Febrile syndrome
without Apparent
Cause in Smaller
Suckling babies of 3
NOTE: Translated
using software of
translation of
Spanish to English
ABSTRACT:
Febrile syndrome without apparent focus in children under 3 months old is
a common problem in clinical practice. Here, we evaluate the role of
lumbar puncture in this group of patients to assess the frequency of
viral meningitis. We analyzed 253 medical records of patients hospitalized
in the Seclusion Service of Roberto del Río Hospital from January 2001 to
January 2003. The age ranged from 2 to 87 days; 55.7% of patients were
younger that 28 days, and 86.6% were younger than 2 months. Most common
manifestations were fever and poor appetite. Laboratory tests showed
abnormal WBC in 28% of patients. CRP and ESR were impaired in 1.6% and
10.7% respectively. Blood cultures were positive in 3.2%, and urinalysis
were abnormal in 30 patients. We performed lumbar puncture in 223 of 253
patients (88%). It yielded abnormal CSF findings in only 14 children.
Viral meningitis was diagnosed in 10 patients and bacterial meningitis 4
patients.Pyelonephritis or occult bacteremia were confirmed in 11.8% and
4.7% respectively. Treatment was started in 125 patients, but only 62
completed it. We conclude that lumbar puncture is a diagnostic tool in
febrile infants to rule out diseases having high morbidity and mortality
rates, that must be receive prompt treatment. In febrile infants under 3
months of age with no apparent focus, bacterial disease must be suspected
Author:
Ecuadorian
magazine of neurology
