical observation. In children < 3 months, empirical parenteral antibiotic treatment is also indicated.

  • Conflict of interest: disclosure forms provided by the authors are available along with the full text of this article at www.ntvg.nl, search for A7331; click on ‘Belangenverstrengeling’ (‘Conflict of interest’). Financial support for this article: R.G. Nijman has received grants from the Netherlands Organisation for Health Research and Development (ZonMw), Erasmus Doelmatigheid en Quality Foundation of the Dutch Medical Specialists (SKMS).