Claudius Ilene, Baraff Larry J
Department of Emergency Medicine, University of Southern California and Children's Hospital, 1200 State Street 1011, Los Angeles, CA 90033, USA.
Emerg Med Clin North Am. 2010 Feb;28(1):67-84, vii-viii. doi: 10.1016/j.emc.2009.09.002.
Fever is defined as a rectal temperature greater than 38.0 degrees C (>100.4 degrees F). A recently documented fever at home should be considered the same as a fever in the ED and should be managed similarly. All febrile infants younger than 28 days should receive a "full sepsis workup" and be admitted for parenteral antibiotic therapy. Clinical and laboratory criteria can be used to identify a low-risk population of febrile infants aged 1 to 4 months who have not received 2 doses of conjugate vaccines for bacterial meningitis. Children with sickle cell disease are at high risk and require special evaluation. MRSA infections are now common and should be considered in all patients with pyoderma, severe pneumonia, and catheter-related sepsis. HSV infection of the CNS should be considered whenever a patient has altered mental status and CSF findings are not diagnostic of bacterial meningitis. Fever rarely represents life-threatening pathology; however, a handful of less common serious causes of pediatric fever exist with the potential for morbidity and mortality.
发热定义为直肠温度高于38.0摄氏度（>100.4华氏度）。近期在家记录的发热应被视为与急诊室的发热相同，并应进行类似处理。所有28日龄以下的发热婴儿都应接受“全面的败血症检查”，并住院接受静脉抗生素治疗。临床和实验室标准可用于识别1至4个月龄未接种2剂细菌性脑膜炎结合疫苗的低风险发热婴儿群体。患有镰状细胞病的儿童风险较高，需要特殊评估。耐甲氧西林金黄色葡萄球菌感染现在很常见，所有患有脓疱病、严重肺炎和导管相关败血症的患者都应考虑这种感染。每当患者出现精神状态改变且脑脊液检查结果不能诊断细菌性脑膜炎时，都应考虑中枢神经系统的单纯疱疹病毒感染。发热很少代表危及生命的病变；然而，存在一些不太常见的小儿发热严重病因，有导致发病和死亡的可能性。
