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During the past decade, children have received routine vaccinations against Haemophilus influenzae type b and pneumococcus, and, as a result, the rate of serious bacterial infections (SBIs) caused by these organisms has plummeted. This change mandates review of the approach to evaluation and treatment of febrile children. These authors studied 68 infants younger than 3 months with either home or emergency department temperatures ≥100.4°F and 917 children aged 3 to 24 months with ED temperatures ≥102.3°F who presented to the ED of a tertiary care center in San Diego in 2003. Children younger than 3 months underwent an extensive standardized work-up, and older children underwent testing based on physician discretion.
Overall, 129 children (13%…