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A Score Identifying Serious Bacterial Infections in Children With Fever Without Source

Lacour, Annick Galetto MD; Zamora, Samuel A. MD; Gervaix, Alain MD

Pediatric Infectious Disease Journal: July 2008 - Volume 27 - Issue 7 - pp 654-656
doi: 10.1097/INF.0b013e318168d2b4
Brief Reports

The objective of the study was to develop a simple clinical tool to identify serious bacterial infection (SBI) in children with fever without a source. For each child, a clinical assessment, a white blood cell count, a urine analysis, a determination of C-reactive protein, procalcitonin, and appropriate cultures were performed. Two hundred two children were studied of whom 54 (27%) had SBI. In the multivariate analysis, only procalcitonin [odds ratio (OR): 37.6], C-reactive protein (OR: 7.8), and urine dipstick (OR: 23.2) remained significantly associated with SBI. The sensitivity of the score for the identification of SBI was 94% and the specificity 81%. In the validation set the sensitivity of the score was 94% and the specificity 78%.

From the Child and Adolescent Department, University Hospital, Geneva, Switzerland.

Accepted for publication January 14, 2008.

Address for correspondence: Annick Galetto Lacour, MD, Département de l'enfant et de l'adolescent, HUG, Hôpital des Enfants, rue Willy-Donzé 6, 1211 Genève 14. E-mail: annick.galetto@hcuge.ch.

© 2008 Lippincott Williams & Wilkins, Inc.