Fever without source in infants and young children.

Febrile infants and young children pose a challenge to primary care physicians because the clinical appearance of children who present with fever without source that is related to a viral illness may be similar to the appearance of those with occult bacteremia. The evaluation of the febrile infant and child comprises a comprehensive history, a thorough physical examination and judicious use of laboratory studies. The information derived from this evaluation will help clinicians with the two key management decisions that face physicians caring for this vulnerable population: the initiation and use of antimicrobial therapy, and inpatient versus outpatient management. Although no optimal diagnostic and therapeutic schema exists, physicians should take a structured and rational approach to these patients, depending on their own clinical experience and interpretation of the literature on this topic.