Study on 480 hospitalized febrile children: evaluation of the septic risk and results of the antibiotic and corticosteroid combined therapy.

The febrile child, previously healthy, represents a frequent diagnosis and management problem for pediatricians who work in private offices and those in hospital emergency departments. We are specifically interested in the identification, for the febrile child with septic risk, of severity parameters permitting to assess the likelihood of a serious bacterial infection. In the retrospective study we present, carried out on children admitted for febrile illness, two factors were mainly evaluated: 1. identification of the septic risk on the basis of some laboratory and clinical parameters; 2. effectiveness of an early antibiotic plus corticosteroid treatment in a sub-group of children with septic risk. The parameters we considered have been the degree of temperature upon admission, the clinical appearance and the C-reactive protein (C-RP) values. A significant correlation resulted for levels of temperature over 39 degrees C, toxic-appearing child and very positive C-RP values. We have defined this condition as a "threatening" fever requiring an immediate hospitalization in order to administer appropriate blood tests and cultures, and also, according to our rationale, to start an early antibiotic plus corticosteroid therapy (within 6-12 hours from the disease onset).