Red Flags That Signal Serious Illness in Children

Clinicians in primary care settings occasionally are faced with the challenge of recognizing and identifying serious illness in children. To examine clinical features of serious infection in children (age range, 1 month–18 years), investigators in the U.K. performed a systematic review of data from 30 modest-quality studies conducted in ambulatory settings with a low prevalence of serious disease. Serious infections included sepsis and bacteremia, meningitis, pneumonia, osteomyelitis, cellulitis, gastroenteritis with dehydration, complicated urinary tract infections, and viral respiratory disease causing hypoxia.

Important red flags for all types of serious infections were meningeal irritation, petechial rash, seizures, and unconsciousness. …